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Introduction: The risk of transmission of pathogens such as hepatitis B virus threatens the safety of transfused patients especially in high endemic areas. The aim of this study was to determine the incidence and factors associated with hepatitis B virus surface antigen (HBsAg) seroconversion in blood donors at the Regional Blood Transfusion Centre of Ouagadougou. Methods: A retrospective cohort study of voluntary non-remunerated blood donors (VNRBD), was conducted from 2008 to 2017. Data on HBsAg seroconversion were collected. The Kaplan-Meier method and the Log-Rank test were used to estimate the survival curves. Cox’s regression identified the factors associated with this seroconversion. Results: Of 23,494 donors, 559 had HBsAg seroconversion. The number of donor years was 58,637.50 and the HBV incidence rate was 9.53 per 1000 donor years. The median seroconversion time was 75.73 months with extremes of 2.7 months and 107.12 months. The risk of seroconversion was 1.30 times higher among donors aged 21 to 24 years old (p = 0.007) and 2.49 times higher among those over 24 years old (p < 0.0001) than among donors under 21 years old. Female donors were 1.11 times more likely to seroconvert than male donors (p = 0.33). Donor residence was not significantly associated with HBsAg seroconversion (Hazard ratio = 1.12; p = 0.36). The risk of seroconversion decreased significantly with the number of blood donations (Hazard ratio = 0.58; p = 0.006). Conclusion: The incidence of HBsAg remains high among blood donors, which could have a negative impact on transfusion safety. The age of the blood donor was significantly associated to AgHBs seroconversion.

Burkina Faso has high prevalence of anemia in pregnancy (hemoglobin < 11 g/dL), despite the implementation of the WHO recommended guidelines. This study aimed to test the effects of personalized support for pregnant women at home on the trend of anemia prevalence in pregnancy. A cluster randomized trial was conducted from January 2015 to August 2016 at Sindou health district in Burkina Faso. Data were collected from 617 women in their first or second trimester of pregnancy, including 440 and 177 women in the intervention and control groups, respectively. The intervention consisted of a monthly home-based visit to the pregnant woman, focusing on nutritional counseling and pregnancy management, alongside an improvement antenatal visit quality. Compared with the prevalence of anemia in pregnancy in the control group [64.0% (95% confidence interval [CI]: 52.1–74.4%)], that of the intervention group was significantly lower from the fifth home visit onward [36.8% (95% CI: 32.1–41.8%)] (P < 0.001). The adjusted difference-in-differences in anemia prevalence between the two groups was –19.8% (95% CI: –30.2% to –9.4%) for women who received more than four home visits (P < 0.001). The corresponding difference in hemoglobin levels was 0.644 g/dL (95% CI: 0.309–0.167; P < 0.001). Personalized support for pregnant women at home, combined with appropriate antenatal care, can significantly reduce anemia prevalence during pregnancy in rural Burkina Faso.

Introduction : L’anemie de grossesse, ou gravidique, demeure un probleme majeur de sante publique dans les pays a faible revenu. La qualite de la ressource humaine est primordiale pour garantir l’efficacite des interventions. Cette etude avait pour objectif d’evaluer les connaissances et les pratiques des professionnels de sante et des agents de sante communautaires en matiere de prevention de l’anemie de grossesse au Burkina Faso.Methode : Il s’agit d’une etude transversale descriptive. Les donnees ont ete collectees a l’aide d’un questionnaire aupres des agents professionnels de sante et des agents de sante communautaires dans la region des Cascades.Resultats : Au total, 124 agents professionnels de sante et 77 agents de sante communautaires ont participe a l’enquete. Les connaissances des agents professionnels de sante sur la prevention de l’anemie de grossesse etaient « suffisantes » dans 25 % des cas et celles des agents de sante communautaires etaient « acceptables » dans 33,8 % des cas. Ni le nombre ni la diversite des themes de formation continue et des informations recues n’etaient associes au niveau de connaissances des agents sur la prevention de l’anemie. Les agents professionnels de sante des hopitaux (ORa = 6,7 ; IC 95 % : 1,3-34,5) et ceux ayant ete formes sur la prevention de la transmission mere-enfant du virus de l’immunodeficience humaine (VIH) (ORa = 3,0 ; IC 95 % : 1,0-8,0) ainsi que les agents de sante communautaires ayant ete scolarises (OR = 2,2 ; IC 95 % : 1,3-4,0) avaient les meilleurs niveaux de connaissances. Mais les agents professionnels de sante les plus qualifies etaient plutot concentres dans les hopitaux et non dans les centres de sante peripheriques censes promouvoir les mesures essentielles de prevention de l’anemie de grossesse.Conclusion : La prevention de l’anemie de grossesse reste un defi au Burkina Faso au regard du faible niveau de connaissances et des pratiques dans les centres de sante peripheriques et dans la communaute. Une amelioration des connaissances et des pratiques des acteurs peripheriques de soins a travers de meilleurs curricula de formation continue pourraient contribuer a lutte contre l’anemie de la femme enceinte.

Background: Despite numerous advances in medicine and clinical care, in developing countries, adult undernutrition is overlooked and not considered as a sufficient medical priority. The objective of this study was to identify the magnitude of adult undernutrition and its associated factors in hospitalized patients. Methods: Cross-sectional study, performed in the university hospital in Bobo-Dioulasso, from August to September 2016, in a sample of 244 adult individuals. Patients were included in the study consecutively to their admission. A structured questionnaire was applied consisting of anthropometric, clinical and dietary data. The patients were evaluated and dichotomized into undernourished and non-undernourished. The rate of undernutrtion was reported using and associated factors were tested using the unadjusted crude Odds ratios (COR) with 95% confidence interval (95% CI) and the Chi-square test. Results: Undernutrition occurred in 32.4% of the sample and at the univariate analysis, the variables associated with undernutrition were: recent and involuntary weight loss (COR = 2.58, 95% CI = 1.45 - 4.59, p < 0.001); disease chronic evolution (COR = 2.29, 95% CI = 1.23 - 4.23, p = 0.008) and females (COR = 1.76, 95% CI = 1.02 - 6.06, p = 0.04). Conclusion: Adult undernutrition is common in hospitalized patients. A proper early diagnosis and therapy need to be considered as medical priority of the entire healthcare team that treats adult’s inpatients.

Introduction:anaemia in pregnancy is a public health concern in Burkina Faso. This study aims at identifying the factors associated with the prevalence of anaemia in pregnant women at a regional level in Burkina Faso. Methods:we conducted a cross-sectional study in the region called “Cascades”, located at the Western part of Burkina Faso. The study population included all pregnant women who attended antenatal care clinics in all public peripheral health facilities (districts) between May and June 2012 and agreed to participate in the study. They provided blood sample from which we measured the haemoglobin concentration using the Hemocue® system. The factors associated with anaemia in the study population were identified through multiple logistic regressions. Results:the prevalence (95% CI) of anaemia in pregnancy in the Cascades region was 58.9% (56.6% - 61.2%). Anaemia in pregnancy was more common in district of Banfora (OR = 1.40; 95% CI: 1.07-1.83), among housewives (OR = 2.96; 95% CI: 1.10-8.0), in the Mossi ethnic group (OR = 1.39; 95% CI: 1.04-1.85) and among the wives of farmers and artisans (OR = 2.55; 95% CI: 1.59-4.07). Anaemia in pregnancy was less frequent among women who drank local beer (OR = 0.68; 95% CI: 0.49-0.94). Conclusion:the prevalence of anaemia in pregnancy is high in Burkina Faso. Improving women's income level may contribute to reduce it. Further studies are needed to elucidate the link between the consumption of local beer, the local diet practices and anaemia in pregnant women.

Background: The recommendation of the WHO and UNICEF is that all infants should be exclusively breastfed up to 6 months of age. Identifying associated factors to exclusively breastfeeding is crucial to improve this key public health intervention. The objectives of the study were to investigate rates of exclusive breastfeeding and to identify potential associated factors. Methods: A Community based cross-sectional study design was conducted in three health districts. Cluster sampling was used. For the community based cross-sectional study, a total of 1832 infants was included. Exclusive breastfeeding have been investigated among the 563 under 6 month’s infants. The associations between exclusive breastfeeding and independent variables were tested using the Chi-square test. Crude Odds ratios with 95 % confidence intervals were used to investigate the factors independently associated with exclusively breastfeeding. Results: Proportion of infant 0 - 5.9 months of age who are fed exclusively with breastmilk was 40.0%. Ear of age for mother was found to be more likely to practice exclusive breastfeeding, COR [95CI%] = 2.11 [1.24 - 3.60] for 15 - 20 years of age and 2.0 [1.22 - 3.26]. Receiving advices, on exclusive breastfeeding was found to be more likely to practice exclusive breastfeeding, COR: 2.07, 95% CI: [1.44 - 2.98]. Mothers who have practice early initiation to breastfeeding were found to be more likely to practice exclusive breastfeeding COR: 1.62, 95% CI: [1.15 - 2.27]. Skilled delivery was found to be more likely to practice exclusive breastfeeding than non-skilled deliveries, COR: 1.66, 95% CI: [1.16 - 2.35]. Low numbers of living children by mother, young children, were found to be more likely to practice exclusive breastfeeding. Conclusions: Exclusive breastfeeding continues to be low in rural areas of Burkina Faso. As Exclusive breastfeeding is associated to lower morbidity and mortality risk, improving the skills of health providers to give adequate feeding support to the mothers is critical for promoting exclusively breastfeeding.

INTRODUCTION In order to cover the shortage of midwives (MWs) in the health district of Tougan, Burkina Faso, a strategy for the decentralization of emergency obstetric cares, based on ad hoc interventions undertaken by MW to manage obstetric complications in health centers (HCs), has been developed in rural areas. This study aimed to describe this experience and to analyze the achieved results. METHODS We conducted a cross-sectional, analytical, intervention study based on a review of routine data from all the parturients treated from 2013 to 2015. Data collection took place from 5 to 20 January 2016. Chi-square Test, odds ratios (ORs) and their 95% confidence intervals were calculated. RESULTS A total of 416 parturients with obstetric complications were treated by zonal MW. The average age of patients was 26.4 years. The median distance travelled to treat parturients was 15 km, with an average intervention period of 21.1 minutes (standard deviation = 7.13 minutes). Dystocias accounted for half (50.7%, CI95%= 45.8-55.6) of treated complications followed by hemorrhage (26.4%, CI95%= 22.3%-31.0%). More than 77% of interventions resulted in local resolution of obstetric complications. Finally, the intervention outcome was subject to the pathology treated (OR=5.88; p < 0.001). CONCLUSION This strategy was an answer to the shortage of MWs in the perypheral HCs in the health district of Tougan. In this particular context, this intervention could provide an alternative solution to the shortage of human resources for health in rural areas.

Children living with HIV should be diagnosed as early as possible and linked to antiretroviral treatment. The costs of HIV virological testing, individual and social implications of the disease require critical quality of the medical approach to diagnostic strategy. Socioeconomic data can be used to refine the medical decision. The objective of this analysis was to determine informative capacity of socioeconomic indices in the diagnosis and approach of HIV in severely malnourished children using receiver operating characteristic (ROC) curves. Materials and Methods: This was a test performance analysis conducted from data of severely malnourished children at an inpatient feeding therapeutic center in Ouagadougou. Anthropometric and social indices have been used as tests; their sensitivity, specificity and predictive values have been calculated. ROC curves and areas under curves were obtained. Medical decision aid scheme has been validated from severely malnourished children data. Results: Socioeconomic indices showed high performance to discriminate severely malnourished HIV infected and uninfected children, with high area under ROC curves. The medical decision aid scheme specificity reached 97.6% with predictive values close to 85%. Conclusion: This approach can help for expanding ART for children in low income countries and achieve the maximum ART benefits in child socioeconomic kneed context.

Severe anemia during pregnancy remains an acute maternal health problem in low income countries and its management is a challenge. This study aimed to analyze the characteristics of hospitalized pregnant women with severe anemia and issue of the management in a regional hospital of a low income country. Material and Methods: This was a retrospective descriptive study from January 1, 2007 to December 31, 2008, at a regional hospital maternity. Data of the 283 pregnancy severe anemia cases have been analyzed using usual Pearson’s Chi square test or Fisher’s exact test. Results: Of the 283 women with pregnancy severe anemia, 98% were illiterate, 98% were household women; majority were in the third trimester (64%); 41% had no previous delivery; 49% did not had antenatal care. There were no statistics association between hemoglobin values stage and gestational age, gravidity and parity. During the hospitalization, from the 283 women with pregnancy severe anemia, deliveries occurred on 22.6%; abortion on 1%. From the 64 deliveries, 45.3% were alive preterm birth, 20.3% preterm stillbirth, 25.0% at term birth and 9.4% at term stillbirth. Between the 45 alive babies, 91% were low birth weight. In global, from the 283 women, mortality rate was 2.8%. Conclusion: Severe anemia during pregnancy results in maternal mortality, preterm, low birth and stillbirth even between hospitalized women. As most of the pregnancy anemia risk factors are chronic poverty related factors, intervention must be focused on prevention including health pregnant women iron supplementation and adequate nutritional diet promoting at both health facilities and community level.

Individual causes and community determinants are synergic in maternal death occurrence. This study aimed to identify maternal mortality risk factors in a regional hospital. Material and Methods: This was a retrospective cohort study from data of 1807 hospitalized women. To identify maternal mortality risks factors, mortality hazard ratio (HR CI95%) has been calculated in univariate analysis and Cox proportional hazard model. Results: During hospitalization, 30 maternal deaths occurred. From Cox regression, adjusted mortality HR confirmed that women age older than 35 (HR = 2.5, CI95%: [1.2-5.7] and younger than 19 (HR = 3.02, CI95%: [1.5-6.7]); distance to hospital ≥10 Km (HR = 4.1, CI95%: [1.8-9.4]; multiple deliveries (HR = 2.4, CI95%: [1.1-7.3]), less ante natal care (

This study aimed to analyze the impact of anemia on mortality rate and nutritional recovery, during severely malnourished inpatient treatment. Material and Methods: This was a retrospective cohort study conducted from data of severely malnourished children hospitalized at a feeding the rapeutic center. Pearson’s Chi square test, General linear model, Mortality relatives risks, Kaplan-Meir survival curves have been used. Results: At admission, 85.3% of included malnourished children had anemia (Hb ≤ 11 g/dl) and 10.6% severe anemic (Hb 6 g/dl). Mortality rate did not differed significantly from severely malnourished children with anemia (12.4%) and without anemia (22.2%), p = 0.12. Kaplan Meir survival curves did not differed significantly between the two groups, (p Log Rank = 0.11). From admission to discharge, anthropometric Z-scores means evolution did not differed significantly between severely malnourished children with and without anemia at admission. But anthropometric Z-scores means evolution differed significantly within each group’s subjects: WHZ (between groups: p = 0.74; within subjects: p 0.001), and WAZ (between groups: p = 0.54; within subjects: p 0.001). Conclusion: With a strong respect of current recommendation of anemia treatment of inpatient severely malnutrition management, there is no increased mortality rate in SAM anemic group; and nutritional recovery is significant within subjects of SAM anemic and non anemic children, without difference between groups.

Appropriate use of antibiotics remains critical for success in achieving MDG4. The aim of this study was to investigate antibiotics prescribing practices to febrile under-five children outpatients in urban public health services in a low income country. Methods: From March to April 2013, a cross-sectional epidemiological study of care facilities visit by under-five age, for febrile illness, was carried out in urban health services in Bobo-Dioulasso, Burkina Faso. Patient demographics, diagnoses and medications were recorded. We calculated for each diagnoses several indicators for antibiotics use. Results: Our study showed an over-prescription of antibiotics at the university teaching hospital (78.08%) and at the first level facilities (57.71%) for under-five outpatients for febrile illness. There was evidence of high antibiotic prescription in children with diarrhea (more than 9 on 10 at university teaching hospital of diarrhea cases and 60% at the first level facilities), in children with Upper respiratory tract infections (respectively 60% and 85.2% of cases at university teaching hospital and at the first level facilities) and in children with malaria (respectively 47.5% and 17.6% of cases at university teaching hospital and at the first level facilities). Overuse, misuse and inappropriately prescribed antibiotic coexisted in our results: at university teaching hospital 90.9% of diarrhea cases, 60% of URTI cases, 47.5% of malaria cases received antibiotic prescription; at first level heath care facilities 85.2% of URTI, 17.6% of malaria cases received an prescribed antibiotic and 11.8% of LRTI did not received a prescribed antibiotic. Developing countries have poor access to newer antibiotics and irrational antibiotics use remains a global problem. Overuse and misuse of antibiotics combat, rigorous infectious diseases diagnosis, antimicrobial resistance consequences education of users and health professional’s prescribers, and improved surveillance of antimicrobial resistance, must be strengthened.

Background Noroviruses (NoV) are a leading cause of gastroenteritis worldwide. Few epidemiological data regarding the NoV strains circulating in African countries are available. Objectives To determine the prevalence of NoV in Bobo Dioulasso (Burkina Faso) in both symptomatic and asymptomatic gastroenteritis patients. Study design Patients both with and without gastro-intestinal disorders were selected. Clinical and epidemiological data, as well as stool samples, were collected through March to April 2011. NoV molecular detection (genogrouping and genotyping) and viral load quantification were also performed for all samples. Results NoV were detected in 22.2% of the 418 collected stool samples (21.2% and 24.8% from the 293 symptomatic patients (SP) and the 125 asymptomatic patients (ASP) respectively). Genogroup (G) distribution was 7.5%, 10.2% and 3.4% for GI, GII and both GI/GII respectively among SP and 12.0%, 11.2% and 1.6% for GI, GII and both GI/GII, respectively, among ASP. Average viral load values were higher in SP than in ASP for GI ( p = 0.03) but not for GII. Phylogenic analysis showed a high degree of genotype diversity in SP and ASP. One recombinant GII.7/GII.6 sequence was, to the best of our knowledge, detected for the first time. Conclusions This study enabled identification of the specific molecular epidemiology of NoV strains circulating in a representative country in Eastern Africa, and additionally showed that ASP could play an important “reservoir” role. A high strain diversity was detected with a surprisingly high proportion of NoV GI compared to the common genotypes usually reported in comparable epidemiological studies.

In low income countries, severe acute malnutrition remains a major problem for HIV-infected children and an important risk factor for mortality. This study aims to analyze HIV impact on mortality rate and nutritional recovery among severely malnourished HIV/AIDS uninfected and infected children. This was a retrospective cohort study conducted from data of 521 hospitalized severely malnourished children. We used Pearson’s Chi square test to compare proportions; and Student’s independent t-test to compare means; general linear model to analyze repeated measurements. We used mortality relative risk with confidence interval (CI 95%), Kaplan-Meir survival curves and Cox proportional hazard models to analyze the HIV impact on mortality rate. Case fatality rate differed significantly from SAM HIV uninfected (10.7%) and HIV infected children (39.7%), p cations have synergism on death occurrence in sever acute malnutrition; when associated to HIV infection, case fatality rate increases many times. Weight gain and anthropometrics index evolution were very slow for SAM HIV infected children, and specific diet may be needed for more nutritional recovery. Effective interventions, updated and adapting to local country context, to improve survival of severely malnourished HIV/AIDS infected children in HIV and SAM prevalent settings are urgently needed in the area of SAM’s community-based treatment approach.

Background Strokes are more and more frequent in the world, particularly in Africa. The evolution of their magnitude remains still poorly documented in the context of Burkina Faso, particularly in Bobo-Dioulasso. That is why this study was conducted to clarify the epidemiology of stroke and its risk factors in order to raise the alarm. Objective Investigate the evolution of the magnitude of stroke and its risk factors at the Teaching Hospital of Bobo-Dioulasso between 2009 and 2013. Methods It was a descriptive transversal type, retrospective collection, covering the period from January 1st 2009 to December 31st 2013. It focused on the medical records of adults admitted to hospital for stroke with (confirmed cases) or without brain scanner confirmation (not confirmed cases). Results The number of the included cases was 967. The average age was 61.06 years more or less 14.35 years, with a sex ratio of 1.58. They were on average 05.55% of admissions annually within the services involved in their care. Their number and their proportion among admissions have increased in overall during the period. Confirmed cases represented 34.23% of all the cases, with 38.37% of hemorrhagic strokes. When they had been well documented, the risk factors such as high blood pressure, smoking and diabetes were found respectively in 75.80%, 22.46% and 07.46% of all cases. The frequency of arterial hypertension and diabetes had an overall growing trend also. Conclusion Strokes are more and more frequent in Bobo-Dioulasso, just like its main risk factors high blood pressure and diabetes. It is urgent to prevent the latter in order to reduce the extent of the stroke.

Summary Similarities between humans and swine have been established on the basis of anatomic and physiologic characteristics. Consequently, the use of swine in biomedical research has increased over the last few decades. Most cardiopulmonary bypass (CPB) techniques in swine are only partial CPBs without cardiac arrest or aortic clamping. In addition, the post-operative period is often limited to a few hours. We decided to establish a swine model of total CPB with cardiac arrest and aortic clamping while allowing a post-operative period of 24 h. The purpose of this article is to describe our swine model that closely simulates the human situation in CPB surgery. Cardiac arrest with cardioplegia and aortic clamping was undertaken for 75 min. CPB was well-tolerated, and all pigs were weaned from it. Post-operative care was continued for 24 h. Hemodynamic and respiratory changes, characterized by reduced cardiac function, arrhythmias, and decreased oxygenation associated with ischemia-reperfusion and the inflammatory process under CPB, were recorded and compared to the same parameters in control pigs.

Facial fractures may be associated with concomitant lesions of other parts of body with some of these injuries being life-threatening. This retrospective study reports the types of associated injury and the factors influencing their occurrence, in patients with facial fractures. In 18.2% of 604 patients, one associated injury at least was recorded. The most common associated injury was cranial trauma (9.9%), followed by limbs fractures (9.1%), chest trauma (2%), spine injury (0.5%) and eye ball rupture (0.5%). A poly trauma was recorded in 3.2% of the patients who had sustained a cerebral trauma, a spinal injury or a thoracic trauma. Death occurred in two patients (0.3%) who had respectively a spinal injury and a chest trauma. The occurrence of associated injuries correlated significantly with the fracture type with solitary mandibular fracture being a significant predictor of associated injuries. Although not statistically significant, multiple facial fractures and violence were more associated with concomitant injuries. The findings of this study recall the need for initial full examination of the trauma patients particularly victims of violence, patients presenting with multiple facial fractures or single facial bone fracture involving the mandible, the trauma patients? multidisciplinary management as well as trauma prevention.

The pulmonary vascular and systemic effects of PGE1 were studied in a canine model of pulmonary hypertension. Systemic arterial, central venous and pulmonary arterial pressures were monitor

Experiments were designed to determine the role of products of cyclooxygenase in contractions of coronary smooth muscle evoked by serotonin. Rings of canine coronary artery without endothelium were suspended in organ chambers filled with modified Krebs-Ringer bicarbonate solution. Serotonin caused concentration-dependent contractions followed by secondary relaxations at higher doses. Indomethacin and meclofenamate augmented both the contraction and the relaxation. Indomethacin did not affect contractions evoked by increasing concentrations of either phenylephrine, prostaglandin F2 alpha, or potassium chloride. Propranolol did not affect the concentration-response curve to serotonin under control conditions; it prevented the facilitated contraction to the monoamine but not the augmented secondary relaxation caused by the inhibitors of cyclooxygenase. These results suggest that endogenous prostanoids simultaneously inhibit the contractile process and brake relaxations induced by higher concentrations of serotonin. As a consequence, inhibitors of prostanoid formation facilitate the vasospastic component of the response to the monoamine in large coronary arteries. For unknown reasons, propranolol prevents this facilitation.