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Wedminere Noëlie Zoungrana-Yameogo,1 Lucresse Corine Fassinou,2 Calypse Ngwasiri,3 Sekou Samadoulougou,4,5 Isidore Tiandiogo Traoré,1,6 Hervé Hien,1,6 Fidèle Bakiono,7 Maxime Drabo,8,9 Fati Kirakoya-Samadoulougou3 1Service d’information et d’épidémiologie, Centre Hospitalier Universitaire de Tengandogo, Ouagadougou, Burkina Faso; 2Institut Supérieur des Sciences de la Santé, Université Nazi Boni, Bobo-Dioulasso, Burkina Faso; 3Centre de Recherche en Epidémiologie, Biostatistique et Recherche Clinique, Ecole de Santé Publique, Université Libre de Bruxelles, Bruxelles, Belgique; 4Evaluation Platform on Obesity Prevention, Quebec Heart and Lung Institute, Quebec, QC, G1V 4G5, Canada; 5Centre for Research on Planning and Development (CRAD), Université Laval, Quebec, QC, G1V 0A6, Canada; 6Centre Muraz, Institut National de Santé Publique, Bobo-Dioulasso, Burkina Faso; 7Secrétariat Permanent du conseil national de lutte contre le SIDA et les infections sexuellement transmissible, ministère de la santé, Ouagadougou, Burkina Faso; 8Département biomédical et santé publique, Institut de recherche en sciences de la santé, Ouagadougou, Burkina Faso; 9Laboratoire de santé publique de l’Ecole doctorale des sciences de la santé (ED2S), Université Joseph Ki Zerbo Ouagadougou, Ouagadougou, Burkina FasoCorrespondence: Lucresse Corine Fassinou, Institut Supérieur des Sciences de la Santé, Université Nazi Boni, Bobo-Dioulasso, Burkina Faso, Email corinefas123@gmail.comBackground: Since the scale-up of antiretroviral therapy (ART) services in Burkina-Faso, achieving an AIDS-free generation depends on optimal ART adherence. However, no data exists on the population group differences on the level of ART adherence in Burkina-Faso. This study analyzes ART adherence among pregnant-and breastfeeding-women, non-pregnant women, and men in Burkina-Faso.Methods: From December 2019 to March 2020, a cross-sectional study among adult HIV-infected patients in Burkina-Faso, belonging either to the active file or the Prevention of Mother-To-Child Transmission programs was conducted. An analysis was performed and adherence was measured based on the number of times, patients did not meet the number of doses prescribed and did not take the ART treatment in the month prior to the survey. Logistic-regression models were used to identify factors associated with poor ART adherence and the adjusted odds ratios (aORs) with their 95% confidence intervals (95% CI) were reported.Results: The prevalence of good adherence was higher in the group of pregnant-and breastfeeding-women (86.6%, n = 112) compared to the other groups (73.1%, n=1017 in non-pregnant women and 72.0%, n = 318 in men). No association was found between ART adherence and the socio-demographic, clinical, and therapeutic characteristics of pregnant-and breastfeeding-women and men groups. However, non-pregnant women with a high level of education (aOR = 1.70; 95% CI: 1.16– 2.49), having ever belonged to a support group (aOR= 1.47; 95% CI: 1.07– 2.04), not having income-generating occupations (aOR= 1.53; 95% CI: 1.11– 2.12), and in advanced clinical stage (aOR= 1.42; 95% CI: 1.06– 1.91) were more susceptible to have poor adherence compared to their pairs.Conclusion: Findings showed a large difference in ART adherence among pregnant-and breastfeeding-women, non-pregnant women and men and highlight the need for differentiated healthcare delivery according to population while specifically considering addressing the interest in early initiation of treatment and the benefit of support groups meeting.Keywords: adherence, HIV, antiretroviral therapy, PMTCT, Burkina Faso

Copyright of Mali Médical is the property of Mali Medical, Faculte de Medecine, de Pharmacie et d'Odonto-stomatologie and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Toussaint Rouamba,1,* Houreratou Barry,2,* Esperance Ouédraogo,1 Marc Christian Tahita,1 Nobila Valentin Yaméogo,3 Armel Poda,4 Arnaud Eric Diendéré,5 Abdoul-Salam Ouedraogo,4 Innocent Valea,1 Amariane M Koné,2 Cherileila Thiombiano,2 Isidore Traoré,2 Zekiba Tarnagda,1 Serge A Sawadogo,6 Zakaria Gansané,7 Yibar Kambiré,8 Idrissa Sanou,8 Fatou Barro-Traoré,8 Maxime K Drabo,1 Halidou Tinto1 On behalf of the CHLORAZ Study Group1Institut de Recherche en Sciences de la Santé (CNRST-IRSS), Nanoro, Burkina Faso; 2Institut National de Santé Publique, Centre Muraz, Bobo-Dioulasso, Burkina Faso; 3Centre Hospitalier Universitaire Yalgado Ouédraogo, Ouagadougou, Burkina Faso; 4Centre Hospitalier Universitaire Sourou Sanon, Bobo-Dioulasso, Burkina Faso; 5Centre Hospitalier Universitaire de Bogodogo, Ouagadougou, Burkina Faso; 6Centre PrïmO Nelson Mandela (Promotion de la Recherche et de l’Innovation en Immunologie Médicale de Ouagadougou), Ouagadougou, Burkina Faso; 7Clinical Monitoring in Africa-Clinical Research Organization, Ouagadougou, Burkina Faso; 8Centre Hospitalier Universitaire de Tengandogo, Ouagadougou, Burkina Faso*These authors contributed equally to this workCorrespondence: Toussaint RouambaInstitut de Recherche en Sciences de la Santé (CNRST-IRSS), 528, Avenue Kumda-Yoore, BP 218 Ouagadougou CMS 11, Ouagadougou, Nanoro, Burkina FasoTel +226 666 532 04Email rouambatoussaint@gmail.comIntroduction: Though chloroquine derivatives are used in the treatment of coronavirus disease 2019 (COVID-19) in many countries worldwide, doubts remain about the safety and efficacy of these drugs, especially in African communities where published data are scarce.Methods: We conducted an observational prospective cohort study from April 24 to September 03, 2020, in Burkina Faso to assess (as primary outcome) the clinical, biological, and cardiac (electrocardiographic) safety of chloroquine or hydroxychloroquine plus azithromycin administered to COVID-19 patients. The main secondary outcomes were all-cause mortality and median time of viral clearance.Results: A total of 153 patients were enrolled and followed for 21 days. Among patients who took at least one dose of chloroquine or hydroxychloroquine (90.1% [138/153]), few clinical adverse events were reported and were mainly rash/pruritus, diarrhea, chest pain, and palpitations. No statistically significant increase in hepatic, renal, and hematological parameters or electrolyte disorders were reported. However, there was a significant increase in the QTc value without exceeding 500ms, especially in those who received chloroquine phosphate. Three adverse events of special interest classified as serious (known from chloroquine derivatives) were recorded namely pruritus, paresthesia, and drowsiness. One case of death occurred. The average onset of SARS-CoV-2 PCR negativity was estimated at 7.0 (95% CI: 5.0– 10.0) days.Conclusion: Hydroxychloroquine appeared to be well tolerated in treated COVID-19 patients in Burkina Faso. In the absence of a robust methodological approach that could generate a high level of scientific evidence, our results could at least contribute to guide health decisions that should be made based on different sources of scientific evidence including those from our study.Keywords: SARS-CoV-2, chloroquine, hydroxychloroquine, azithromycin, safety, virus shedding

Copyright of Médecine et Santé Tropicales is the property of John Libbey Eurotext Ltd. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Abstract Background A prospective study aiming at assessing the effect of adding a third dose sulphadoxine-pyrimethamine (SP) to the standard two-dose intermittent preventive treatment for pregnant women was carried out in Hounde, Burkina Faso, between March 2006 and July 2008. Pregnant women were identified as earlier as possible during pregnancy through a network of home visitors, referred to the health facilities for inclusion and followed up until delivery. Methods Study participants were enrolled at antenatal care (ANC) visits and randomized to receive either two or three doses of SP at the appropriate time. Women were visited daily and a blood slide was collected when there was fever (body temperature > 37.5°C) or history of fever. Women were encouraged to attend ANC and deliver in the health centre, where the new-born was examined and weighed. The timing and frequency of malaria infection was analysed in relation to the risk of low birth weight, maternal anaemia and perinatal mortality. Results Data on birth weight and haemoglobin were available for 1,034 women. The incidence of malaria infections was significantly lower in women having received three instead of two doses of SP. Occurrence of first malaria infection during the first or second trimester was associated with a higher risk of low birth weight: incidence rate ratios of 3.56 (p < 0.001) and 1.72 (p = 0.034), respectively. After adjusting for possible confounding factors, the risk remained significantly higher for the infection in the first trimester of pregnancy (adjusted incidence rate ratio = 2.07, p = 0.002). The risk of maternal anaemia and perinatal mortality was not associated with the timing of first malaria infection. Conclusion Malaria infection during first trimester of pregnancy is associated to a higher risk of low birth weight. Women should be encouraged to use long-lasting insecticidal nets before and throughout their pregnancy.

Abstract Background Intermittent preventive treatment with sulphadoxine-pyrimethamine (IPTp-SP) is being implemented in most malaria endemic countries as a standard two-doses regimen as it reduces the risk of low birth weight (LBW) and the prevalence of maternal anaemia. Nevertheless, where the risk of infection close to delivery is high because of intense transmission, a third IPTp-SP dose may further reduce the negative effects of malaria on pregnancy outcome. Methods Pregnant women in the 2nd or 3rd trimester were randomized to receive either 2 (SP2) or 3 doses (SP3) of SP. Trained field workers paid home visits to the women for drug administration according to a predefined drug delivery schedule. Women were encouraged to attend their scheduled ANC visits and to deliver at the health facilities where the new-born was weighed. The prevalence of LBW ( Results Data from 1274 singleton pregnancies were analysed (641 in the SP3 and 633 in the SP2 group). The uptake of the intervention appeared to be low. Though the prevalence of LBW in both intervention groups was similar (adjusted Incident Rate Ratio, AIRR = 0.92, 95%CI: 0.69-1.24) in the ITT analysis, the risk of severe anaemia was significantly lower in the SP3 group compared to the SP2 group (AIRR = 0.38, 95%CI: 0.16 - 0.90). The PP analysis showed a trend of reduced risk of LBW, severe anaemia and premature delivery in the SP3 group, albeit the difference between two and three IPTp-SP did not reach statistical significance. Conclusion The risk of LBW and severe anaemia tended to be lower in the SP3 group, though this was not statistically significant, probably due to the low uptake of the intervention which reduced the power of the study. Further studies are needed for establishing whether a third SP dose has a real benefit in preventing the negative effects of malaria in pregnancy in settings where transmission is markedly seasonal.

With reductions in the malaria burden stalling in the past years, gene drive holds promise as a novel way of reducing disease transmission. Governance and decision-making processes are pivotal aspects of the legitimate adoption of this technology. Here, the authors explore Target Malaria's journey in developing a community agreement model for the release of non-gene drive genetically modified mosquitoes. They describe the iterative development of the model, including consultations with experts, stakeholder engagement, and alignment with principles of procedural justice. Several challenges were identified during its development, including defining communities, ensuring adequate information, consultation, monitoring, and achieving a common decision between dissenting and consenting viewpoints. They underscore the complexity of developing a legitimate model and emphasize the importance of transparency, procedural legitimacy, and adherence to ethical principles. This paper does not describe the model itself, which will be the subject of another paper. Instead it focuses on the process, to share this experience with other projects-those working with gene drive, or any other projects requiring a community-level decision-making process. The model builds on Target Malaria's experience with the release of genetically modified sterile male mosquitoes, to address the challenges posed by modified mosquitoes which are fertile and would therefore be expected to persist longer in the environment and spread further than the sterile male mosquito strains. While the level of spread and persistence of these non gene drive, but fertile, modified mosquitoes are expected to be substantially lower than those of the gene drive mosquitoes, the process is an essential advance in accommodating the broader geographical and temporal concerns associated with the more permanent spread of gene drive mosquitoes. The work described here constitutes part of the evolution of a community agreement process that could be applied to proposals for releases of gene drive mosquitoes for malaria control. In describing this process, Target Malaria hopes to contribute to the ongoing dialogue on good practices for community agreement engagement in research for genetic vector control approaches and to share the experience of building legitimacy while designing such agreement models., Competing Interests: Declarations. Ethics approval and consent to participate: Not applicable. Consent for publication: As this paper does not disclose any individual information from participants, specific consent for publication was not sought. Competing interests: All the authors are part of or consultants to Target Malaria., (© 2024. The Author(s).)

The CO 2 reduction reaction (CO 2 RR) is a feasible way to convert this greenhouse gas into molecules of industrial interest. Herein we present the modification of the Cu foam cathode using molecular catalyst hybrid from cobalt phthalocyanine (CoPc) to increase selectivity and stability towards CO 2 RR products in a flow cell setup.

From 2012 to 2023, the Malaria Research and Training Center (MRTC), based out of the University of Sciences, Techniques and Technologies of Bamako (USTTB), was part of the Target Malaria research consortium working towards developing novel gene drive-based tools for controlling populations of malaria vector mosquitoes. As part of this work, Target Malaria Mali has undertaken a range of in-depth engagement activities with the communities where their research is conducted and with other stakeholders nationally. These activities were meant to ensure that the project's activities took place with the agreement of those communities, and that those communities were able to play a role in shaping the project's approach to ensure that its eventual outcomes were in line with their needs and concerns. This paper aims to conduct a critical assessment of those 10 years of stakeholder engagement in order to identify good practices which can inform future engagement work on gene drive research in West Africa. It sets out a range of approaches and practices that enabled the Target Malaria Mali team to engage a variety of stakeholders, to share information, collect feedback, and determine community agreement, in a manner that was inclusive, effective, and culturally appropriate. These can be useful tools for those working on gene drive research and other area-wide vector control methods in West African contexts to ensure that their research is aligned with the interests of the communities who are intended to be its ultimate beneficiaries, and to allow those communities to play a meaningful role in the research process., Competing Interests: Author BR and IC was employed by Emerging Ag, Inc. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Dicko, Kodio, Samoura, Traoré, Sykes, Drabo, Thizy, Coche, Robinson, Sanogo, Yagouré, Diop and Coulibaly.)

An electrodeposition technique of low-enriched uranium onto boron-doped diamond (BDD) electrodes for uranium electro-assembling, sequestration, uranium electrowinning (as the electroextraction alternative), and future neutron detection applications has been developed. Our findings through physicochemical characterization and an in-depth XPS analysis show that the U/BDD system consists of a blend of uranium oxides with IV, V, and VI oxidation states. Results show that U 5+ is present and stable under open atmospheric conditions. The U electrodeposition on BDD creates smooth surfaces, free of voids, with uniform deposition of homogeneous tiny particles of stable uranium oxides, instead of chunky particles, and uranium compound mixtures, like large fibers of the precursor uranyl. Our electrochemical method operates without high temperatures or hazardous compounds. Uranium corrosion and oxidation processes occur spontaneously and parallel to the electrochemical formation of metallic uranium on BDD electrode surfaces, with metallic uranium reacting with water, producing fine particles of UO 2 . This work represents the first attempt to create a surface of uranium oxides, where the film thickness can be controlled for future applications, e.g. , improving sensitivity in neutron detection technologies. Our U electro-assembling method provides a sustainable strategy for uranium electro-recovery from nuclear wastes, immobilizing uranium as a storage method or as U-film fabrication (U/BDD) for future neutron detection applications. Besides, this work contributes to uranium-based technologies, improving them and providing a better understanding of their electrochemical properties, e.g. , uranium redox processes, uranium oxides' formation, and stability evaluation. These properties are of remarkable need for uranium-based target formation. The use of our U/BDD method is proposed as an environmental protocol to recover and immobilize uranium-235, and other fissile materials, from civil and defense wastes, contaminated systems, and stockpiles., Competing Interests: The authors declare no competing financial interest., (© 2023 The Authors. Published by American Chemical Society.)

Introduction: In Burkina Faso, the first cases of COVID-19 were reported in March 2020. Health personnel are on the front line of COVID-19 control, and it is important to understand their perceptions and knowledge of the disease. The objective was to determine the knowledge and perceptions of healthcare personnel of COVID-19 in the city of Ouagadougou., Method: The study was conducted in five plots in the city of Ouagadougou. A total of 20 health workers from public and private health centers in the city of Ouagadougou were selected during May 2020. In-depth individual interviews were conducted, and a thematic analysis was performed using NVIVO., Results and Discussion: The routes of transmission identified were promiscuity, respiratory tract, and physical contact. Various symptoms have been noted, such as fever, cough, and runny nose. However, they recognize that these symptoms are not sufficient to make a diagnosis of COVID-19. Similarly, the treatments mentioned are modern medicine and phytomedicine., Conclusion: The research has generated information on healthcare workers' knowledge and perceptions of COVID-19. Therefore, they are useful for decision-making regarding protective measures for health workers in the management of COVID-19., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2023 Yaya Bocoum, Kadio, Some, Ouedraogo, Drabo and Kouanda.)

Gene drive mosquitoes are increasingly considered a potential transformational tool for vector control of malaria mosquitoes. As part of efforts to promote responsible research in this field, a number of guidance documents have been published by the World Health Organization, National Academies and expert groups. While virtually all recent guidance documents on gene drive research stress the importance of stakeholder engagement activities, no specific guidelines on implementing them have been established. Target Malaria, a not-for-profit research consortium developing a vector-control gene drive approach to eliminate malaria, has reflected on how its stakeholder engagement strategy translates engagement guidance documents into practice. The project analysed and addressed the tension between the context specificities and the international recommendations. The engagement strategy combines published recommendations for responsible gene drive research, information collected from the local context where the project operates and a set of principles guiding the choices made. This strategy was first developed during the early phases of the project's research, years ahead of any activities with gene drive mosquitoes in those countries of operations. These earlier activities, and their related engagement, allow the project to develop and adapt an engagement strategy appropriate for potential gene drive research in its field site countries. This paper offers a description of a stakeholder engagement strategy operationalization based on (1) adaptation to stakeholder preferences, (2) inclusiveness and (3) empowerment and accountability. The authors hope to offer concrete examples to support other projects with the development and implementation of their engagement strategies with particular attention to the co-development principle., (© 2022. The Author(s).)

Every year, malaria kills approximately 405,000 people in Sub-Saharan Africa, most of them children under the age of five years. In many countries, progress in malaria control has been threatened by the rapid spread of resistance to antimalarial drugs and insecticides. Novel genetic mosquito control approaches could play an important role in future integrated malaria control strategies. In July 2019, the Target Malaria consortium proceeded with the first release of hemizygous genetically-modified (GM) sterile and non-transgenic sibling males of the malaria mosquito Anopheles coluzzii in Burkina Faso. This study aimed to determine the potential fitness cost associated to the transgene and gather important information related to the dynamic of transgene-carrying mosquitoes, crucial for next development steps. Bayesian estimations confirmed that GM males had lower survival and were less mobile than their wild type (WT) siblings. The estimated male population size in Bana village, at the time of the release was 28,000 - 37,000. These results provide unique information about the fitness and behaviour of released GM males that will inform future releases of more effective strains of the A. gambiae complex., (© 2022. The Author(s).)

Goals: We studied the socio-demographic and paraclinicalcharacteristics of tuberculosis patients to identify the factors associated with their deaths in Bamako., Materials and Methods: A retrospective cohort study was carried out on tuberculosis patients registered in Bamako from October 1, 2017 to September 30, 2018. Quantitative variables were presented by their mean, qualitative ones by their proportions. Analysis was performed with R version 3.5.0., Results: Out of 2396 patients enrolled, 25 to 45-year olds represented 50.3% and children 4.51%; the average age 37.3 years; the sex ratio M/F 1.94 and co-infected TB/HIV 8.64%. 25 to 45 year olds (HR=2.58; 95% CI [1.35-4.92]; p=0,0042) and those ≥ 46 years (HR=4.64; 95% CI [2.39-9.01] ; p=5.69e -06 ) and positive HIV status (HR= 5.87 ; 95% CI [2.24-15.41] ; p= 0.0003) were associated with an increased risk of patient death., Conclusion: Tuberculosis affects young and old males. The risks of death identified were the patient's age and positive HIV status. We recommend specific monitoring of patients aged 25 to 45 and 46 and over and those with positive HIV status., (Le comité de rédaction se réserve le droit de renvoyer aux auteurs avant toute soumission à l'avis des lecteurs les manuscrits qui ne seraient pas conformes à ces modalités de présentation. En outre il leur conseille de conserver un exemplaire du manuscrit, des figures et des tableaux.)

Background: Innovative tools are needed to complement the existing approach for malaria elimination. Gene drive mosquitoes are one potential new technology in the control of malaria vectors. Target Malaria is one of the research projects developing this technology, and in July 2019, the project proceeded to an important step for this evaluation pathway: the small-scale release of non-gene drive sterile male mosquitoes in a village in Burkina Faso. In addition to the entomological and laboratory work to prepare for this important milestone, significant community and stakeholder engagement work was done. The existing guidelines on gene drive mosquito provide an overall framework for such engagement work. However, they do not provide a road map on how to proceed or what benchmarks should be used to assess this work., Methods: This study provides a review of engagement activities relevant to field trials on non-gene drive genetically-modified mosquitoes as well as an assessment framework-using both qualitative and quantitative studies as well as an audit procedure. The latter was implemented to evaluate whether the release activities could proceed with the appropriate level of agreement from the community., Results: This paper shows the importance of this first phase of work to innovate and learn about engagement processes for responsible research in the field of genetic approaches for malaria vector control. The function of these assessments is crucial for the learning agenda. The assessments demonstrated ways to increase understanding and ensure effective progress with field studies and, therefore, the pathway for responsible research., Conclusion: Gene drive technology is increasingly considered as a promising approach to control vector borne diseases, in particular malaria. Stakeholders' involvement in this research process is one of the recurring requirements in international guidance documents. With this paper Target Malaria offers an opportunity to explore the practical achievements and challenges of stakeholder engagement during early phases of a technology evaluation, and in particular how it implemented an assessment framework to learn from its experience., (© 2021. The Author(s).)

Stakeholder engagement is an essential pillar for the development of innovative public health interventions, including genetic approaches for malaria vector control. Scientific terminologies are mainly lacking in local languages, yet when research activities involve international partnership, the question of technical jargon and its translation is crucial for effective and meaningful communication with stakeholders. Target Malaria, a not-for-profit research consortium developing innovative genetic approaches to malaria vector control, carried out a linguistic exercise in Mali, Burkina Faso and Uganda to establish the appropriate translation of its key terminology to local languages of sites where the teams operate. While reviewing the literature, there was no commonly agreed approach to establish such glossary of technical terms in local languages of the field sites where Target Malaria operates. Because of its commitment to the value of co-development, Target Malaria decided to apply this principle for the linguistic work and to take the opportunity of this process to empower communities to take part in the dialogue on innovative vector control. The project worked with linguists from other institutions (whether public research ones or private language centre) who developed a first potential glossary in the local language after better understanding the project scientific approach. This initial glossary was then tested during focus groups with community members, which significantly improved the proposed translations by making them more appropriate to the local context and cultural understanding. The stepwise process revealed the complexity and importance of elaborating a common language with communities as well as the imbrication of language with cultural aspects. This exercise demonstrated the strength of a co-development approach with communities and language experts as a way to develop knowledge together and to tailor communication to the audience even in the language used.

Objective: to study the factors associatedlost to follow-up in People Living with HIV on antiretroviral therapy (ART) at the Ambulatory Treatment Center (ATC)., Methods: This is a retrospective case-control study of two years. It concerned all HIV-infected patients aged 15 and over who were started on ART for at least 4 months. Each case was matched with two controls by sex and age ± 5 years., Results: The proportionlost to follow-up was 21%.The median age lost to follow-up was 36 years (IQR: 30-42 years), sex ratio was 1.4 in favor of women. The median initial CD4 cell count was 151 cells / mm 3 (IQR: 51-245) versus 207 (IQR: 67-482) for controls and the median lost to follow-up was 6 months (IQR: 4-9 months): 5-16) for controls. In multivariate analysis, the factors associated lost to follow-up were: unmarried (adjusted OR = 3.84, P = 0.0346); the initial CD4 <200 cells / mm3 (adjusted OR = 3.88, P = 0.0393) and the duration of ARV <= 6 months (adjusted OR = 6.59, P = 0.0047). The protective factors against lost to follow-up were: Body Mass Index of the last visited > = 18.5 kg / m2 (adjusted OR = 0.07, P = 0.0069); (OR adjusted = 0.06, P = 0.0197) and initiation to ART in the rainy season (adjusted OR = 0.21, P = 0.0220)., Conclusion: These results can be supplemented by quantitative and qualitative studies., (Le comité de rédaction se réserve le droit de renvoyer aux auteurs avant toute soumission à l'avis des lecteurs les manuscrits qui ne seraient pas conformes à ces modalités de présentation. En outre il leur conseille de conserver un exemplaire du manuscrit, des figures et des tableaux.)

Background: Most field entomology research projects require active participation by local community members. Since 2012, Target Malaria, a not-for-profit research consortium, has been working with residents in the village of Bana, in Western Burkina Faso, in various studies involving mosquito collections, releases and recaptures. The long-term goal of this work is to develop innovative solutions to combat malaria in Africa with the help of mosquito modification technologies. Since the start of the project, Bana residents have played an important role in research activities, yet the motivations and expectations that drive their participation remain under-investigated. This study examines the factors that motivate some members of the local community to contribute to the implementation of Target Malaria's activities, and, more broadly, explores the reasons that animate citizen participation in entomological research work in malaria-endemic regions., Methods: A qualitative approach was used to survey the factors motivating members of the local community to assist in the implementation of Target Malaria's entomological research activities in Bana. Eighty-five individual in-depth and semi-structured interviews were conducted, followed by three focus groups, one with youths who had participated in mosquito collections, and two with adult men and women from the village. All data collected were fully transcribed, processed, and subjected to thematic content analysis., Results: Data showed that the willingness of local community members to participate in entomological research activities was informed by a wide range of motivational factors. Although interviewees expressed their motivations under different semantic registers, the data showed a degree of consistency around five categories of motivation: (a) enhance domestic protection from mosquitoes and malaria, (b) contribute to a future world free of the disease, (c) acquire knowledge and skills, (d) earn financial compensation, and (e) gain social prestige for the village., Conclusion: These varying motivations reflect a set of differing personal and collective perceptions about the participation process, combining short and long-term, individual and collective motivations. Beyond the specific circumstances of this case, the study highlights the complex reasons that drive collective participation in entomological research and vector control activities. Detailed knowledge of community expectations should underpin any effort to mobilize local participation in field research activities.

Introduction: The Central East region of Burkina Faso has vaccine coverage which is among the lowest in the country with an epidemiological profile marked by the occurrence of measles or meningitis outbreaks. This study was conducted with the aim of carrying out an equity analysis of the organization of immunization services in this region in order to identify factors that cause potential inequities in vaccination offer., Materials and Method: This descriptive cross-sectional study covered the seven districts in the Central East region. Data collection was done in two weeks combined with observation method, individual interviews and document review. Part of the data was collected using a self-administered questionnaire. The data analysis was performed with the Epi info 7 software using a plan designed for this purpose., Results: A total of 144 health centers in the region (93.0% coverage) were surveyed. The average distance between villages and health facilities was 5.2 km with 16.2% of villages that were located more than 10 km from a health facility. Health centers had an average of four health workers, however the urban health centers had more workers than those in rural areas. About 16% of the villages did not benefit from an on-site vaccination trip due to the unavailability of transport logistics. More than half of the health centers (53.9%) had experienced vaccine shortages in the last six months before the study. More than 5,000 safety boxes containing used syringes were stored in the districts of the region., Conclusion: This study identified factors potentially responsible for an inequity in providing vaccination services in the Central East region. These factors include, but are not limited to, the geographical distribution of the health centers, the availability of transport logistics, and the shortage in vaccines and deficiencies in the waste disposal system. Concerted actions should be developed, involving all stakeholders in the health system in order to address these issues.

Background: Little is known about the organization of primary care facilities in sub-Saharan Africa that might lead to potentially inappropriate prescribing. The aim of this study was to analyze the factors that could lead to potentially inappropriate prescribing in primary care facilities in Bobo-Dioulasso (Burkina Faso), taking into consideration the patient's perspective., Methods: A cross-sectional qualitative study was conducted in primary care facilities from November 2013 to February 2014. People aged 60 years or more with at least one chronic disease were included. Individual interviews were conducted. An analysis of the thematic content of the interviews was conducted., Results: Our results showed that the patient referral system was insufficient. We also found many different prescribers for older people seeking care and poor communication between prescribers and patients. This caused some consequences such as the absence of review of drugs consumed before a new prescription, a lack of exchange on medication changes and repeated treatment change during hospitalization. Most of the persons who prescribed potentially inappropriate medications were nurses., Conclusion: The poor communication between prescribers and patients is a challenge for the prevention of prescribing potentially inappropriate medications. Teamwork is an important feature of the organizational care system, strengthening it could be a way to improve rational prescription., (Copyright © 2015 Elsevier Masson SAS. All rights reserved.)

In sub-Saharan Africa, various studies have been conducted on severe disability in activities of daily living, instrumental or domestic activities. These studies have reported different rates without describing the social context for understanding their results. This study was conducted in Burkina Faso to fill the gaps in scientific information on disability in these areas. We conducted a cross-sectional descriptive study in Bobo-Dioulasso among the older population, aged 60 and above. Their functional status was evaluated using the Functional Autonomy Measurement System (SMAF). Data analysis was done with the help of Stata. A systematic random sample of 351 aging adults was interviewed. Moderate to severe functional disability or the need for supervision or assistance was present in 7% in activities of daily living and 86% in instrumental or domestic activities of daily living. This need for assistance varied according to the different activities or items in each domain. The proportions of disability found in this study are higher than those of previous studies that measured the often severe disabilities. All persons with disability claimed to have stable human resources which help them to manage their disabilities. The social context instrumental or domestic activities of daily living are divided by generation and/or by sex. That explains some results. With this division, it's inacceptable in some family that elders and/or old men do instrumental or domestic activities of daily living as prepare meals, do laundry, carry water to wash. The variation of this division from one family to another complicates the assessment of functional disability. To best manage elders disabilities, strategies must develop to: 1) retard the resignation of the family in care of its elderly in functional disability, 2) anticipate the preparation of formal social networks, public structures to support the elderly.

Background: Delivery of quality care remains a major challenge for all heathcare institutions. The 5S quality control scheme was applied in the Ouidah hospital zone in Benin starting in 2012. The objective of the present survey was to evaluate its impact in 2013., Methods: This was a descriptive and analytic survey of the Ouidha hospital zone. Three techniques – interview, observation, review – were used to collect data from the healthcare staff, hospital users, and documents describing the strategy of the implementation., Results: Implementation of the 5S strategy was considered, on average, to be "satisfactory" with scores of 56% for context, 61% for inputs, and 51% for processes. The internal and external users judged care delivery "very satisfactory" with a score of 79%., Conclusion: Although the results appear satisfactory, the future hospital policy must strengthen the quality insurance process, ensure the availability of management tools, and provide training and further motivation for the "5S" management teams., (Copyright © 2014 Elsevier Masson SAS. All rights reserved.)

World Health Organization estimates indicate 216 million malaria episodes in 2010, including 81% in the African region. One of the recommended means of prevention in pregnant women is intermittent preventive treatment, until 2012, two doses of sulfadoxine/pyrimethamine or three doesfor a woman living with HIV In the Pobè-Adja-Ouèrè-Kétou health zone of Benin, coverage ofintermittent preventive treatment remains low (49% against a forecast of 80%) several years after implementation of this strategy. We conducted a cross-sectional study in June and July 2012 to identify factors associated with low intermittent preventive treatment coverage in this area. A total of 339 women were interviewed and 48% ofthem received less than two doses of sulfadoxine pyrimethamine during their prenatal consultations. The variables associated with low intermittent preventive treatment coverage were low antenatal care coverage (p < 0.001) and a prenatal consultation in the private sector (p = 0.039). In the light of our results, actions must be taken by this health zone to encourage women to complete the four visits during pregnancy.

Background: Globally, a significant increase in functional disability among the elderly is expected in the near future. It is therefore vital to begin considering how Sub-Saharan Africa countries can best start building or strengthening the care and support system for that target population. Study objectives are: 1) identify the key actors of the social system who maintain elders in functional autonomy at home in Bobo-Dioulasso (Burkina Faso) and 2) to describe the functional status of older people living at home., Methods: We conducted a longitudinal descriptive study among the elderly aged 60 and above (351). Their functional status was evaluated using the Functional Autonomy Measurement System (SMAF). Data analysis was done using the statistical software package STATA (SE11)., Results: In Bobo-Dioulasso, 68% of seniors have good functional capacity or a slight incapacity and 32% have moderate to severe incapacities. Older people die before (3%) or during (14%) moderate to severe disabilities. This would mean that the quality of medical and/or social care is not good for maintaining functional autonomy of older people with moderate to severe disabilities. Two main groups of people contribute to maintain elders in functional autonomy: the elderly themselves and their family. Community, private or public structures for maintaining elders in functional autonomy are non-existent. The social system for maintaining elders in functional autonomy is incomplete and failing. In case of functional handicap at home, the elders die. But stakeholders are not conscious of this situation; they believe that this system is good for maintaining elders in functional autonomy., Conclusion: It is likely that the absence of formal care and support structure likely shortens the lifespan of severely disabled older people. Stakeholders have not yet looked at this possibility. The stakeholders should seriously think about: 1) how to establish the third level of actors who can fulfill the needs to maintain elders in functional autonomy that are not satisfied by others (family members or the older individuals themselves), and 2) how to reinforce the role of each actor and the collaboration between the different groups of people of this system.

Background: In sub-Sahara Africa, the strong involvement of the family in multidimensional cares/supports of elderly is often presented like the family ensures almost everything to these people. Thus, few studies have focused on unmet needs of the elderly in their family or above. This study was conducted in Bobo-Dioulasso to identify those needs., Methods: This is a longitudinal study including 58 people or 15 elderly and 43 caregivers from 15 families in Bobo-Dioulasso. In addition to regular observations of these families during 1 year, we conducted in-depth individual interview with each participant at the beginning and at the end of the study. The data were analyzed using QSR NVivo 8 software., Results: A priori, respondents let believe that there is no unmet functional needs of the elderly in their family. However, the food, the first and main functional need of the elderly is not qualitatively satisfied by their family as well as other equipments or health needs. The quality of social cares/supports, biomedical cares and community supports are insufficient when these cares/supports are provided. The family demands many free or subsidized services to public or community structures then they are not currently available., Discussion: In a context of widespread poverty, it is difficult for each actor of the social system of maintaining elderly in functional autonomy to provide services/supports of optimal quality. A synergy of action will reduce the unmet needs of the elderly in Bobo-Dioulasso., (Copyright © 2013 Elsevier Masson SAS. All rights reserved.)

It is a retrospective study in the Service of Dermatology at the University Hospital Center Yalgado Ouédraogo of Ouagadougou (C.H.U.-YO). This study aimed to list the leishmaniasis clinical cases reported in the registers of this department from January 1999 to December 2007. In total, 251 leishmaniasis clinical cases have been reported. The hospital prevalence was 1,1%. Women represented 53% versus 47% men. The average age of patients was 22,78 ans +/- 121. The most frequent clinical forms were those often crusted (40.2%), papulo ulcerative (16.7%) and papulonodular (13.9%). Lesions most often sat on the lower limbs (33%) and thoracic limbs (45%). On the therapeutic level, the first line treatment meglumine antimonite (Glucantime) accounted for only 25.9% of prescriptions.

Introduction: As a result of ageing of the population, most countries of sub-Saharan Africa, either spontaneously and/or in response to international incentives, are starting to develop sectorial or multisectorial action plans in favour of the elderly. Are these plans relevant and consistent and do they improve the health of the elderly? This study was performed to assess the relevance, consistency and implementation of the National Health Programme for the Elderly (PNSPA) 2008-2012 in Burkina Faso., Methods: This qualitative analysis was conducted in Ouagadougou in November-December 2011 in 47 subjects including 27 elderly subjects and 20 stakeholders responsible for the design and/or implementation of the PNSPA. These respondents were selected rattionally and were individually interviewed. Content analysis was therefore performed., Results: The PNSPA is relevant in the Burkinabe context. It takes into account the health needs of elderly people in Burkina Faso as well as the availability of resources in health centres. It presents several consistency problems. It has rarely been implemented due to lack of political support and inadequate financial resources., Discussion: The Burkina Faso PNSPA has encountered more difficulties than similar plans in Senegal and Mali, which have also encountered low implementation rates. This situation confirms that the elderly in sub-Saharan Africa constitute a top priority vulnerable population but which is neglected by all actors to varying degrees.

Many people and financial institutions believe that the elderly are not a priority in sub-Saharan Africa, a region marked by serious economic, socio-political and health crises. The purpose of this paper is to describe and analyze the assumptions and arguments underlying this view and to demonstrate that the elderly are a vulnerable priority population ignored by all stakeholders and primarily by technical and financial partners. The premise is that development must be viewed as a whole. In addition to improving the living conditions of children, youth and women, efforts to promote development in Africa must also take into account the needs of the elderly. The paper argues that there are four main reasons for focusing on the elderly in sub-Saharan Africa: systemic reasons, ethical/humanitarian reasons, developmental reasons and/or the interests and future of youth and adults.

Introduction: Healthcare-associated infections are a common consequence of unsafe health care practices and are a major issue for patient safety. Health care workers play a key role in patient safety and the quality of care, with factors such as poor compliance with hygiene standards and poor knowledge of infection risks having a major impact. However, the role of health care workers in patient safety has been overlooked in the literature. The objectives of this study were i) to examine health care workers' awareness of infection risks and ii) to assess levels of hand hygiene compliance and barriers to patient safety., Methods: A one-day cross-sectional survey was conducted in June 2011 at the Ziniaré health district hospital. The study focused on the health care workers present on the day of the survey in hospital care units and involved interviews and observations., Results: The study found that 30.04% of the health care workers knew the definition of healthcare-associated infections. Only 44.4% of the health care workers reported that the hands of health care workers (in the event of poor hand hygiene compliance) were the main mode of transmission of germs between patients in a care facility. In addition, only 21.43% (12/56) of the participants were aware of the main factors that increase the risk of health care-associated infections. The level of compliance with hygiene protocols was low (36.85%)., Conclusion: The promotion of patient safety and quality of care requires a focus on training and behavior change among health care workers.

In sub-Saharan Africa, very little research has been conducted on moderate to severe disabilities affecting mobility, communication and mental function in elderly people living at home. The studies that have been conducted have not always described the broader social context, a key factor for understanding and interpreting results. This study was conducted in Burkina Faso and was designed to fill the gaps in our understanding of disability in these areas. A cross-sectional descriptive study was conducted in Bobo-Dioulasso among the elderly population (aged 60 and above). Functional status was assessed using the Functional Autonomy Measurement System (SMAF). Data analysis was performed using Stata software. Interviews were conducted with a systematic random sample of 351 elderly adults. Moderate to severe functional disability or the need for supervision or assistance were related to mobility in 10 % of cases, to mental function in 28 % of cases and to communication in 37 % of cases. The need for assistance varied according to the different activities or items in each domain. The rates of disability in this study were higher than those found in previous studies, which have often assessed severe disabilities. All individuals affected by disability stated that they had a stable support network to manage their disability. Families were found to be the primary source of support. The results can be explained by the social context. A good visibility of moderate to severe disabilities should contribute to the development of effective policies to provide care and support to the elderly.

In sub-Saharan Africa, while antiretroviral therapy (ART) becomes widely available, access to biological measurements to monitor patients under ART remains scarce, making the management of ART difficult. We described the management of switching to second-line ART where HIV care is provided mainly in secondary health-care structures, in the region of Segou, Mali. Of 865 patients, followed under ART for a median time of 15 months, 40 switched to second-line ART (3.3 switches/100 person years). Reason for switching was failure in 18 patients (after 21 months in median) and severe intolerance in 13 (after three months in median). Switching to second-line ART occurred earlier when motivated by intolerance than by failure. The low rate of switch compares well with other studies, but was low compared to the expected rate of failure, and may indicate that physicians are reluctant to switch ART when treatment options are limited.

Objective: Develop, implement and evaluate a form of community involvement in TB care in three rural health districts (DS)., Methods: Profiles of community representatives were identified within the therapeutic itineraries of TB patients (PATB). Community contributions have been made in a specific context via a committee of community resource persons. The results of patients' care and management were compared over time (2005 to 2007) and space (comparison made with 3 other DS controls)., Results: The multifaceted community interventions (material and psycho-social support to patients) have been integrated into the regular management plan for PATB. In the first 12 months, the detection and cure rates have increased significantly in the intervention area, before stabilizing over the course of the following 12 months., Conclusion: Community involvement in care can strengthen the capacity of health services to respond and meet the expectations of PATB, including for those with chronic diseases. It requires a coherent distribution of tasks amongst all actors and stakeholders and balance of power relationships between different contributors to care.

In Mali, there were 4508 new cases of tuberculosis in 2003, and 5222 in 2006. Tuberculosis (TB) is thus an important public health problem, decreasing the physical, financial and social capital of individuals, their families and society. Because responses to TB have not yet applied a sufficiently integrated approach that can improve patients' access to quality care, this FORESA project advocates a patient-centered approach. Before any intervention, FORESA thus sought to analyse the situation of TB in Mali and responses to it. The study aims to analyse the discourse about and popular representations of TB (its forms, its signs), the situations in which people are exposed to it or transmit it, and popular practices related to its prevention and the experience of having it. This qualitative, descriptive and analytical study includes a literature review, in-depth interviews with opinion leaders, community health workers and TB patients, focus groups, and the observations of practices. The interviews were recorded, transcribed, and analysed. Subjects provided informed consent to participation. This study showed that: * the terms for TB in local languages (Bambara, Dogon and Fulfuldé) include white cough, big cough, and long cough; * These communities differentiate between 2 main forms of cough (simple and wet); * TB is perceived as a transmissible disease, a disease of contact with a contaminated body or objects; * TB is seen as a serious, contagious, hereditary, shameful disease that may result from the transgression of social norms; * The prevention of TB consists of avoiding people who have the disease or transmitting factors; * Therapeutic remedies, in order, are self-medication, the use of traditional healers, and finally visits to health centres; * The population wants more information about TB and be involved in the fight against it. This study shows the many points of convergence about TB nosology, etiology and therapy between the Mopti population and other groups in Mali (including the Mande, Senoufo and Soso), between the population of Mali and some ethnic groups in Burkina Faso (such as the Dioula, Bobo, Tiéfo Vigué), and between the population of Mali and, Burkina Faso and others in Africa (Gambia, Nigeria, South Africa, etc.). There is also a difference between popular knowledge about TB and biomedical knowledge. The population does not know that TB is transmitted mainly, even exclusively, by nasal droplets or that patients are no longer contagious after two weeks of treatment. The widespread dissemination of this information may have a positive effect, reducing stigmatization and improving access to treatment. Mali must strengthen the skills of all participants in the fight against tuberculosis, to strengthen their framework and to monitor and evaluate their activities.

Background: Improvement in management systems for tuberculosis (TB) care is urgently needed in West Africa. In 2003, an experimental action research network began there, involving care providers, health system managers, and TB programme managers. Each project in all 6 countries used a "patient-centered" approach to improve tuberculosis case management., Methods: The research teams included care providers, district medical officers, anthropologists and TB programme managers. Each research team conducted its project for a one-year period and then assessed its results. The specific problems identified were low TB detection rates (Burkina Faso, Côte d'Ivoire and Niger) and poor compliance among patients receiving treatment, including their ensuing loss to follow-up (Benin, Mali and Senegal). Investigators concluded that these weaknesses were due to the lack of access to care (geographical, financial and cultural), the complexity of the care system and the low quality of care. Solutions for all 6 countries aimed at improving access to high-quality care., Results: One year after the experiment began, results varied from one country to another. In general, all participants understood the need to collaborate beyond national health systems because the problems from all 6 countries were quite similar. The research process led to better sharing of work between care providers and sometimes between care providers and TB patients. It provided participants with new concepts and a constant opportunity to implement them. These repeated meetings, however, keep care providers away from their offices., Conclusion: The research would have improved case management and care more effectively had the teams taken into account the psychological and sociological need of TB patients. A new regional dynamic has begun and must be pursued to help improve health care systems.

Our main objective was to study gastritis associated to duodeno-gastric reflux. It is about a longitudinal study case/witness, paired according to the sex and the age. It was unrolled from February 2005 to January 2006 in the digestive diseases department of the hospital Gabriél Touré, and endoscopic centers of Promenade des Angevins, and clinique Farako. The patients profited from an upper digestive endoscopy to appreciate endoscopic aspect of gastritis associated to bile in the stomach mucus lake. The gastric biopsies were systematic. This study included 50 patients having gastritis associated to bile in gastric mucus lake compared to 50 patients having gastritis associated to clearly gastric mucus lake. The sex-ratio was 1.26 in favour of men. The average age of the patients was of 41.30 +/- 15.43 years. On the symptomatic hand, fetid breath was significantly met in duodeno-gastric reflux (p = 0.013). Potash consumption in the "tô" (millet cake) was significantly reported in gastritis associated to bile in gastric mucus lake (p = 0.042). The endoscopic aspects were comparable. Histological aspects of nonatrophic chronic gastritis were significantly mint in witnesses as well into the antrum as into the fundus (p = 0.0001 and p = 0.00023). The reactional gastritis aspect was the prerogative of duodenogastric reflux (p ranging between 10(-6) and 3.10 (-6). Helicobacter pylori infection was found comparable in the two groups (p = 0.297). Dysplasia although rare was found only in gastritis associated to duodeno-gastric reflux. Gastritis associated to bile in gastric mucus does not se,nm to have specific clinical, endoscopic and histological presentation. However the presence of dysplasia must have an attentive monitoring.

The vaccine (NANP)3-TT is a synthetic peptide of the circumsporozoite protein (CS) of Plasmodium falciparum coupled to tetanus toxoid (TT) as protein carrier and adsorbed to aluminium hydroxide as adjuvant. The objectives of the study were to assess the immunogenicity and the protective efficacy of the vaccine in an area where malaria is endemic. The study was conducted in a zone of irrigated rice cultivation known as the Vallée du Kou to the North of Bobo-Dioulasso. Malaria transmission is permanent in the Vallée with maxima in July and November. The study was conducted from June to December 1988. It was a controlled randomised, double blind, prospective vaccine trial. A total of 123 infants from 3 to 5 months of age were randomly assigned to three groups. Group I (controls) received three doses of TT alone, group II received two doses of TT and one of (NANP)3-TT and group III received three doses of (NANP)3-TT. These vaccines were administered simultaneously with the Enlarged Program of Immunisation (EPI) vaccines. The clinical parasitological and immunological status of the children was then monitored over a period of five months. No systemic reactions to the vaccine were observed in the infants either immediately after administration or during the follow-up. Minor local tumefactions were observed in only 3% of the children. The vaccine was found to be immunogenic with a peak IgG response at day 75, when 56% (group II) and 60% (group III) showed antibody titres of at least four times that seen at day 0. The response, however, was a short duration; by day 150 the average antibody titres were not significantly different between the three groups. The incidence and the level of parasiaemia and the incidence of clinical malaria were also not significantly different for each of the three groups during the period of the study. The association of (NANP)3 with tetanus toxoid was not shown to be immunologically inhibitive. The results, despite not showing a protective effect for the vaccine (NANP)3-TT, have shown its immunogenicity and therefore suggest that further development of this vaccine may be worthwhile.