[Availability and affordability of diagnosis and treatment for asthma and COPD in Ouagadougou, Burkina Faso]

INTRODUCTION

Chronic respiratory diseases, particularly asthma and Chronic Obstructive Pulmonary Disease (COPD), pose a significant threat to public health. This study aims to determine the accessibility and affordability of means of diagnosis and treatment.

METHODS

This was a cross-sectional study covering the period from August to December 2021 in Ouagadougou, Burkina Faso. This study involved 107 health centers and 135 pharmacies. The World Health Organization/Health Action International definition was used as a benchmark for accessibility to medicines.

RESULTS

Out of 107 health centers, 29 (27.1%) had a spirometer. The average cost of spirometry represented 19.88 days of salary for a patient paid at the minimum wage. The most widely available drugs were salbutamol in a pressurized metered dose inhaler (pMDI) (88.1%) and prednisone 20mg tablet (87.4%). No disease-modifying drug was available in public pharmacies. Affordable drugs were salbutamol 4mg tablet and aminophylline 100mg tablet.

CONCLUSION

The means of diagnosis and treatment of asthma and COPD are insufficiently available, especially in the public sector, which is characterized by a nearly total absence of basic treatment.

Knowledge, practices and beliefs of students regarding health effects of shisha use in Ouagadougou, Burkina Faso: A cross‑sectional study

Background

The tobacco epidemic is one of the biggest public health threats the world has ever faced. Shisha use has recently been gaining increased popularity in many developed and developing countries.

Objectives

To determine the prevalence of shisha use among students in Ouagadougou, Burkina Faso, and associated knowledge, smoking practices and beliefs about health effects.

Methods

A total of 443 students were selected for this cross-sectional study, using a stratified sampling method. Data on shisha use, knowledge about shisha, shisha smoking practices, and factors associated with use of shisha were collected via a questionnaire. The association between the independent variables and shisha use was assessed using a χ² test (p<0.05). Binary logistic regression analysis was used to determine variables that were independently associated with shisha smoking.

Results

Of the 421 respondents, 162 (38.5%) indicated that they had smoked shisha; 14.0% were regular smokers. We found that 183 students (43.5%) had poor knowledge about the health effects of shisha. The main reasons for shisha smoking were being in the company of friends who were users (57.4%), the pleasant flavour and fragrance of shisha (25.9%), and fashion (22.2%). Ninety-nine shisha smokers (61.1%) also consumed alcohol. Factors associated with shisha smoking included age <20 years (p<0.001), gender (p=0.034), and educational level of the respondent's father (p=0.0001) and mother (p=0.0004).

Conclusion

We found a relatively high prevalence of shisha smoking among the students, and that 43.5% of them had poor knowledge about its effects on health. Developing surveillance, intervention and regulatory/policy frameworks specific to shisha has become a public health priority.

Study synopsis

What the study adds. The study provides additional data from resource-poor settings such as Burkia Faso, where there is an overall high prevalence of Sisha smoking, and also among students who are poorly informed about the health effects of smoking. Implications of the findings. The data informs advocacy and intervention strategies to combat smoking and decrease overall tobacco use in an African setting.

Multi-Actors' Co-Implementation of Climate-Smart Village Approach in West Africa: Achievements and Lessons Learnt

Climate change and variability are significant challenges for the environment and food security worldwide. Development strategies focusing simultaneously on adaptive farming, productivity, and reducing greenhouse gas (GHG) emissions-known as climate-smart agriculture (CSA) strategies-are key to responding to these challenges. For almost a decade, within the framework of Climate Change, Agriculture and Food Security (CCAFS), World Agroforestry (ICRAF), and its partners have been using Participatory Action Research (PAR) to fully engage key stakeholders in co-creating such CSA development strategies. This includes the testing of Agricultural Research for Development (AR4D) CSA scalability options. The multidisciplinary teams include the National Research and Extension Systems (NARES), national meteorological services (NMS), non-profit organizations (NGOs), and local radio programs, among others. The CCAFS-West Africa Program, World Agroforestry-West and Central Africa (ICRAF-WCA), International Union for Conservation of Nature (IUCN), University of Reading, and Centre Régional de Formation et d'Application en Agro-météorologie et Hydrologie Opérationnelle (AGRHYMET) provide technical backstopping to the national teams. Climate information (CI) was used as an entry point to inform the development of CSA technologies and practices within Climate-Smart Villages (CSV). This groundwork has led to a greater understanding of three critical factors for successful CSV implementation: (1) Building strong partnerships to co-design and develop agricultural systems that improve ecosystem and population resilience, (2) Key stakeholders (researchers, farmers, development agents, and students) capacity strengthening through vocational and academic training, and (3) Using CI for livelihood planning at all scales. These three factors support more effective identification and testing of agricultural technologies and practices addressing climate variability and change at plot, community, and landscape levels. This paper discusses the PAR-CSA methodology and parameters for evaluation, including biophysical and social change. Keys to success, including communication, knowledge sharing tools, and scalability are also discussed. Finally, future opportunities for improvement are presented, including knowledge product development, CSA policy and investment planning, capacity building, further engagement of the private sector, and additional research on existing practices and tools.

Prevalence of obstructive sleep apnoea in sleep consultations in Burkina Faso: Implications for monitoring

BACKGROUND

Obstructive sleep apnoea syndrome (OSAS) is the most common respiratory disorder related to sleep. Its prevalence in developed countries varies from 3% to 28%. In several African countries, including Burkina Faso, this syndrome is still under-diagnosed and goes largely untreated. It is necessary to conduct studies in different contexts to determine the characteristics and develop the strategies for management of OSAS.

OBJECTIVES

To determine the prevalence of OSAS in Burkina Faso.

METHODS

This prospective study recruited 106 patients coming for consultation for sleep disorders at the Yalgado Ouedraogo University Hospital Center, who responded to a self-questionnaire and were diagnosed by respiratory polygraphy.

RESULTS

A total of 77 patients (72.6%) had OSAS. The male to female ratio was 1.4:1 and the mean (standard deviation) age was 47.8 (12.8) years. The majority of the patients (53.8%) were obese. The main reason for consultation was snoring (84%), followed by hypopnea-apnoea reported (59.4%) and daytime sleepiness (45.3%). The most common comorbidity factor was hypertension (50%), followed by decreased libido (16%) and diabetes (13.2%). A continuous positive-pressure (CPAP) machine was prescribed to 51.25% of the patients, but only 22% were able to acquire it.

CONCLUSION

The monitoring of OSAS is relatively new in Burkina Faso. This study showed the profile of patients with OSAS and difficulties in accessing continuous positive airway pressure (CPAP) devices for treatment.

Patients' Families' Perceptions of Lupus in Sub-Saharan Africa

Lupus is an autoimmune disease affecting the connective tissue. Its clinical and biological polymorphism is often misunderstood by patients and families and can lead to treatment interruption and a decision to turn to alternative medicine. We used a questionnaire to assess the degree of knowledge of this disease of family members living with lupus patients. Of the 56 lupus patients receiving regular follow-up at our hospital, 123 members of 30 of their families (53.5%) participated. Overall, among these families, 81.5% of the participants perceived the disease as predominantly non-mystical, 72.3% as hereditary, 87.9% as non-contagious, and 60.9% as curable ; 90.2% considered it compatible with pregnancy, another 90.2% with work, and 73.9% with sports activity. The principal clinical signs mentioned involved joint (22.7%), skin (13%), and finger-related (11.3%) disorders, with renal disease (9.7%), heart disease (8.1%), and general signs (8.1%) mentioned most frequently as the main complications. The best-known medications for disease control were corticosteroids (20.3%) and hydroxychloroquine (17%). Family members considered non-adherence (53.6%) the most frequent factor in disease flares. More than half were unaware of the life expectancy associated with this disease, but 30.1 % thought it was lower than that of the national population of Gabon - 70 years. Only 64 (52%) of the respondents had seen documentation about lupus, mostly through the Internet (65.6%). Lupus is not a disease that families know and understand well.

[Survival of malignant and paramalignant pleural effusions in Ouagadougou]

This study aimed to present the survival of patients with malignant and paramalignant pleural effusion (MPE) in a context of resource-limited countries. We retrospectively studied patients received for malignant and paramalignant pleural effusion in three health facilities in Ouagadougou from 1st August 2009 to 30 July 2015. Survival was analyzed according to various characteristics related to patients and disease. Eighty patients with a mean age of 54 years were selected. The sex-ratio was 0.9. Sixteen patients had comorbidities. Pleural effusion was revealing, synchronous and metachronous in respectively 55 %, 26.3 % and 17.5 % of cases. Lung cancer was the most common cause of MPE (27.5 %), followed by breast cancer (18.7 %). The median overall survival was 3 months; it varied between primary cancers: 5 months for primary cancer unknown, 4 months for lung cancers and 2 months for breast cancers. Sex and the presence of comorbidities were independent factors influencing survival of patients. In this study, patient survival length is strongly compromised by inadequacies of medical technical equipment.

[Inventory of fixtures on the tolerance of the treatment) of the resistant multi-tuberculosis (Burkina Faso)]

OBJECTIVES

Estimate the tolerance of antituberculous drugs prescribed in the treatment of multi resistant tuberculosis on patients followed in the service of Pneumology of the University hospital of Yalgado Ouedraogo.

PATIENTS AND METHODS

It was a retrospective and prospective longitudinal investigation. The files of patients allowed to inform the questionnaire for the retrospective phase (2010-2011), the follow-up of patients during the prospective phase (2011-2013) allowed for data collection. All the patients under antituberculous treatment of 2nd line between January 1st, 2010 and the August 31st, 2013 were included.

RESULTS

71 cases of multi resistant tuberculosis (MRT) were included. The sex-ratio was 3.4. The age bracket from 30 to 39 was the most represented (39.4 %). A notion of tubercular contage was found in 18 (25.3%) patients. All MRT patient had histories of treatment including aminoside lasting more than 2 months. Intolerance of the treatment was reported in 57 patients. Intolerance predominated in 30 to 39 years olds and in Tuberculosis/HIV co-infected patients. The neurological (47.9%) and psychiatric (47.9%) infringements were the most represented. Vestibulocochlear impact was seen in 42.3% of cases with 18.3% reporting of total deafness.

CONCLUSION

The intolerance of the antituberculous treatment of the second line is real focus for clinicians. Shorter timeframes would avoid certain therapeutic modifications thought to be at the origin of failures.

[Knowledge, attitudes and practices of healthcare professionals at the Souro Sanou university hospital of Bobo Dioulasso regarding Mellitus diabetes]

INTRODUCTION

In Burkina Faso, the insufficiency of doctoral interns, of endocrinologists, and medical services specialized in the coverage of the diabetes, means that these cases are relegated to general practitioners and the paramedical staff.

OBJECTIVES

To study the level of knowledge, attitudes and practices of the medical and paramedical staff on the coverage of sugar diabetes in the Souro Sanou University Hospital of Bobo Dioulasso.

METHOD

A cross-sectional study of descriptive type was conducted over a 3 month period, from March 1st to May 31st, 2013. The investigated population was constituted of healthcare professionals represented by general practitioners, female nurses, State-certified male nurses, and patented male nurses of the Souro Sanou University Hospital of Bobo Dioulasso. A questionnaire, adapted for each professional category, was administered to the participants. A notation grid enabled us to record the level of knowledge, attitude and practice of the staff regarding sugar induced diabetes.

RESULTS

Three hundred four (304) healthcare professionals, 187 men and 117 women (sex ratio of 1.59) were investigated. The average age was of 40.84 years with extremes of 26 and 60 years. Their level of knowledge, attitude and practice on sugar induced diabetes varied from one professional category to another. Clinical signs of the disease, as well as its physiopathology were well known by healthcare providers. However, the definition of the disease, its diagnostic criteria, its classification by cause, were little known general practitioners. The general practitioners, had a good attitude and practice in front of a case of diabetes compared to other professional categories.

CONCLUSION

Adapted staff recycling is essential across the professional categories for healthcare providers of the university hospital.

[Pathologies in internal medicine: concerning Burkina Faso]

The objective of our study was to determining the epidemiological, diagnosis and evolutionary aspects of pathologies admitted for care in the service of internal medicine between January 1, 2007 to December 31, 2009.

MATERIALS AND METHODS

A cross-sectional retrospective and descriptive study was conducted over three years, from the review of medical records of patients admitted to the Department of internal medicine of the Souro Sanou university hospital.

RESULTS

Our study concerned 5362 patients. The average age had been 43.10 years old ±12.2. The sex ratio was 1.16: 1. The majority of our patients were from a low socio-economic background. HIV/AIDS had been the most frequent condition with the rate of admission of 24%, followed by cerebral vascular accidents with 8.6%. The recovery rate was of 53.9% and an overall mortality of 33.3%. This mortality had been dominated by infectious and parasitic diseases including HIV/AIDS with a rate of 27.8% of the overall mortality. Early mortality remains high with a rate of 37.4%.

CONCLUSION

In spite of the epidemiological transition marked by the emergence of the cardio-metabolic diseases in the countries of the South, infection by HIV always constitutes the main pathology met in the Department of internal medicine of the Souro Sanou university hospital, it is responsible for a high mortality cause of mortality. The emphasis must be placed on early treatment and especially the communication for the change of behavior aiming at an early screening of the HIV. This would allow to reduce effectively the AIDS-related lethality to internal medicine.

[Contribution of medical files for mining workers in Burkina Fasso]

INTRODUCTION

The inhalation of silica dust stemming from traditional mining in Burkina Faso is associated with a high amount of pneumoconiosis cases. A medical consultation performed before and after the hiring of a mine worker should allow authorities to make the diagnosis.

MATERIAL AND METHOD

A cross-sectional retrospective study with descriptive aim was conducted from January, 2010 until December, 2012 including mine workers admitted in several health centers in Ouagadougou for medical check-ups. The data was collected by means of a questionnaire informed during the exploration of their files.

RESULTS

331 male mine workers, with an average age of 33.05 ± 5.9 years old [range: 21-54]. Among them, 224 (67.7%) had come for a pre-employment medical examination (PME).The consumption of tobacco and alcohol were found at more than 40 % of the worker of mine in the PME. No respiratory dysfunctions and very few thoracic radiographic anomalies (TR) had been recorded during the mine workers' PMEs. During the annual medical examination (AME) respiratory dysfunctional signs were recorded in 63.9% of the workers, dominated by exertional dyspnea (19.6%). Spirometry revealed obstructive ventilatory disorders in 40.9% of the worker. The TR showed small rounded opacities of type "p" and "q" in 33.3% of the cases. 57 worker (25.4%) were declared unfit during this AME.

CONCLUSION

The medical check-up remains a strong avenue for the prevention of occupational diseases such as pneumoconiosis in all mine workers. They should serve not only as an individual precaution but as a collective measure.

[State of tolerance of multi resistant tuberculosis treatment (Burkina Faso)]

OBJECTIVES

Estimate the tolerance of antituberculous drugs prescribed in the treatment of multi resistant tuberculosis on patients followed in the service of Pneumology of the University hospital of Yalgado Ouedraogo.

PATIENTS AND METHODS

It was a retrospective and prospective longitudinal investigation. The files of patients allowed to inform the questionnaire for the retrospective phase (2010-2011), the follow-up of patients during the prospective phase (2011-2013) allowed for data collection. All the patients under antituberculous treatment of 2nd line between January 1st, 2010 and the August 31st, 2013 were included.

RESULTS

71 cases of multi resistant tuberculosis (MRT) were included. The sex-ratio was 3.4. The age bracket from 30 to 39 was the most represented (39.4 %). A notion of tubercular contage was found in 18 (25.3%) patients. All MRT patient had histories of treatment including aminoside lasting more than 2 months. Intolerance of the treatment was reported in 57 patients. Intolerance predominated in 30 to 39 years olds and in Tuberculosis/HIV co-infected patients. The neurological (47.9%) and psychiatric (47.9%) infringements were the most represented. Vestibulocochlear impact was seen in 42.3% of cases with 18.3% reporting of total deafness.

CONCLUSION

The intolerance of the antituberculous treatment of the second line is real focus for clinicians. Shorter timeframes would avoid certain therapeutic modifications thought to be at the origin of failures.

[Pulmonary tuberculosis: knowledge, beliefs and practices of tubercular patients' carers in Ouagadougou]

OBJECTIVE

Describe the knowledge, beliefs and practices on tuberculosis of tubercular patients' carers in Ouagadougou.

METHODS

A prospective descriptive transversal study was carried out. Participants were sourced from the four Centers of Diagnosis and Treatment, the National Center for the Fight Against Tuberculosis and the department of Pneumology of the Yalgado Ouédraogo University hospital. The recruitment was exhaustive and included the carers of tubercular patients (pulmonary tuberculosis with positive microscopy).

RESULTS

The average age of the carers was 36 years ± 14, with a majority of them bring male. In 33.7% of the cases the carer was a sibling and not schooled in 45.2%. A good understanding of tuberculosis was found at 20.2 % of the carers. Among the subjects which had a good understanding, 71.4 % were schooled and 88.1% came from an urban environment. Understanding tuberculosis is associated with academic level. Knowledge of the modes of contamination of tuberculosis was low (48,1%). Among the carers, 37% did not know that the tubercular patient should not be isolated by their circle of acquaintances, 19.2% assured the supervision of medicine intake. Respectively, 1.4% and 5.8% believe that tuberculosis is associated with witchcraft and divine punishment. Approximately two thirds of the carers refused to share the same dish as the tubercular patient.

CONCLUSION

An insufficient general knowledge of tuberculosis emerges from our work and modes of contamination. The beliefs and behavioral practices of the carers towards the tubercular patients tend to increase the stigmatization of tuberculosis.

[Actor of health in Asthmatic patients management in Burkona Faso]

OBJECTIVE

Identify the obstacles with the best coverage of the patient asthmatic by the actors of the health in Ouagadougou.

METHOD

Transverse Study with descriptive aim from January till December 2012, associated with a review of the literature concerning the role of the actors of health in the coverage of the asthma.

RESULT

the technique of demonstration of the grip of the spray measuring glass was known to 46 % of the doctors. A medical prescription was required by 9 % of the pharmacists before the delivery of medicine asthmatic. The check of the conformity of the prescription was made by 30 % of the pharmacists, the demonstration of the grip of the spray measuring glass to the pharmacy was assured by 73,6 % of the pharmacists and mastered well by 34,5 %.Within the framework of the treatment of the asthma, 43,2 % of the male nurses knew that β2-mimetic and corticoids were the most used medicine. β2-mimetic inhaled by quick action was recommended by 40,6 % of the male nurses in the occasional asthma, this prescription is not in compliance with the recommendations of GINA.

CONCLUSION

A need for training / recycling is expressed by almost all of the actors of health occurring in the coverage of the asthma in Burkina Faso.

[Attitude of private pharmacists in the dispensation of asthma drugs]

INTRODUCTION

Despite recommendations, asthma remains poorly controlled in many countries. Asthmatic patients see pharmacy staff regularly to obtain medications. The aim of this study was to evaluate the attitude of pharmacists in Burkina Faso about dispensing asthma drugs.

METHOD

A self-administered anonymous questionnaire was used to collect data in a descriptive cross-sectional study related to pharmacists' attitudes in the management of asthma in the city of Ouagadougou (November 2010-June 2011).

RESULTS

The rate of participation of pharmacists in the study was 82.4%. Of the pharmacists surveyed, 70.1% reported having received asthma patients both during acute asthma exacerbations and when stable. Only 9% of pharmacists insisted on a prescription when asthma patients came to the pharmacy without one. A total of 73.6% of pharmacists explained and demonstrated how to use the spray to the patients. Among pharmacists who demonstrated how to use devices, only 6.7% actually checked patients' technique. Inhaler technique demonstration was done verbally in 68.8% of case. Among pharmacists, 34.5% reported a good mastery of inhaler techniques.

CONCLUSION

The techniques for dispensing asthma drugs are not well established among pharmacists and therefore the provision of continuous medical education to pharmacists is important.

Acute intoxications in two university hospitals in Burkina Faso

INTRODUCTION

Acute intoxications become more and more a serious problem in developing countries. However, epidemiologic data are very scarce in these countries.

OBJECTIVE

To describe the characteristics of acute intoxications in two University Hospitals of Ouagadougou (Burkina Faso).

METHODS

All cases admitted to the emergency services of the two sole University Hospitals of Ouagadougou from July 1, 2006 to June 30, 2007, were included. We analysed the medical records for demographical and etiological characteristics of the acute poisoned-patients.

RESULTS

Acute poisoned-patients (436) represented 1.9% of the patients admitted to these services. The majority of acute poisoned-patients were pre-school children followed by young adults. Accidental intoxications (70.8%) were more common than intentional (28.9) and suicidal attempts (0.3%). Among poisoned-patients, female patients represented a great majority. Pharmaceuticals were the most common cause of acute intoxication, followed by chemicals, animals' toxins, food, alcohol and addictive drugs.

CONCLUSION

Our study revealed that pharmaceuticals were the most common cause of acute intoxications. The great majority of poisoned-patients were young. Female patients were the major poisoned-patients. Most admissions in the emergency services due to acute intoxications resulted from accidental poisoning.

[Knowledge, attitudes and practices of general practitioners about asthma in the city of Ouagadougou]

INTRODUCTION

In spite of a better understanding of the physiopathology of asthma and the existence of effective molecules, morbidity and mortality of asthma across the world are constantly increasing. International guidelines are not apparently applied. This study intended to assess the knowledge, attitudes and practices of general practitioners on asthma in Ouagadougou.

METHODS

This was a cross-sectional anonymous self-administered questionnaire involving 93 General Practitioners practicing in Ouagadougou.

RESULTS

The participation rate was 63.4% or 59 respondents. The majority of General Practitioners (88%).know the chronic nature of asthma and 61% of them had good knowledge of severe asthma signs. The post-exercise asthma and medication asthma were known respectively by 22% and 15% of General Practitioners. Knowledge of the technique of using pressurized metered dose inhalers was bad in 54% of General Practitioners. In intermittent asthma, 52.5% of General Practitioners prescribed steroids including 27% in oral form. Inhaled corticosteroids were associated with β2-agonists by 34% of General Practitioners in persistent asthma. After initial treatment, 44% of study physicians routinely referred their patients to pulmonologists. Drug costs, lack of in-service training and lack of national guidelines were perceived as barriers by 56%, 66% and 44% of General Practitioners.

CONCLUSION

The management of asthma is not optimal. The training of General Practitioners on the management of asthma is essential.

[Acute bacterial meningitis: the role of molecular biology in the epidemiological surveillance and epidemic alert in Burkina Faso]

In Burkina Faso, monitoring of acute meningitis epidemics is difficult to be implemented by routine bacteriology. The Polymerase Chain Reaction (PCR) that freed us from some constraints should allow better documentation of acute bacterial meningitis epidemics [7]. It was about a transverse study with descriptive aim along one year. The recruitment of cases was exhaustive and sample was representative of population at risk. Among the suspected ABM, 87 cases were confirmed by all biological diagnosis methods. Among these 87 confirmed cases, 82.7% were PCR positive. The culture was performed in 82 cases and 54.5% were positive. A statistical difference was observed. The sex ratio was 1.4:1, the average age of patients was 11± 4, 6 years [0-59], 26.4% of cases were observed on less than one year. Meningococcal meningitis ranked first with a rate of 46%. The peak incidence was observed during week 13-2003 or 15, 3%. The weeks pre and per epidemic (week11-week 13) PCR had the highest rate of confirmation for Neisseria meningitidis 78, 8%. The W135 was the most represented or 91%. PCR is thus an excellent alert tool for acute meningitis epidemics.

[Epidemio-clinical aspects of adult acute bacterial pneumonia at Yalgado Ouédraogo University Health Center]

INTRODUCTION

Bacterial Pneumopathies are low respiratory infections due to parenchyma pulmonary attack, which etiologic agent is a bacteria different from tubercular bacillus. Factually, the treatment is based on a probalistic antibiotherapy. This requires awareness of the epidemiology of the germs which are responsible in a given region, at a given period.

PATIENTS AND METHOD

In order to better grasp mainly the bacteriological and therapeutic aspects of adult bacterial Pneumopathies in Burkina Faso, we have come up with a two year journal/documentary.

RESULTS

The reported most frequent germs are respectively: Streptococcus pneumoniae (32,6%), Klebsiella pneumoniae (21%) et Staphylococcus aureus (13,9%). Negative Gram bacteries represented 53.5% of isolated germ and Acinetobacter was found only with HIV positive patients. The streptococcus was sensitive to association amoxicilline + clavulanic in 91.7% of the cases, to ceftriaxone in 83.3% of cases, to ampicilline and to amoxicilline in 66.7% of cases The clinical evolution of our patients was favorable in 74.5% of the cases with 21.8% deaths. The evolution was more significant within alcoholic patients (p = 0.001) as well as tobacco addicted patients (p = 0.02).

CONCLUSION

The high morbi-morbidity due to acute pneumopathy could be improved through a better awareness and regular updating of local bacterial ecology.

[Epidemio-clinical aspects of bacterial acute infant Pneumopathies at Yalgado Ouédraogo University Health Center]

INTRODUCTION

Infections of low respiratory tracks represent a public health issue and are a frequent reason for antibiotic prescription . For children in Africa, they are the main morbidity factor (50% of visits) and mortality (about 20% of infant mortality). Actually, the antibiotherapy, mainly probabilistic, rests on the awareness of the epidemiology of the germs which are responsible in a given region, at a given period. The purpose of this study was to evaluate the Epidemio-clinical aspects of bacterial acute infant Pneumopathies at Yalgado Ouédraogo Univercity Health Center.

PATIENTS AND METHOD

This a descriptive retrospective study, base on the files of hospitalized patients in the Paediatric Unit of CHU YO from January 1, 2005 through December 31, 2006.

RESULTS

All in all, 5803 patients with 658 cases of acute bacterial pneumopathy (11.3%) were hospitalized in the paediatric unit. Besides, acute bacterial Pneumopathies, 254 patients had another associated affection. Proteino-calorific malnutrition were frequent (59.7%), coupled with anaemia (36%). The reported most frequent germs are respectively: Streptococcus pneumoniae (29.3%), Klebsiella pneumoniae (29.3%) et Staphylococcus aureus (25%). The streptococcus was sensitive to association amoxicilline + clavulanic in 66.7% of the cases, to ceftriaxone in 57.1 % of cases. It was 100% resistant to ampicilline and to amoxicilline. The clinical evolution of our patients was favorable in 90% of the cases with 5.5% deaths.

CONCLUSION

Pneumopathies affect mostly children who are less than 2 years old favored by malnutrition and anaemia. The high morbid-morbidity related to this pathology could be improved through a better awareness and regular updating of local bacterial ecology.

[Impact of infectious diseases on HIV infected patients in pneumology department of Ouagadougou]

To study the mortality and morbidity of infectious diseases for HIV infected patients admitted to the pneumology department of CHU Yalgado Ouédraogo, Burkina Faso, the authors run a retrospective survey on 225 sick people. The output of this survey revealed that 92% of the patients where HIV infected, 67.1% of the patients were below 40 years of age and the average age was 36.7. The most common infectious pathologies were bacterial lung diseases (44.9%) and tuberculosis (33.8). The overall mortality rate was 26.2%. The most lethal pathologies were respectively, bacterial diseases 44.9%, tuberculosis 33.8%, cases where the cause was not found 9.8%. In most of the cases, patients at stage B and C of HIV/AIDS were admitted to hospital (74.7%). This situation raises the issue of late diagnostic of side infections, due the tardiness in consulting and therefore, the difficulties resulting from HIV patients' healthcare in our context.

Treatment seeking behaviour of smear-positive tuberculosis patients diagnosed in Burkina Faso

SETTING

Yalgado Ouedraogo University Health Centre and National Tuberculosis Centre, Ouagadougou, Burkina Faso.

OBJECTIVE

To identify causes and circumstances leading to delays in the diagnosis of sputum-positive tuberculosis (TB).

DESIGN

A cross-sectional study conducted between October and December 2001. Data were collected on reasons for consulting and admission to hospital, health units visited and diagnoses.

RESULTS

Before obtaining a diagnosis, 24.5% of patients had visited a public health unit, 31% had visited a private health unit, 31% had treated themselves and 6% had visited a traditional healer. In total, 16% of visits to the National Tuberculosis Centre and the Yalgado Ouedraogo University Health Centre were initiated by the patients themselves, 43% by a relative and 41% by a health worker. The average delay to diagnosis was 4 months. Only 24.5% of patients had undergone smear microscopy compared to 44.2% who had undergone chest X-ray. The majority of patients came from the outskirts of Ouagadougou.

CONCLUSION

Delays in TB diagnosis seem to be due to the lack of awareness of patients and the incompetence of some health workers. Training and supervision of staff and TB information campaigns targeted at the population (transmission, symptoms and treatment) will improve TB control in Burkina Faso.

Obstacles to the implementation of directly observed treatment in Ouagadougou, Burkina Faso

SETTING

Five tuberculosis (TB) diagnosis and treatment centres in Ouagadougou, Burkina Faso.

OBJECTIVE

To identify obstacles to the direct observation of anti-tuberculosis treatment (DOT) so that it can be adapted to local contexts.

DESIGN

A cross-sectional study conducted between August and September 2002 among new and retreatment TB cases in the initial phase of treatment. Information and suggestions were collected on obstacles encountered in DOT.

RESULTS

Among 74 patients interviewed, the main difficulties were the lack of assiduity among health personnel, the daily travel, the long distances, the high transportation costs and the high number of tablets. The main suggestions were a reduction in the number of tablets taken at a time, decentralisation of places where tablets are to be taken and weekly provision of drugs.

CONCLUSION

Obstacles to DOT should be addressed to optimise the effectiveness of anti-tuberculosis treatment.

[Etiologies of ocular and eyelid trauma in Burkina Faso]

PURPOSE

To identify the epidemiological features of ocular traumas in Burkina Faso.

METHODS

A retrospective study was conducted in the eye department of the National Hospital of Ouagadougou, from January 1995 to 31 December 1997. All cases of eye trauma during this period were included.

RESULTS

The study showed that ocular traumas represented 9.80% of the reasons for consultation in the unit. 73% of the patients were male. The median age was 21. School children and students were the most frequently involved 25.8%) and 58.9% of the patients came from Ouagadougou while 41.1% came from the rural areas. Public thoroughfare accidents (were the main causes of the trauma (25%). Among the traumatic agents, 26% involved vegetal materials.

CONCLUSION

Ocular traumas are a major cause of blindness in Western Africa and concern mostly young people. Prevention strategies based on education and information about road safety could reduce the incidence of ocular traumatisms.

[Clinical, radiographic and ultrasonographic aspects of mediastinal nodular tuberculosis in the era of HIV infection]

OBJECTIVE

The purpose of this study was to determine the clinical, radiographic, and ultrasonographic aspects of mediastinal nodal tuberculosis and ascertain its clinical course in the era of HIV infection.

PATIENTS AND METHODS

We reviewed retrospectively 39 patients referred to the Ouédraogo Yalgado National Hospital Center and the National Anticancer Institute between February 1996 and December 1999 for mediastinal nodal tuberculosis. Endoscopic proof of tuberculosis was obtained in 30 cases (81.8%). HIV serology was positive in 26 of the 30 patients tested (86.6%).

RESULTS

Nodal mediastinal tuberculosis accounted for 1.7% of the cases of tuberculosis recorded over the same period at the Anticancer Institute. Mean age of the patients was 32.8 years and the sex ratio was 1.05 in favor of men. Clinically, a past medical history was found in 18 cases (46%) including a herpes zoster in 6 (15.4%), cough in 38 (97.5%). Weight loss (95%), fever (100%) and peripheral node enlargement (20%) were found frequently, probably related to HIV infection more than tuberculosis. Radiographically, standard x-rays evidenced associated lesions in 22 cases, with 59% having predominant parenchymatous lesions. Other localizations of tuberculosis were very frequent (42.5%).

DISCUSSION

Bronchial fibroscopy is most contributive to diagnosis of mediastinal nodal tuberculosis with an 81.8% yield in our series. HIV infection had a determining effect on the disease course since among the 16 patients who died, 14 were HIV-positive (52%).