Effets identitaires de la socialisation différentielle de genre sur les aspirations au premier enfant et au mariage des jeunes adolescent(e)s à Ouagadougou: une étude mixte

Studies show that gender socialisation shapes differently the gendered identity, self-esteem, and sexual behaviours of girls and boys. While pre-adolescence is viewed as a pivotal period for gendered socialisation, few studies in francophone Africa investigate the role of gender identity effects on aspirations and sexual and reproductive behaviours at this life stage. This article explores how the internalisation of gender stereotypes during socialisation is linked to the aspirations of girls and boys for certain life events, such as having their first child or getting married. A survey was conducted in 10 primary schools in Ouagadougou, among pupils aged between 9 and 16 years, as well as seven focus group discussions with their parents. The findings indicate a gender-based variation in the effects of adherence to unequal gender norms among young adolescents. As a result, girls tend to have earlier aspirations towards marriage and later aspirations for childbearing, while boys show earlier aspirations for childbearing and later ones for marriage. These effects may expose both girls and boys to risks of poor sexual and reproductive health. Interventions promoting egalitarian gender norms could boost girls' self-esteem as well as mutual respect among young adolescents of both genders, aiming to improve their sexual and reproductive health during adolescence and into adulthood.

[Tuberculosis of the palatine tonsil mimicking a malignant lesion and associating pulmonary tuberculous miliaria: about a case in Ouagadougou, Burkina Faso]

Tonsillar tuberculosis is the infectious localization of Koch's bacillus in the palatine tonsils. It is rare. Tonsillar tuberculosis associated with miliary tuberculosis is even more exceptional.

Objective

The aim of our work is to report a rare case of tuberculous tonsillitis associated with miliary tuberculosis.

Patient and methods

This was a case of tonsillar tuberculosis associated with miliary tuberculosis. The main complaint was chronic odynophagia, which had been present for 7 months and was associated with weight loss. Questioning also revealed alcohol, tobacco and marijuana consumption.

Results

Oropharyngoscopy revealed an enlarged, ulcerated and hemorrhagic right tonsil, suggesting a malignant lesion. Diagnostic tonsillectomy with anatomopathological examination of the surgical specimen led to the diagnosis of tonsillar tuberculosis. A postoperative chest X-ray revealed tuberculous miliaria. No other tuberculosis site was identified. No other confirmatory biological tests were carried out. The patient was treated with 4 anti-tuberculosis drugs (rifampicin, isoniazid, pyrazinamide, ethambutol) during 2 months and 2 anti-tuberculosis drugs (Rifampicin, Isoniazid) during 4 months. The evolution was favorable and the patient was declared cured at the end of treatment. There was no recurrence after 5 years.

Conclusion

Tonsillar tuberculosis is rare. Tonsillar tuberculosis associated with pulmonary miliaria is even more exceptional. Tonsil biopsy for anatomopathological examination is sufficient for diagnosis. A chest X-ray should be requested as part of the preoperative workup prior to any tonsillar biopsy or tonsillectomy. GeneXpert (MTB/RIF) should be carried out if possible, not only for its value in the biological confirmation of tuberculosis but also to identify rifampicin resistance. Antibacillary treatment often leads to a favorable outcome.

Detection and Characterization of Carbapenemase-Producing Escherichia coli and Klebsiella pneumoniae from Hospital Effluents of Ouagadougou, Burkina Faso

Hospital wastewater is a recognized reservoir for resistant Gram-negative bacteria. This study aimed to screen for carbapenemase-producing Escherichia coli and Klebsiella pneumoniae and their resistance determinants in two hospital effluents of Ouagadougou. Carbapenem-resistant E. coli and K. pneumoniae were selectively isolated from wastewater collected from two public hospitals in Ouagadougou, Burkina Faso. Bacterial species were identified via MALDI-TOF mass spectrometry. Carbapenemase production was studied phenotypically using antibiotic susceptibility testing via the disk diffusion method. The presence of carbapenemases was further characterized by PCR. A total of 14 E. coli (13.59%) and 19 K. pneumoniae (17.92%) carbapenemase-producing isolates were identified with different distributions. They were, respectively, blaNDM (71.43%), blaVIM (42.86%), blaIMP (28.57%), blaKPC (14.29%), blaOXA-48 (14.29%); and blaKPC (68.42%), blaNDM (68.42%), blaIMP (10.53%), blaVIM (10.53%), and blaOXA-48 (5.26%). In addition, eight (57.14%) E. coli and eleven (57.89%) K. pneumoniae isolates exhibited more than one carbapenemase, KPC and NDM being the most prevalent combination. Our results highlight the presence of clinically relevant carbapenemase-producing isolates in hospital effluents, suggesting their presence also in hospitals. Their spread into the environment via hospital effluents calls for intensive antimicrobial resistance (AMR) surveillance.

COVID-19, food coping strategies and households resilience: the case of informal sector in Burkina Faso

The closure of markets in the city of Ouagadougou due to COVID-19 pandemic has had consequences on the food security status of households, in particular households of informal sector. The objective of this paper is to analyze the effect of COVID-19 on households' likelihood to resort to food coping strategies taking into account their resilience capacities. A survey was carried out among 503 households of small traders in five markets in the city of Ouagadougou. This survey identified seven mutually inclusive food coping strategies which are endogenous and exogenous to households. Thus, the multivariate probit model was used to identify the factors explaining the adoption of these strategies. The results indicate that the COVID-19 pandemic has had an impact on households' likelihood to use certain food coping strategies. Furthermore, the results show that assets and access to basic services is the main pillar of household resilience that reduces how likely a household resort to coping strategies due to COVID-19. Therefore, strengthening adaptive capacity and improving social security of households of informal sector are relevant.

[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.

Socio-cultural influences on children's feeding habits and feeding frequencies in Ouagadougou, Burkina Faso: a retrospective survey

BACKGROUND

From 6 months of age, children need, in addition to breast milk, a complementary food whose nutritional composition meets their needs. However, low consumption of child-specific foods in favor of adult foods has been documented. Thus, the lack of adaptation of children to family feeding conditions has been the source of frequent malnutrition in some low-income countries. In Burkina Faso, little data is available on family-type food consumption by children. The objective was to describe the socio-cultural influences on feeding habits and food consumption frequencies of infants aged 6-23 months in Ouagadougou.

METHODS

The study was conducted from March to June 2022 using a structured questionnaire. A reminder of the previous 24 h' meals was used to assess 618 children's food consumption. Mother-child pairs were selected using the simple random sampling method, and data collection was done by the interview method. Sphinx V5, IBM SPSS Statistics 20.0 and XLSTAT 2016 software were used to process data.

RESULTS

Influences between the consumption of certain foods and the mother's social status were observed. The most consumed foods are simple porridges (67.48%), Tô/rice (65.70%), cookies and cakes (62.94%), juices and sweetened drinks (62.94%). Cowpeas (17.31%), improved porridge (13.92%) and eggs (6.63%) are the least consumed. The most meals frequency was three meals daily (33.98%), and children with the minimum daily meal frequency were 86.41%. Principal component analysis showed that the mother's social status influenced the consumption of imported infant flours, fish soups, fruits, juices and sweetened drinks, cookies and cakes, simple porridge, and tô/rice. Concerning the consumption of local infant porridges, 55.72% of the children who consumed them appreciated positively. However, for 57.75% of the parents, the lack of information limits the consumption rate of this type of flour.

CONCLUSION

High consumption of family-type meals was observed and was influenced by parental social status. In addition, the rate of acceptable meal frequencies was generally high.

Research of Antibiotic Residues and Bacterial Strain's Antibiotic Resistance Profile in the Liquid Effluents Evacuated in Nature by Two CHUs and a Mixed WWTP of Ouagadougou (Burkina Faso)

Background

In Burkina Faso, suspicions have been raised that hospital liquid effluents are a source of microbiological contaminants in surface waters of urban and peri-urban areas. This study aimed to determine the antibiotic residues and the antibiotic resistance phenotype of potential pathogenic bacteria in the hospital liquid effluents discharged into nature by the CHUs Bogodogo, Yalgado Ouédraogo and the WWTS of Kossodo.

Methods

Fifteen samples of liquid effluents discharged into nature were collected. Antibiotic residues were identified by HPLC. A wavelength of 254 nm for the UV detector was set. Antibiotic testing was realized according to CASFM 2019 recommendations.

Results

Three molecules including Amoxicillin, Chloramphenicol and Ceftriaxone were detected in 13 samples. The strains characterized were 06 E. coli, 09 Pseudomonas spp, 05 Staphylococcus aureus and 04 Salmonella spp. Thus, none of the strains was resistant to Imipenem, but they were resistant to Amoxiclav with rates of 83.33% (E. coli), 88.88% (Pseudomonas spp) and 100% (Staphylococcus aureus and Salmonella spp).

Conclusion

Ouagadougou hospital liquid effluents discharged into nature are contaminated with antibiotic residues and potential pathogenic bacteria.

Aspects scanographiques de la pneumopathie à COVID-19 à Ouagadougou: Étude multicentrique à propos de 1017 cas

OBJECTIVE

To study the chest CT profile of SARS-CoV-2 pneumonia in patients in the city of Ouagadougou.

PATIENTS AND METHODS

descriptive cross-sectional study with retrospective collection of 1017 patients of both sexes. Included were patients aged 15 and over who had performed a chest CT scan without or with injection of contrast product, suspected or positive for COVID -19. The variables analyzed were: the history, the nature of the examination, the socio-demographic, clinical, CT data including the description of the tomodensitometric lesions and their characteristics, the extent of the parenchymal lesions according to the visual estimate of the French thoracic Imaging Society, complications, other lesions on the chest CT scan and CORADS classification. All parameters (age, sex on the one hand and clinical and CT findings on the other) were subjected to statistical analysis.

RESULTS

The mean age of the patients was 56.95 years, predominantly male (1.47). Dyspnea was the most frequent symptomatology, at 46.26% (n = 506). Diabetes was the most common comorbidity with 29.37% (n = 94). Frosted glass opacity accounted for 90.95% of elementary lesions which were predominantly in plaque in 44.35% (n = 451), bilateral in (82.79%) and peripheral subpleural in (81.51%). The lower lobes were the most affected and postero-basal involvement predominant with greater involvement in the right lung. The extent was severe in 28.42% (n = 289). Thirty-nine point twenty-three (39.23)% or 399 of cases presented with complications dominated by pleural effusion at 56.39% (n = 225) and pulmonary embolism at 34.08% (n = 136 ). The lesions were classified as CORADS type in 815 CT reports. CORADS 5 type lesions were found in 47% of patients. Five hundred and ninety-two (592) PCRs of our patients were undetermined, in 58.21%. The PCR was positive in 342 cases or 33.63%. The bi- and multivariate analysis noted: a statistically significant link between the age and the extent of the lesions, between the extent of the lesions and the clinical context, between the extent of the lesions and comorbidities such as diabetes, Hypertension and renal failure. There was also a link between the PCR result and basic lesions such as ground glass and crazy paving and between the occurrence of pulmonary embolism and the presence of hypertension.

DISCUSSION

The scanographic profile corresponded to that described in the literature. Frosted glass was the most common elementary lesion. The impairment was severe to critical in patients over 65 with comorbidity. CT angiography was the most requested in front of signs such as dyspnea and desaturation CONCLUSION: A study on CT specificities with precision on the onset of symptoms and the notion of vaccination would complement these results.

Survival of patients operated on for breast cancer in Ouagadougou/Burkina Faso

BACKGROUND AND OBJECTIVES

Breast cancer is the most common cancer in women. The objective is to study the survival of patients operated on for breast cancer.

METHODS

Descriptive and analytical study of the survival of patients operated on for breast cancer between January 1, 2013 and December 31, 2020 in Ouagadougou. Survival was assessed by the Kaplan-Meier method and comparisons by the log-rank test. Prognostic factors were determined using the Cox model.

RESULTS

We collected 550 cases. Overall survival at 5 years was 66.2%. Those under 30 years of age had a low 5-year overall survival (53%). The 5-year overall survival was poor in rural patients (63.5%), triple-negative patients (77.2%), HER2+ patients (50.5%) and stage IV patients (29.8%). In multivariate analysis, higher education (p < 0.001) and higher socioeconomic level (p < 0.001) were associated with better prognoses.

CONCLUSIONS

The survival of patients operated on for breast cancer remains to be improved. It is influenced by multiple factors especially the socio-economic and educational level of the patients.

[Giant cervical lipoma: Report on one case in Ouagadougou, Burkina Faso]

OBJECTIVE

To report on a case of rare giant anterior cervical lipoma.

PATIENTS AND METHODS

This was a 60-year-old male patient received in March 2020 for an anterior cervical swelling in progressive evolution since 20 years. The condition was negatively impacting the patient's quality of life with a feeling of cervical heaviness, discomfort, head movement limitations, with no sign of compression. Despite this significant discomfort, the patient first consulted several traditional practitioners with different traditional treatments without success, the mass having been taken for a goiter. It is in the face of the failure of traditherapeuts that the patient finally decided to consult in our care structure.

RESULTS

Physical examination found a large left paramedian formation which appeared soft, mobile vis-a-vis the two plans, and sensitive; it measured 13 cm on its longer axis, and surrounding skin showed scarifications, witness to previous traditional treatments. Cervical CT eliminated goiter and made it possible to diagnose a giant cervical lipoma. A cervicotomy was performed under general anesthesia with a total one-block excision of an encapsulated mass. The evolution was favorable with a good healing. The histological examination of the mass identified a well-differentiated lipoma. There was no relapse up until 24 months later.

CONCLUSION

The giant anterior cervical lipoma is rare. The differential diagnosis is mainly posed with a large goiter or liposarcoma. CT or MRI make it possible to confirm the diagnosis. Its treatment is exclusively surgical and the examination of the operative piece by the pathologist confirms the diagnosis. An extended post-operative monitoring is recommended given the risks of relapse and of malignant degeneration.

Total, Patient and System Diagnostic Delays for Pulmonary Bacilliferous Tuberculosis in the Six Diagnostic and Treatment Centers in the Five Health Districts of the Central Region, Burkina Faso, 2018

Introduction

Long diagnosis delay contributes significantly to the failure to eradicate tuberculosis. The objective of this study was to evaluate the total, patient and system delays in diagnosis of pulmonary bacilliferous in the six tuberculosis Diagnostic and Treatment Centers in the five health districts of the central region in Burkina Faso.

Methods

A descriptive cross-sectional study was conducted among 384 microscopy-positive pulmonary tuberculosis patients in 2018 to address this objective. It concerned the socio-demographic, clinical, microbiological characteristics, and referral location/pathway characteristics of the patients. We then calculated the different delays. The “patient” (time from first symptoms to first consultation), “system” (time from first consultation to first diagnosis) and total (time from first symptoms to diagnosis) median diagnostic delay were estimated.

Results

The median “total”, “patient” and “system” diagnostic times were 37, 21 and 7 days, respectively. Of the 384 patients surveyed, 158 patients or 41.25% of patients had a long total diagnostic delay (> 45 days). The number of patients with a long system diagnostic delay was 125 patients (32.55%; p < 0.001) and those with a long patient diagnostic delay were 105 patients (27.34%; p < 0.001).

Conclusion

The total diagnosis delay of pulmonary tuberculosis was long for almost half of the patients. Awareness of the signs of tuberculosis among patients and caregivers, and consultation in a health center must be intensified to help considerably reduce these delays.

Supplementary Information

The online version contains supplementary material available at 10.1007/s44197-021-00027-z.

A case report from Ouagadougou and review of the literature

Introduction

GIST can occur in all segments of the gastrointestinal tract with a predilection for the stomach. Retroperitoneal localization remains exceptional. We report a case to describe our diagnostic and therapeutic approach.

Case presentation

A 55-year-old patient was admitted with borborygms and a sensation of lumbar swelling for 6 months. He was diabetic and hypertensive. The clinical examination noted a right lumbar mass with perception of bowel sound anterior to the mass, with minimal discomfort and mobility. Ultrasound revealed a hypervascularised, encapsulated, well-limited retroperitoneal tissue mass in contact with the right psoas muscle. Abdomino-pelvic CT scan showed a large, hypervascularized, encapsulated, calcified tissue mass measuring 147 × 106 mm in close contact with the outer edge of the right psoas muscle, suspected of being malignant. MRI noted a suspicious process developed at the expense of the right psoas muscle in its lumbar and iliac portion suggestive of a psoas rhabdomyosarcoma. The patient underwent laparotomy with a retroperitoneal approach by lumbar incision. Histology and immunohistochemistry revealed a GIST expressing CD117. The patient was put on imatinib for 6 months. He is complaint-free after 4 months.

Discussion

Despite the rarity of retroperitoneal GIST, it should be considered in the presence of any retroperitoneal mass. This will allow for early management.

Conclusion

Retroperitoneum is an exceptional location for GIST. Surgery remains the mainstay of curative treatment. Adjuvant imatinib reduces the risk of recurrence. The prognosis is usually good.

•

We report a case of retroperitoneal gastroinstestinal stroma tumor (GIST)GIST: an exceptional location of a rare tumor in a 55-year-old patient from Ouagadougou.

•

The symptoms have evolved about six months. The clinical examination noted a right lumbar mass with perception of bowel sound anterior to the mass.

•

Histology and immunohistochemistry revealed a GIST expressing CD117

•

The patient underwent laparotomy with a right lumbar incision on top of the swelling with uneventful postoperative course.

[Clinical and paraclinical profile of autoimmune myasthenia gravis in Ouagadougou, Burkina Faso]

INTRODUCTION

Certain differences in the epidemiological, clinical, paraclinical and evolution profiles of autoimmune myasthenia gravis (AIMG) are increasingly described in patients according to geographic origins. The present study was carried out in order to help characterize the socio-demographic, clinical and paraclinical profile of AIMG in Ouagadougou, Burkina Faso.

PATIENTS AND METHODS

This was a cross-sectional, descriptive, multicenter, hospital study carried out in Ouagadougou (Burkina Faso), over a period of 5 years 6 months, from March 2015 to September 2019. The study concerned all patients who had a clinical symptomatology suggestive of myasthenia gravis, associated with the presence in the serum of anti-AChR Ab and / or anti-MuSK Ab and / or the presence of a >10% decrement in electroneuromyography and / or a positive therapeutic test for oral anticholinestherasics. Sociodemographic, clinical and paraclinical variables, were analyzed.

RESULTS

A total of 25 patients (15 women and 10 men), were included. The young adult form was predominant (20 cases). The median time between the first symptoms and the diagnosis was 28.4 months +/- 44.8 (2 - 217 months). Diplopia and/or ptosis (80%) and dysphonia (72%) were the most frequent revealing clinical presentations. On admission, 7 patients (28%) had a moderate generalized form (MGFA class III) and 9 patients (36%) had a severe to very severe generalized form (MGFA class IV to V). Plasma Ab assays were performed in 17 patients (68%): anti-RACh Ab were positive in 11 patients (64.7%) and anti-MuSK Ab in 3 patients (14.3%). Thoracic CT revealed thymus hyperplasia in 12 patients (48%), thymoma in 5 patients (20%). Hyperthyroidism was associated in 2 patients (8%).

CONCLUSION

AIMG in Ouagadougou, Burkina Faso is marked by delayed diagnosis, a predominance in young women, severe generalized forms and a high frequency of plasma anti-MuSK Ab. This profile appears to be different from that of Caucasian patients. Collaborative studies in the sub-Saharan region on AIMG in general populations are needed.

[Prevalence and risk factors associated with intradialytic hypotension in Sub-Saharan Africa: The case of Burkina Faso]

AIM

The aim of our study was to determine the prevalence and factors associated with intradialytic hypotension in our cohort of chronic hemodialysis patients.

METHODS

This was a prospective monocentric study over a six-month period. Intradialytic hypotension was defined as a decrease in systolic blood pressure ≥ 20mmHg or a decrease in mean arterial pressure of 10mmHg associated with clinical events and the need for nursing interventions. The groups were compared using univariate analysis of variance.

RESULTS

We included 48 patients and counted 3014 hemodialysis sessions. The mean age was 44.7±15 years. The prevalence of intradialytic hypotension was 12.4%, with cramps 20 (41.7%) as the main symptom. Factors associated with frequent intradialytic hypotension compared to the groups without intradialytic hypotension and with infrequent intradialytic hypotension were age (61±13 years, p=0.018), diabetes (33.3%, p=0.019), high body mass index (27, 3±7.8kg/m2, p=0.002), interdialytic weight gain ≥ 5% of baseline weight (66.7%, p=0.033), hourly ultrafiltration (800±275ml/h, p=0.037) and perdialytic feeding (33.3%, p=0.016). Low pre-dialysis diastolic blood pressure (72±13mmHg, p=0.012) and high baseline weight (73.9±17.5kg, p=0.028) were associated with frequent versus infrequent intradialytic hypotension.

CONCLUSION

Intradialytic hypotension is common in our context. Its prevention in at-risk patients is critical to reducing morbidity and mortality and improving quality of life.

[Central Post-Stroke Pain at the Tingandogo University Teaching Hospital of Ouagadougou (Burkina Faso): Frequency, Clinical Profile, Quality of Life of Patients and Associated Factors]

Objective

Few studies have been done on central post-stroke pain (CPSP) in Sub-Saharan Africa, while taking it into account would improve the quality of life of stroke survivors. The purpose of this study was to determine the prevalence of CPSP, to describe its clinical profile, to assess the quality of life of patients and to identify the factors associated with its occurrence, from a prospective hospital series in Ouagadougou, Burkina Faso.

Methodology

It was a prospective, descriptive and analytical longitudinal follow-up study, conducted from January 2015 to March 2020, at the Tingandogo University Hospital, in Ouagadougou, Burkina Faso. The study involved all patients over the age of 16, consecutively hospitalized for stroke confirmed by CT and / or brain MRI, then reviewed every three months in outpatient Neurology, during at least 9 months after their stroke. The sociodemographic and clinical characteristics of the patients, the nature of the stroke, the existence of CPSP and, if applicable, its clinical characteristics, its treatment and its impact on the quality of life of the patients were recorded; a bivariate then multivariate analysis with logistic regression step by step, made it possible to search for the factors associated with the occurrence of CPSP. The significance threshold used was p < 0.05.

Results

A total of 236 patients were collected, out of which 28 patients presented a CPSP (11.9%), after a mean duration of post-stroke follow-up of 12.9 months. Cerebral infarction, intracerebral hemorrhage and cerebral venous thrombosis accounted for 69.5%, 29.7% and 0.8% respectively. The mean age of patients with CPSP was 54.6 years, with a male predominance (53.6%). The mean time to onset for CPSP was 3.8 months after stroke. Pains such as burning (75%) and allodynia (67.8%) were the most common. The average CPSP intensity was 7.6 / 10 on the visual analog scale. Hypoaesthesia (96.4%) and paraesthesia (71.4%) were the signs or symptoms most commonly associated with CPSP. CPSP had a moderate to severe negative impact on usual work, general activity and mood of patients in 60.7%, 50% and 46.4% of patients, respectively. Amitriptyline (75%) and / or level II analgesics (60.7%,) were the most used molecules, and effective in 57% of cases. Only age ≤ 50 years was independently associated with the occurrence of CPSP (OR 2.86; p = 0.03).

Conclusion

CPSP affects more than 1 in 10 stroke patients and moderately to severely affects the quality of life for most of these patients. Screening and adequate management of CPSP as part of multidisciplinary post-stroke follow-up will contribute to improve the quality of life of stroke patients and will facilitate their social and professional reintegration.

[Clinical and therapeutic aspects of sexual violence received at CHU Yalgado Ouedraogo, Burkina Faso)]

INTRODUCTION

Sexual abuse is a health problem that needs to be adequately and comprehensively managed. A preventive strategy must be conducted to deter potential abusers. The purpose of the study was to describe the cases of sexual abuse received in the Department of Gynecology and Obstetrics at Yalgado Ouedraogo University Hospital.

PATIENTS AND METHOD

It was a retrospective and descriptive study covering a period from January 1, 2009 to December 31, 2013.The study involved victims of sexual violence received in the obstetrics and gynecology department of Yalgado OUEDRAOGO Hospital and whose files were usable.

RESULTS

The average age of alleged victims was 16 years, ranging from 03 years to 32 years. Rape was the most frequent reason for consultation (93.1%). It was practiced nightly, usually in the residences. The most common genital lesion was vulvar lacerations (17.8%). The most frequent of non-gynecological lesion was scratches (10.9%).The victims' support was essentially medical and surgical. The short-term prognosis was favorable (100%). Psychological support was marginal.

Evaluation of sexual dysfunctions among women living with a partner in Ouagadougou, Burkina

To study the sexual dysfunctions of women living with a partnerin relationship in the city of Ouagadougou. This was a descriptive, and analytical cross-sectional study collectedwith prospective data collection over the a period of seven (07-) months period from March 1st through November 30th, 2016,. by interviewing It consisted of collecting from 633 women living with a partner in relationship in Ouagadougou data aboutn their sex livfes. The data werehas been processed and analyzed with epi-info software, in version 3.5.3. Statistical tests (Chi-square and, Fisher's exact tests) were used to assess the association between the different variables at athe 5% significance level of 5%. The study participation rate was 90.8%. In our study, 84.5% (n=or 486) women reported having at least one sexual dysfunction in their lifetime. Of those surveyed, 84.5% (486/575) had anorgasmia, 64.3% (370/575) had dyspareunia, 35.8% (206/575) had an problems of arousalexcitement disorder, and 35.1% had (202/575) frigidity. In addition,There were 116 of them (20.3%) hadwith lowdecreased libidosexual desire and 0.7% (4/575) with vaginismus. Female circumcision was the main factor associated with the sexual dysfunction of the respondents. Dyspareunia was 4.2 times more common in women with genital excisioned women than in uncircumcised women The sSexual dysfunction is frequent amongof a womean living within a partnercouple in the city of Ouagadougou is frequent. Because excision is one of the factors [[[The leading factor]]] found in the occurrence of sexual dysfunction in women, hence the need to proscribe this harmful practice must be proscribed in our societies.

Understanding premarital pregnancies among adolescents and young women in Ouagadougou, Burkina Faso

In developing countries, young women between 15 and 24 years of age account for more than 40% of unsafe abortions due to the high number of unwanted and/or out-of-wedlock pregnancies. However, much about the profile of adolescents and young women who usually experience premarital pregnancies remains unknown. This study sought to understand the risk of pregnancy before marriage among adolescents and young women in Ouagadougou, Burkina Faso. By using longitudinal data from a demographic surveillance system, we tested the explanatory power of two theoretical assumptions on premarital childbearing in sub-Saharan Africa, which assumptions are the cultural inheritance model and the social capital model. The results confirmed the explanatory power of the cultural inheritance model on the one hand and partially confirmed the power of the social capital model on the other hand. These results highlight the need for a multipronged approach to sexual and reproductive health for young people. Efforts against premarital pregnancies among adolescents and young women would be more effective if they were based on participatory approaches, incorporating actions at both community and institutional levels, as suggested by the recent Global Accelerated Action for the Health of Adolescents logical framework.

Dengue rapid diagnostic tests: Health professionals' practices and challenges in Burkina Faso

Objectives

Dengue fever remains unrecognized and under-reported in Africa due to several factors, including health professionals' lack of awareness, important prevalence of other febrile illnesses, most of which are treated presumptively as malaria, and the absence of surveillance systems. In Burkina Faso, health centers have no diagnostic tools to identify and manage dengue, which remains ignored, despite the evidence of seasonal outbreaks in recent years. A qualitative study was conducted to analyze the use of rapid diagnostic tests in six health and social promotion centers (i.e. health-care centers, from the French Centers de Santé et de Promotion Sociale) of Ouagadougou (Burkina Faso) in an exploratory research context.

Methods

Dengue rapid diagnostic tests were introduced into fever-related consultations from December 2013 to January 2014. In-depth individual interviews were conducted in May and June 2014 with 32 health professionals.

Results

Prior to the introduction of the tests, dengue was not well known or diagnosed by health professionals during consultations. Most febrile cases were routinely presumed to be malaria and treated accordingly. With training and routine use of rapid diagnostic tests, health professionals became more knowledgeable about dengue, improving the diagnosis of non-malaria febrile cases and its management, and better prescription practices.

Conclusions

In a context of dengue re-emergence and high prevalence of other febrile illnesses, having rapid diagnostic tools available, especially during epidemics reinforces health professionals' diagnostic and prescribing capacities, allowing an opportune and accurate case management and facilitates diseases surveillance.

Community-based dengue control intervention in Ouagadougou: intervention theory and implementation fidelity

Background

While malaria control is the primary health focus in Burkina Faso, the recent dengue epidemic calls for new interventions. This paper examines the implementation fidelity of an innovative intervention to control dengue in the capital Ouagadougou.

Methods

First we describe the content of the intervention and its theory. We then assess the fidelity of the implementation. This step is essential as preparation for subsequent evaluation of the intervention’s effectiveness. Observations (n = 62), analysis of documents related to the intervention (n = 8), and semi-structured interviews with stakeholders (n = 18) were conducted. The collected data were organized and analyzed using QDA Miner. The theory of the intervention, grounded in reported good practices of community-based interventions, was developed and discussed with key stakeholders.

Results

The theory of the intervention included four components: mobilization and organization, operational planning, community action, and monitoring/evaluation. The interactions among these components were intended to improve people’s knowledge about dengue and enhance the community’s capacity for vector control, which in turn would reduce the burden of the disease. The majority of the planned activities were conducted according to the intervention’s original theory. Adaptations pertained to implementation and monitoring of activities.

Conclusions

Despite certain difficulties, some of which were foreseeable and others not, this experience showed the feasibility of developing community-based interventions for vector-borne diseases in Africa.

[About 98 cases of dengue hospitalized in a private clinic of Ouagadougou: epidemiology, diagnostic and evolution]

Extremely widespread, the dengue is a reemerging infectious disease. In Burkina Faso, dengue is a reality that was little known. The aim of this study was to study epidemiology, diagnostic and outcomes of dengue patients in Ouagadougou. A retrospective study covered a period of two years, from 1 January 2013 to 31 December 2014 in a private clinic in Ouagadougou. Patients included in the study were hospitalized for fever and painful syndrome with a positive test to the dengue non-structural antigen 1 (NS1 Ag). Ninety-eight cases of dengue on 343 suspected cases were registered. The average age of patients was 35.9 years. The sex-ratio (M/F) was 1.18. According to the professional activity, there was a predominance of civil servants (35.7%). The pain syndrome was found in 93.9% of patients. Leukopenia (73.5%), neutropenia (56.1%) and severe thrombocytopenia (57.1%) were the predominant hematological disturbances. Of the patients, 18.4% had hemorrhagic dengue and 11.2%, a dengue shock syndrome. Four patients died. The use of non-steroidal antiinflammatory drugs was associated with the severity of the infection (p=0.04). Dengue fever occurs in our context and constitutes a risk of mortality. The diagnosis of dengue should be performed systematically in front of a painful and febrile syndrome. The vector control is the best way of prevention against dengue pending the development of a vaccine.

[Evaluation of the Practice of Caesarean Section According to Robson's Classification in a Health District of Ouagadougou, Burkina Faso]

The control of the caesarean rate is nowadays an important concern for the obstetric world, the priority being to make every effort to practice a caesarean in all the women who need it only instead of reaching a specific rate. The purpose of the present study was to apply the Robson classification to the evaluation of the practice of caesarean section at the maternity of the Bogodogo District Hospital. It turned to be an analytical cross-sectional study which was carried out from January 1st, 2013 till December 31^st, 2015. The information sources used included the computer base of caesarean sections, the delivery records, the operating room records, the delivery hall and the monthly activity reports. The overall hospital frequency of caesarean section was 33.3%. The rate of caesarean section expected during the same period according to the C-Model was 9.7%. Patients in groups 5 (with a scar uterus) and 6 (nulliparous with siege presentation) of the Robson classification had all a caesarean section and contributed to the overall rate of caesarean for 30 and 8.6% respectively. Low-risk women (groups 1, 2, 3 and 4) had a relative contribution of 31.3% to the overall rate of caesarean section. Improvement of the antenatal assessment of the prognosis of childbirth, particularly in the case of uterine scar or siege presentation, improvement of the quality of the supervision of the delivery work and the fight against prematurity will help to control the rate of caesarean section at the Bogodogo District Hospital.

Molecular Characterization of Diarrheagenic Escherichia Coli in Children Less Than 5 Years of Age with Diarrhea in Ouagadougou, Burkina Faso

Diarrheagenic Escherichia coli (DEC) is important bacteria of children’s endemic and epidemic diarrhea worldwide. The aim of this study was to determine the prevalence of DEC isolated from stool samples collected from children with acute diarrhea living in Ouagadougou, Burkina Faso. From August 2013 to October 2015, stool samples were collected from 315 children under 5 years of age suffering from diarrhea in the “Centre Médical avec Antenne Chirurgicale (CMA)” Paul VI and the CMA of Schiphra. E. coli were isolated and identified by standard microbiological methods, and the 16-plex PCR method was used to further characterize them. Four hundred and nineteen (419) E. coli strains were characterized, of which 31 (7.4%) DEC pathotypes were identified and classified in five E. coli pathotypes: 15 enteroaggregative E. coli (EAEC) (48.4%), 8 enteropathogenic E. coli (EPEC) (25.8%) with 4 typical EPEC and 4 atypical EPEC, 4 enteroinvasive E. coli (EIEC) (12.9%), 3 enterohemorrhagic E. coli (EHEC) 9.67%, and 1 enterotoxigenic E. coli (ETEC) 3.2%. The use of multiplex PCR as a routine in clinical laboratory for the detection of DEC would be a useful mean for a rapid management of an acute diarrhea in children.

[Primary congenital lymphedema: Milroy disease: the first case observed in the Department of Pediatrics at the University Hospital Yalgado Ouedraogo, Ouagadougou]

Congenital lymphedema is the accumulation of lymphatic fluid in the child's interstitial spaces. Milroy disease is a rare, hereditary, autosomal dominant condition showing incomplete penetrance. We report the case of a 7-year old little girl with Milroy disease examined for erysipelas on congenital big right leg. A family history of large congenital member existed. Physical examination showed big oedematous right leg painful to palpation, with skin lichenification and erysipelas. Paraclinical assessment objectified cutaneous lymphedema with vascular involvement suggestive of ectasia of the right saphenous vein. Female karyotype showed no abnormalities, despite the small chromosomal rearrangements. Treatment was based on physiotherapy, bandages, compression stockings and psychotherapy. This first case in Burkina Faso testifies to the rarity of the pathology but especially to the diagnostic difficulties related to the inadequacy of paraclinical investigations.

[Major sickle cell syndromes and infections associated with this condition in children in Burkina Faso]

Introduction

Le but de cette étude était d’étudier les infections chez les enfants présentant un syndrome drépanocytaire majeur.

Méthodes

Étude hospitalière monocentrique, rétrospective descriptive sur dix années menée à Ouagadougou, Burkina Faso. Étaient inclus tous les enfants porteurs d'un syndrome drépanocytaire majeur (homozygote SS et double hétérozygote SC, SD_Punjab, Sβ thalassémique, SO_Arab et SE) hospitalisés pour une infection bactérienne confirmée à la microbiologie.

Résultats

Cent trente trois patients répondaient à nos critères d’inclusion. Le phénotype SS représentait 63,2% des cas et le SC 36,8%. La fréquence des infections était de 21,8%. Celles-ci touchaient dans 45,9% des cas les enfants âgés de 0 à 5 ans. Les signes les plus fréquents étaient les douleurs ostéoarticulaires (42,1%), la toux (25,7%), les douleurs abdominales (23,3%), la pâleur (43,6%). Les broncho-pneumopathies (31,6%), le paludisme (16,5%), les ostéomyélites (12,8%) et les septicémies (10,5%) étaient les principaux diagnostics trouvés. Les agents pathogènes isolés étaient Streptococcus pneumoniae (35,5%) et Salmonella sp (33,3%). Les céphalosporines de 3e génération étaient les antibiotiques les plus fréquemment prescrits. Le taux brut de mortalité était de 7,5%.

Conclusion

Les infections bactériennes et le paludisme dominent le tableau des infections chez l'enfant drépanocytaire majeur au Centre Hospitalier Universitaire Pédiatrique Charles De Gaulle. Les auteurs recommandent la mise en place d’un programme national de prise en charge de la drépanocytose, ce qui permettrait de prévenir voire réduire la survenue des infections chez les enfants drépanocytaires.

[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.

[Obstetric endometritis at the UTH-Yalgado Ouedraogo of Ouagadougou (Burkina Faso): about the management of 102 cases]

This is a descriptive cross-sectional study over a nine months period conducted at the UTH-Yalgado Ouédraogo from all patients in whom the diagnosis of endometritis at obstetrical been laid. Endo-cervical and vaginal swabs were taken from all these patients. Commensal bacteria and anaerobes were investigated in the laboratory. During the study period, 102 cases of obstetric endometritis were recorded that to say a frequency of 1.4% of admissions. The average age of patients was 25.2 years [17-43]. The childbirth mean was 2.5 ± 2 [0-7]. The reason for consultation was dominated by hyperthermia in 98% of cases. The bacterial ecosystem was mainly dominated by Escherichia coli (49.2%), Staphylococcus aureus (29.5%), Streptococcus sp (4.9%). The acid + amoxicillin clavulanic showed low activity on most germs. The average hospital stay of patients was 6.30 days [1-33]. A maternal death was recorded in 3 patients that to say fatality rate of 2.9%. The lethality of endometritis at the UTH-Yalgado Ouedraogo is greater than the rate of 1% allowed by WHO. The resistance of germs is high enough with amoxicillin. The systematization of the bacteriological study is expected to guide the antibiotic to help better fight against maternal mortality.

[Obstetric emergency and non-emergency transfers to the university teaching hospital Yalgado ouedraogo of Ouagadougou: A 3-year study of their epidemiologic, clinical, and prognostic aspects]

OBJECTIVE

to describe the epidemiologic, clinical, and prognostic aspects of the emergency and non-emergency transfers of obstetric patients to Yalgado Ouédraogo University Hospital Center (UHC-YO) in Ouagadougou. this retrospective descriptive study looked at the outcomes of women transferred, on an emergency basis or not, to the obstetrics department of the UHC-YO. The study population comprised all women transferred to the department during 2010, 2011, and 2012. during the study period, there were 9,806 admissions for obstetric disorders<check?>: 43% were transfers. The patients' mean age was 26.11 years [(13-49]. Women transferred from health care facilities within the city of Ouagadougou accounted for 96% of the sample. The leading reason for these transfers - emergency or not - was preeclampsia and eclampsia (24.57%). We recorded a total of 161 maternal deaths, for a mortality rate of 3.9%. Approximately 26.55% of the newborns received immediate intensive care and were then transferred to the neonatology department. maternal and neonatal prognosis is always poor in cases transferred to UHC-YO, despite increased funding for emergency obstetric and neonatal care. Increased population awareness of the importance of prenatal consultation and adequate funding for health care facilities to provide equipment for emergency transfers and staff training in the management of obstetric and neonatal emergencies would probably improve these mortality and morbidity rates.

Estimating the costs for the treatment of abortion complications in two public referral hospitals: a cross-sectional study in Ouagadougou, Burkina Faso

BACKGROUND

Treatment costs of induced abortion complications can consume a substantial amount of hospital resources. This use of hospitals scarce resources to treat induced abortion complications may affect hospitals' capacities to deliver other health care services. In spite of the importance of studying the burden of the treatment of induced abortion complications, few studies have been conducted to document the costs of treating abortion complications in Burkina Faso. Our objective was to estimate the costs of six abortion complications including incomplete abortion, hemorrhage, shock, infection/sepsis, cervix or vagina laceration, and uterus perforation treated in two public referral hospital facilities in Ouagadougou and the cost saving of providing safe abortion care services.

METHODS

The distribution of abortion-related complications was assessed through a review of postabortion care-registers combined with interviews with key informants in maternity wards and in hospital facilities. Two structured questionnaires were used for data collection following the perspective of the hospital. The first questionnaire collected information on the units and the unit costs of drugs and medical supplies used in the treatment of each complication. The second questionnaire gathered information on salaries and overhead expenses. All data were entered in a spreadsheet designed for studying abortion, and analyses were performed on Excel 2007.

RESULTS

Across six types of abortion complications, the mean cost per patient was USD45.86. The total cost to these two public referral hospital facilities for treating the complications of abortion was USD22,472.53 in 2010 equivalent to USD24,466.21 in 2015. Provision of safe abortion care services to women who suffered from complications of unsafe induced abortion and who received care in these public hospitals would only have cost USD2,694, giving potential savings of more than USD19,778.53 in that year.

CONCLUSIONS

The treatment of the complications of abortion consumes a significant proportion (up to USD22,472.53) of the two public hospitals resources in Burkina Faso. Safe abortion care services may represent a cost beneficial alternative, as it may have saved USD19,778.53 in 2010.

[Manicure and pedicure in the city of Ouagadougou (Burkina Faso): practices and risks]

La manucure-pédicure est l'ensemble des soins esthétiques des mains, des pieds et des ongles. Au Burkina Faso, l'usage des produits de manucure-pédicure, les techniques utilisées ainsi que les risques encourus restent méconnus. L'objectif de notre étude était d’évaluer la pratique de la manucure-pédicure dans la ville de Ouagadougou. Nous avons mené une étude transversale descriptive de décembre 2010 à novembre 2012 incluant tout les praticiens ayant au moins six mois d'expérience dans l'activité et les clients présents sur les lieux au moment de l'enquête. Nous avons interrogé au total 313 praticiens et 313 clients. L’âge moyen des praticiens était de 19 ans et celui des clients de 32,2 ans. Les praticiens fixes étaient en majorité des femmes (96,87%), ceux mobiles surtout des hommes (68,37%), et 64,53% des clients étaient des femmes. Le pourcentage de praticiens n'ayant pas reçu de formation professionnelle était de 93,92%. 29,7% des praticiens faisaient tremper les instruments pendant au moins dix minutes dans de l'eau de javel; 75,71% savaient que l'utilisation de certains outils étaient dangereux et 26,51% étaient avaient présenté des effets secondaires. Parmi les clients, 40,25% savaient que le matériel utilisé comportait des risques et 30,35% avaient été victimes d'accidents. Les soins de manucure et de pédicure se font dans les salons de coiffure par des coiffeuses non formées à l'exercice de la profession La provenance et la composition des produits n'est pas connues. Des produits non recommandés sont utilisés (shampooing pour trempage des pieds, lame de rasoir et ciseaux pour raclage des pieds). Le recours à la manucure et/ou pédicure est parfois nécessaire mais cela ne doit pas faire perdre de vue les risques encourus. Une sensibilisation des clients et une formation des praticiens semblent nécessaires pour minimiser les risques.

Malaria related care-seeking-behaviour and expenditures in urban settings: A household survey in Ouagadougou, Burkina Faso

In Sub-Sahara Africa, malaria inflicts a high healthcare expenditure to individuals. However, little is known about healthcare expenditure to individual affected by malaria and determinants of healthcare seeking behaviour in urban settings where private sector is thriving. This study investigated the level and correlates of expenditure among individuals with self-reported malaria episode in Ouagadougou, Burkina Faso. A cross-sectional household survey conducted in August-November 2011 in Ouagadougou covered 8,243 individuals (1,600 households). Using Generalized Estimating Equations, the analysis included 1082 individuals from 715 households, who reported an episode of malaria. Of individuals surveyed, 38.3% sought care from public, 27.4% from private providers, and, 34.2% self-medicated. The median cost for malaria treatment was USD10.1 (4,850.0XOF) with significant different between public, private and self-medication (p<0.001). In public primary care health facilities, the median cost was USD8.4 (4,050.0XOF) for uncomplicated malaria and USD15.2 (7,333.5XOF) for severe malaria. In private-for-profit facilities run by a medical doctor, the median cost was USD30.3 (14,600.0XOF) for uncomplicated malaria and USD 43.0 (20,725.0XOF) for severe malaria. Regardless of the source of care, patients with insurance incurred significantly higher expenditure compared to those without insurance (p<0.001) and medicine accounted for the largest share of the expenditure. The type of provider, having insurance, and the severity of the malaria predict the amount of money spent. The high financial cost of malaria treatment regardless of the providers poses threat to the goal of universal access to malaria interventions, the unique way to achieve elimination goals.

[Men who have sex with men (MSM) and HIV infection in Ouagadougou, Burkina Faso: Knowledge, attitudes, practices and seroprevalence survey]

BACKGROUND

Like many African countries, the issue of sex between men in Burkina Faso remains taboo and sometimes result in social exclusion. This population which is vulnerable to HIV/AIDS is unknown, due to lack of scientific researches.

AIM

Our study aimed to characterize knowledge, attitudes and sexual practices and to estimate HIV seroprevalence among men having sex with men (MSM) living in Ouagadougou.

METHODS

A cross-sectional study was conducted in order to describe and analyze MSM living in Ouagadougou. They were recruited by snowball sampling, aged at least 18 years, and accepted to participate at the study. Data were collected by qualified interviewers through administered questionnaire face to face. HIV test was systematically proposed.

RESULTS

A total of 142 MSM were recruited during the study period. The sample was mostly composed of students or pupils (60.8%), single men (91%), with age range 18-30 years (96.5%). The HIV knowledge median score was 8/10. HIV seroprevalence was 8.9% (4.5-15.4).

CONCLUSION

Our study confirms the vulnerability of MSM living in Ouagadougou about HIV/AIDS given the high rate of HIV seroprevalence. Targeted interventions for prevention, care and scientific research are challenges for the authorities to sustain the achievements of the national fight against HIV and AIDS.

Women's dietary diversity scores and childhood anthropometric measurements as indices of nutrition insecurity along the urban-rural continuum in Ouagadougou, Burkina Faso

Background

Malnutrition is still prevalent worldwide, and its severity, which differs between regions and countries, has led to international organisations proposing its inclusion in the global development framework that will succeed the Millennium Development Goals (post-2015 framework). In Sub-Saharan Africa, malnutrition is particularly severe, among women and children under 5 years. The prevalence of malnutrition has been reported worldwide, differing from region to region and country to country. Nevertheless, little is known about how malnutrition differs between multiple locations along an urban–rural continuum.

Objective

A survey was carried out in and around Ouagadougou, Burkina Faso, between August and September 2014 to map household nutrition insecurity along the urban–rural continuum, using a transect approach to guide the data collection.

Design

Transects of 70 km long and 2 km wide directed radially from the city centre outwards were laid, and data were collected from randomly selected households along these transects. Women's dietary diversity scores (WDDSs) were calculated from a sample of 179 women of reproductive age (15–49 years) from randomly selected households. Additionally, anthropometric data (height/length and weight) of 133 children under 5 years of age were collected along the same transects for the computation of anthropometric indices.

Results

We found that relative proportions of the nutrition indices such as stunting, wasting and underweight varied across the urban–rural continuum. Rural households (15%) had the highest relative proportion of WDDS compared with urban households (11%) and periurban households (8%). There was a significant association between children under 5 years’ nutritional status (wasting, stunting and underweight) and spatial location (p=0.023). The level of agricultural activities is a possible indicator of wasting in children aged 6–59 months (p=0.032).

Conclusion

Childhood undernutrition certainly has a spatial dimension that is highly influenced by the degree of urbanity, which should be taken into consideration in policy formulation and implementation.

[Acute pancreatitis at the Yalgado Ouedraogo University Hospital in Burkina Faso]

AIMS

To study the epidemiological, diagnostic, etiologic, therapeutic and evolutionary aspects of acute pancreatitis in Burkinabe.

MATERIALS AND METHODS

We conducted a cross-sectional descriptive study referred from records of patients hospitalized for acute pancreatitis in the Department of General and Digestive Surgery of the Yalgado Ouedraogo University Hospital in Burkina Faso from 1 January 2007 to 31 December 2012.

RESULTS

We noted 30 cases of acute pancreatitis, a frequency of 0.46 % of hospitalizations and an annual incidence of 4.6 cases per year. There were 22 men. The average age was 42.7 years. Alcohol consumption was found in 56.7%. The clinical aspects were dominated by abdominal pain (100%). Lipasemia was more than three times normal values in 66.3% of cases. An abdominal ultrasound was performed in 26.7% of cases and an abdominal CT was carried out in 50% of cases. The Balthazar score was evaluated in 15 patients and was lower in stage C in 9 cases. The treatment was mainly medical. The evolution was marked by the occurrence of systemic complications in 40% of patients and one death was recorded.

CONCLUSION

Patients suffering from financial hardships present a major handicap for the diagnosis and early treatment.

[Eclampsia at the University hospital Yalgado of Ouagadougou (Burkina Faso) from 1 April 2013 to 31 March 2014]

The objective of this study was to describe the epidemiological, clinical, therapeutic and prognostic aspects of the eclampsia in the obstetrics and gynecology department at the University Teaching Hospital Yalgado Ouedraogo of Ouagadougou. It has been a descriptive crosssectional study over a period of 12 months from 1 April 2013 to 31 March 2014. The main criterion for inclusion in our sample was the occurrence of seizures in a pregnant more than 20 weeks of gestation or recently delivered with elevation of blood pressure and the presence of albumin in the urine. The patients were followed from the onset of the crisis until hospital discharge. Data were collected and analyzed using Epi Info 3.5.1. The significance level of 5% was used for data comparison. We identified 203 cases of eclampsia for 6063 deliveries that to say a frequency of 3.3%. The average age of patients was 27.5 years [14-46]. In socio-demographic terms, patients were housewives in 62.5% of cases, the average rate of the past-deliver number was 4.2 [0-11] and 47.7% of patients were living as married. Clinically, they were referred in 72.4% of cases and were initially admitted into the service for elevation of blood pressure in 40.3% of cases. The mean gestational age was 31.5 weeks [23-41]; diastolic blood pressure exceeded 110 mmHg in 63.1% of cases. Therapeutically, all the patients benefited from a treatment based in anticonvulsant by magnesium sulfate and antihypertensive therapy by nicardipine, clonidine or alpha-methyl-dopa. Maternal prognosis was marked by significant morbidity in 46 cases (22.6%) and mortality in 13 patients that to say a fatality rate of 6.4%. The fetal one was dominated by a perinatal lethality in 31.5% of the cases. Eclampsia is a major cause of maternal and perinatal mortality in the University Teaching Hospital of Ouagadougou. The adoption of strategies for screening during antenatal consultations and early management should contribute to the reduction of the mortality in the mother and child couple in Burkina Faso.

[Epidemiological and etiological aspects of superficial fungal infections among prison inmates in Ouagadougou, Burkina Faso]

OBJECTIVE

The fight against fungal infections in prisons is within the overall framework of the fight against these diseases in the general population. To contribute to the fight against these diseases, we conducted this study among inmates of the big prison of Ouagadougou. It aimed to analyze the epidemiological and etiological aspects of superficial fungal infections among prison inmates in Ouagadougou.

MATERIALS AND METHODS

It was a matter of an analytical descriptive study (December 2011-April 2012) that examined 212 selected using a stratified sampling detainees. It consisted firstly of a survey on risk factors. Secondly, samples were taken from prisoners with suspicious lesions of superficial mycoses. For each lesion, some fragments were examined directly between slide and coverslip in KOH (10% or 30%). The remaining fragments were cultured on Sabouraud-Chloramphenicol and Sabouraud-Chloramphenicol-Actidione. The media were then incubated at 27°C for 1 month before declaring any negativity.

RESULTS

The overall prevalence of superficial fungal infections among prison inmates Ouagadougou was 25.5%. The recent prison inmates (≤24 months) were the most affected (89.8%). Dermatophytes (15.56%) were more isolated than non-dermatophytes (12.26%) Anthropophilic species predominated among dermatophytes: T. mentagrophytes (7.0%), T. rubrum (3.3%), M. langeronii (23%), E. floccosum (1.41%) and T. violaceum (0.94%). M. gypseum (0.47%) was the only land-based species encountered. Non-dermatophytes were Malassezia sp. (11.79%) and Candida sp. (0.47%). Polyparasitism was less represented (7.4% of infected prisoners). Several body sites were mostly infected by one fungal agent. Pityriasis versicolor was the most common fungal infection (37.31%).

CONCLUSION

Considering the results, specific control measures are to be taken against the superficial fungal infections in prisons and in the general population.

Epidemiologic, clinical, and prognostic aspects at the University Hospital Center Yalgado-Ouédraogo of Ouagadougou]

OBJECTIVE

to describe the epidemiologic, clinical, and prognostic aspects of the management of the complications of women who had unsafe (illegal) abortions.

MATERIAL AND METHODS

this prospective, descriptive cross-sectional study took place the Yalgado Ouédraogo University Hospital Center (UHC-YO) in Ouagadougou during the 12-month period from June 2012 to May 2013. The study included all women admitted to the obstetrics-gynecology department during the study period and diagnosed after clinical examination with complications of an unsafe abortion. Data were collected with standardized case report forms. The analysis was conducted with Epi Info 3.5.1 software and Student's, Fisher's, and Pearson's Chi-square tests to compare the data. The threshold for statistical significance was set at 5%.

RESULTS

during the study period, 111 women were admitted for complications of unsafe abortions, for a rate of 1 per 47 deliveries. The women's mean age was 23.6 years and ranged from 15 to 45 years. More than half the women (n=62, 55%) were pregnant for the first time. Hemorrhage was the primary reason for admission: 78 women, or 75%. Only 18 women (16%) admitted to having had an illegal intentional abortions. Complications included endometritis in 10 women (11%), anemia in 6 (5%), and hepatonephritis, also in 6 (5%). Six women died, for a mortality rate of 24%.

CONCLUSION

the epidemiologic profile of women with complications from unsafe abortions is that of a young women pregnant for the first time, who has no income-producing activity. Morbidity is dominated by infectious or hemorrhagic complications and mortality is high. Strengthening activities for prevention, health and sex education, and dissemination of knowledge of and access to contraceptive methods will help to reduce these abortions and their consequences.

Comparing causes of death between formal and informal neighborhoods in urban Africa: evidence from Ouagadougou Health and Demographic Surveillance System

BACKGROUND

The probable coexistence of two or more epidemiological profiles in urban Africa is poorly documented. In particular, very few studies have focused on the comparison of cause-specific mortality between two types of neighborhoods that characterize contemporary southern cities: formal neighborhoods, that is, structured or delineated settlements (planned estates) that have full access to public utilities (electricity and water services), and the informal neighborhoods, that is, spontaneous and unplanned peri-urban settlements where people live in slum-like conditions, often with little or no access to public utilities.

OBJECTIVE

To compare the causes of death between the formal and informal neighborhoods covered by the Ouagadougou Health and Demographic Surveillance Systems (HDSS).

DESIGN

The data used come from the INDEPTH pooled dataset which includes the contribution of Ouagadougou HDSS and are compiled for the INDEPTH Network Data repository. The data were collected between 2009 and 2011 using verbal autopsy (VA) questionnaires completed by four fieldworkers well trained in the conduction of VAs. The VA data were then interpreted using the InterVA-4 program (version 4.02) to arrive at the causes of death.

RESULTS

Communicable diseases are the leading cause of death among children (aged between 29 days and 14 years) in both formal and informal neighborhoods, contributing more than 75% to the mortality rate. Mortality rates from non-communicable diseases (NCDs) are very low before age 15 but are the leading causes from age 50, especially in formal neighborhoods. Mortality from injuries is very low, with no significant difference between the two neighborhoods.

CONCLUSIONS

The fact that mortality from NCDs is higher among adults in formal neighborhoods seems consistent with the idea of a correlation between modern life and epidemiological transition. However, NCDs do affect informal neighborhoods as well. They consist mainly of cardiovascular diseases and neoplasms most of which are preventable and/or manageable through a change in lifestyle. A prevention program would certainly reduce the burden of these chronic diseases among adults and the elderly with a significant economic impact for families.

Costs and consequences of abortions to women and their households: a cross-sectional study in Ouagadougou, Burkina Faso

Little is known about the costs and consequences of abortions to women and their households. Our aim was to study both costs and consequences of induced and spontaneous abortions and complications. We carried out a cross-sectional study between February and September 2012 in Ouagadougou, the capital city of Burkina Faso. Quantitative data of 305 women whose pregnancy ended with either an induced or a spontaneous abortion were prospectively collected on sociodemographic, asset ownership, medical and health expenditures including pre-referral costs following the patient’s perspective. Descriptive analysis and regression analysis of costs were performed. We found that women with induced abortion were often single or never married, younger, more educated and had earlier pregnancies than women with spontaneous abortion. They also tended to be more often under parents’ guardianship compared with women with spontaneous abortion. Women with induced abortion paid much more money to obtain abortion and treatment of the resulting complications compared with women with spontaneous abortion: US$89 (44 252 CFA ie franc of the African Financial Community) vs US$56 (27 668 CFA). The results also suggested that payments associated with induced abortion were catastrophic as they consumed 15% of the gross domestic product per capita. Additionally, 11–16% of total households appeared to have resorted to coping strategies in order to face costs. Both induced and spontaneous abortions may incur high expenses with short-term economic repercussions on households’ poverty. Actions are needed in order to reduce the financial burden of abortion costs and promote an effective use of contraceptives.

[Assessment of knowledge and pain management by traumatological emergencies staff of the teaching hospital of Ouagadougou]

INTRODUCTION

Pain is a frequent reason of consultation in traumatological emergencies. Its management is characterized by oligoanalgesia whose causes are multiple. The purpose of this study is to assess the knowledge and practices of pain management by traumatological emergencies staff of the teaching hospital Yalgado Ouedraogo of Ouagadougou.

MATERIALS AND METHODS

A questionnaire survey of health workers performing in traumatological emergencies has been conducted. Two different questionnaires, one for medical staff and one for the paramedics were administered.

RESULTS

A total of 67 health workers participated in the study with a participation rate of 98% and 100%, respectively, for the medical and paramedical staff. According to their report, 65.3% of medical and 77.7% of paramedical staff had never received training on pain and its management. For 85.7% of physicians, pain should be assessed before treatment, but 79.6% of them didn't know any conventional pain assessment method. All the nurses and 40.8% of physicians felt that pain in the emergency services should not be treated immediately to prevent misdiagnosis. Morphine and regional anesthesia were not used for pain treatment in the emergency room. 10.2% of medical staff and 27.8% of the paramedics said that they systematically search for the analgesicsside effects.

CONCLUSION

The knowledge of health workers about pain and its management is insufficient. The lack of training of health workers on the management of pain is the cause and contributes to explain the oligoanalgesia in this service.

The components of self-rated health among adults in Ouagadougou, Burkina Faso

Background

Although the relationship between self-rated health (SRH) and physical and mental health is well documented in developed countries, very few studies have analyzed this association in the developing world, particularly in Africa. In this study, we examine the associations of SRH with measures of physical and mental health (chronic diseases, functional limitations, and depression) among adults in Ouagadougou, Burkina Faso, and how these associations vary by sex, age, and education level.

Methods

This study was based on 2195 individuals aged 15 years or older who participated in a cross-sectional interviewer-administered health survey conducted in 2010 in areas of the Ouagadougou Health and Demographic Surveillance System. Logistic regression models were used to analyze the associations of poor SRH with chronic diseases, functional limitations, and depression, first in the whole sample and then stratified by sex, age, and education level.

Results

Poor SRH was strongly correlated with chronic diseases and functional limitations, but not with depression, suggesting that in this context, physical health probably makes up most of people’s perceptions of their health status. The effect of functional limitations on poor SRH increased with age, probably because the ability to circumvent or compensate for a disability diminishes with age. The effect of functional limitations was also stronger among the least educated, probably because physical integrity is more important for people who depend on it for their livelihood. In contrast, the effect of chronic diseases appeared to decrease with age. No variation by sex was observed in the associations of SRH with chronic diseases, functional limitations, or depression.

Conclusions

Our findings suggest that different subpopulations delineated by age and education level weight the components of health differently in their self-rated health in Ouagadougou, Burkina Faso. In-depth studies are needed to understand why and how these groups do so.

Gender differences in cognitive impairment and mobility disability in old age: a cross-sectional study in Ouagadougou, Burkina Faso

This study aims to examine differences in cognitive impairment and mobility disability between older men and women in Ouagadougou, Burkina Faso, and to assess the extent to which these differences could be attributable to gender inequalities in life course social and health conditions. Data were collected on 981 men and women aged 50 and older in a 2010 cross-sectional health survey conducted in the Ouagadougou Health and Demographic Surveillance System. Cognitive impairment was assessed using the Leganés cognitive test. Mobility disability was self-reported as having any difficulty walking 400 m without assistance. We used logistic regression to assess gender differences in cognitive impairment and mobility disability. Prevalence of cognitive impairment was 27.6% in women and 7.7% in men, and mobility disability was present in 51.7% of women and 26.5% of men. The women to men odds ratio (95% confidence interval) for cognitive impairment and mobility disability was 3.52 (1.98-6.28) and 3.79 (2.47-5.85), respectively, after adjusting for the observed life course social and health conditions. The female excess was only partially explained by gender inequalities in nutritional status, marital status and, to a lesser extent, education. Among men and women, age, childhood hunger, lack of education, absence of a partner and being underweight were independent risk factors for cognitive impairment, while age, childhood poor health, food insecurity and being overweight were risk factors for mobility disability. Enhancing nutritional status and education opportunities throughout life span could prevent cognitive impairment and mobility disability and partly reduce the female excess in these disabilities.

Epidemiological profile of cutaneous leishmaniasis: retrospective analysis of 7444 cases reported from 1999 to 2005 at Ouagadougou, Burkina Faso

This retrospective study was aimed to describe the trend of the cases and to determine the annual incidence rate of cutaneous leishmaniasis from 1999 to 2005 in the city of Ouagadougou. To achieve these objectives, a retrospective study was conducted. Data collection was conducted from January 1999 to December 2005. In total, 7444 cases of cutaneous leishmaniasis were recorded with an annual average of 1063.30 ± 270. 8 cases. The sex ratio M/F was 0.9. The average age was 22.8 ± 13.5 years. Patients more than 15 year-old accounted for 72.5%. A decrease in the cases of the disease was noted during the months of March, April, May, June, and December. The peak was recorded during the months of September and October. Over 7 years, the average incidence rate was 0.1% ± 0.04 but does not reflect the importance of this pathology. Thus, a prospective study was recommended.