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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.

Background Burkina Faso experienced an epidemic resurgence of dengue in 2016, which led to the implementation of several control strategies. In order to allow a better adaptation of these strategies, we studied the spatio-temporal distribution of dengue. Methods Monthly dengue cases from 2016 to 2019, aggregated at the health district level, were used to map the crude incidence, excess risk, and smoothed incidence of dengue in Burkina Faso with GeoDa software. A Kulldoff scan on Satscan software was then used to identify spatio-temporal clustering of cases. Results The results show that the distribution of dengue fever across the health districts of Burkina Faso is heterogeneous. Dengue was considered non-endemic in 9 out of the 70 health districts, minimally endemic in 45 districts ( 100 incidences) in 4 districts. The main cluster covered the health districts of Baskuy, Nongr-massom, Sig-noghin, Boulmiougou, and Bogodogo. The months of October and November corresponded to the peak of cases and a significant temporal cluster in 2017. Conclusion This study identified the spatial and temporal clustering of dengue cases in Burkina Faso. These results may help to develop better preventive strategies.

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.

Background: The global recommendations of the WHO and UNICEF are that all infants should start breastfeeding within one hour of birth. It is low-cost and has substantial potential to reduce neonatal and early infant morbidity. The objectives of the study were to investigate rate of early initiation of breastfeeding and to identify potential associated factors. Methods: A community based cross-sectional study design was conducted in three districts of Burkina Faso. Cluster sampling was used. The data were collected by using a structured and pretested interview questionnaire. The associations between early initiation and independent variables were tested using the Chi-square test. Crude Odds ratios (COR) with 95% confidence intervals were used. Results: Percentage of children who were put to the breast within one hour of birth was fair (41%). Having more than 2 antenatal care visits was found to be 1.43 times more likely to initiate breastfeeding early, COR: 1.4, 95% CI: [1.14 - 1.81], p < 0.001. Receiving advices, during pregnancy, on early initiation of breastfeeding, child feeding and child growth, were found to be more likely to initiate breastfeeding early, respectively COR: 1.52, 95% CI: [1.25 - 1.80]; 1.39, 95% CI: [1.15 - 1.67] and 1.39, 95% CI: [1.15 - 1.67], with p < 0.001. Mothers having skilled delivery were found to be more likely to initiate breastfeeding early, COR: 1.47, 95% CI: [1.20 - 1.79], p < 0.001. Conclusions: This study demonstrates that delayed initiation of breastfeeding continues to be a problem in rural areas of Burkina Faso, as only four in 10 newborn infants received breast milk within the first hour of birth. The results show that receiving advices on early initiation of breastfeeding, child growth and feeding and skilled delivery were found to be more likely to initiate breastfeeding within one hour of delivery. Therefore improving the skills of health providers and, mother individual counselling and strengthening community-based support, are critical to improve timely initiation of breastfeeding.

Anemia in pregnancy remains a major public health problem in low-income countries. The quality of human resources is essential for effective interventions. The objective of this study was to assess knowledge and practices of health professionals and community health workers on the prevention of anemia in pregnancy in Burkina Faso.It is a descriptive cross-sectional study. Data was gathered using a structured questionnaire for health professionals and community health workers in the Cascades region.A total of 124 health professionals and 77 community health workers were enrolled. Knowledge of health professionals on the prevention of anemia in pregnancy was ?sufficient? in 25% of cases and that of community health workers was ?acceptable? in 33.8% of cases. Neither the number nor the variety of in-training topics and information received were associated with the knowledge level of the agents on the prevention of anemia. Hospital health professionals (AOR = 6.7, 95% CI: 1.3-34.5) and those trained in the prevention of mother-to-child transmission of HIV (AOR = 3.0, 95% CI) 1.0-8.0) as well as community health workers who were in school (OR = 2.2, 95% CI: 1.3-4.0) had the highest levels of knowledge. But, skilled health professionals (midwives) were rather concentrated in hospitals and not in peripheral health centers that were supposed to promote essential measures to prevent anemia in pregnancy.The prevention of anemia in pregnancy remains a challenge in Burkina Faso, partially because of the low level of knowledge and practices in peripheral health centers and in the community. Improving the knowledge and practices of peripheral healthcare providers through better in-training curricula could help reduce anemia in pregnancy prevalence.

This article reports on a 3-year ethnographic study in a Boston Public school of the performance of Haitian students on the Massachusetts Comprehensive Assessment System (MCAS) and its lasting and likely impact upon them. MCAS is a mandated exam required for students to graduate from high school. Although there are certain provisions for students with limited English proficiency (LEP) to participate under the mandate, LEP students face the test with an enormous disadvantage compared with other students. The issue of second language acquisition appears to have been completely dismissed in the mandated policy. In light of the challenges faced by students with LEP, the article focuses on the core issues at hand in the Massachusetts standardized exam. It analyzes the complexities of language use and acquisition with respect to students with LEP, the pitfalls of the mandated exam, and the effects and impacts created by MCAS on students and their communities. It suggests that an educational system should take into consideration the complexity of acquiring a second language in a particular social context and develop new testing policies and requirements for students whose first language is not English.

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.

Cerebral hypoxia during cardiac arrest is the leading cause of mortality and morbidity in survival victims. To reduce cerebral damage, studies focus on finding effective treatments during the resuscitation period. Our report focuses on a 36-year-old police officer who had had two cardiac arrests (one at home and one at the hospital). After acute treatment, his cardiac and brain functions recovered impressively. Neuropsychological results were normal except for mild anomia. He also reported some retrograde memory loss. Surprisingly, he also reported an improvement in a very specific capacity, his episodic memory. We here review the possible causes and mechanisms that may have affected his memory abilities.

The microscopic processes of fracture or breakdown are unknown, the models are contradicted or leave unexplained several observations, the suspected relationships between the electrical properties, the mechanical properties and the charge properties of the dielectrics are not confirmed by characterization of space charges and we do not know how to relate the results to the reliability of the materials. To overcome these difficulties: (1) we apply the energy localization principle used in mechanics and detonics, (2) we replace by electron traps that localize polarization energy, the defects imagined by Griffith in mechanics and dislocations used in detonation to explain the hot spot formation, (3) the effect of strain rates is taken into account because the localized energy is of the order of the binding energies and the trapping and detrapping characteristic times are of the order of the atomic polarization time (10-9 s). We can thus explain by multiphonon processes the transfer of the localized energy towards the bounds and explain the observations which occur when the strain rates are very high, (4) we develop an electron beam technique to measure the extension of the electron trapping domain and the localized energy beyond which a total discharge of the material occurs. These measurements characterize the space charges in the dielectric interfaces where the hot spots are formed. This technique makes it possible to reproduce most of the observations that remained unexplained and to link the measurements made to the properties and reliability of the insulators.

In a first part, the applicability of secondary ion emission to surface analysis is discussed by considering the ejection and ionization processes of atoms and taking into account the progressive erosion of the sample. In a second part, the general features of the secondary ion emission induced by the adsorption of a gas are presented. The effect of oxygen adsorption on M+ metal ion production is studied as a function of oxygen coverage for pure metals, alloys and single crystals. In particular, an incorporation process which takes place at a critical coverage is described on a nickel single crystal (100).

The charge dynamics of insulating or weakly conductive materials can be studied by the secondary electronic emission (SEE) method. Those two types of compounds behave differently to irradiation: charge trappers such as PMMA or SiO2 can have a charge excess after irradiation, so that they can be trapped for a long time, and can even cause 'microbreakdowns' to dielectric breakdowns, while in contrast, conductive materials have a kind of charge flow. SEE yield can also be affected by changing the current density. When the current density increases, the SEE intrinsic yield σ0 and the SEE stationary yield σst decrease. Unexpected behaviour of negative charging is observed showing that there must be competition between diffusion and accumulation effects.

Foils of Polymethyl methacrylate (PMMA) 2 mm thick were studied by measuring the total Secondary Electron Emission yield (SEE yield) in a dedicated Scanning Electron Microscope especially equipped to study the fundamental aspects of the charge transport and trapping in insulating materials. The intrinsic SEE yield , (yield of the uncharged material) and the charging kinetics were studied under low current density pA/cm2. The curve of the primary beam energy variation of exhibits a maximum intrinsic yield at 370 ± 20 eV and two crossover energies ± 20 eV and ± 20 eV for which . For 1 PMMA is positively charged and negatively for 1. As electron injection is proceeding under the low current density used, the SEE yield varies from to the steady value . This value that expresses the equality between the average number of emitted and injected electrons, characterizes the steady charge regime called “Self-Regulated Regime”. The evolution of during the injection process is due to the internal field that blocks or enhances the secondary electron emission, according to the positive or negative nature of the trapped charges. A current density effect, characterized by a steady SEE yield slightly higher than unity, , instead of one, is observed at high energy (for example 4000 eV) for a strong current density $J>10^{+6 }$ pA/cm2. It is interpreted by a field ionisation (Poole-Frenkel type) that enhances the secondary electron emission.

Amorphous N- or Ge-doped H:SiO2 films deposited on silica by the matrix distributed electron cyclotron resonance-PECVD method were irradiated by an electron-beam with different doses in order to pole the material and induce second harmonic generation (SHG). SHG was measured using the Maker-fringe method. When irradiated at an acceleration voltage of 25 kV, an incident current of 5 nA during 480 s, the N-doped H:SiO2 films exhibited a maximum second harmonic signal in the order of 0.003 pm/V, but when irradiated with an acceleration voltage of 30 kV, at 5 nA during 240 s, the films exhibited a maximum second harmonic signal of 0.006 pm/V. With a smaller current of 0.5 nA during 25 s and 25 kV acceleration voltage, the Ge-doped H:SiO2 films (3.8 at. % Ge) showed a maximum second-order nonlinearity of 0.0005 pm/V. But an H:SiO2 films with a smaller Ge content (1.0 at. % Ge), showed a large SHG: d33=0.09 pm/V when irradiated at 25 kV, 0.5 nA during 15 s.

Studies on the distribution of the electric field produced by a thermal poling process in a layer of Ge-doped silica on silicon substrate, by using secondary electron emission yield (SEEY) measurements (δ) are presented. Comparing δ0 between poled and unpoled areas, the SEEY at the origin of electron injection, we pointed out an electric field 0.5 μm below the surface for our poling conditions and directed in the same direction as the external field applied during the poling process. Then, the dependence of δ on the injected dose of electrons allows us to deduce that the poling process disturbs the glass structure strongly enough for leading to a weak conductivity. It is then easy to display the poled areas. We have also pointed out an effect of the electric properties of the glass on the measurements obtained with the Electron Probe for MicroAnalysis.

This article presents a study performed with a dedicated scanning electron microscope on the electrical property evolution of surfaces of (0001)-oriented sapphire (Al2O3) and (100)-oriented yttria-stabilized zirconia (YSZ) single crystals, during a 1.1 keV electron irradiation at room temperature. The type of charges trapped on the irradiated areas and the charging kinetics are determined by measuring the total secondary electron emission yield σ during the injection process, by means of two complementary detectors. At low current density (

Introduction La medecine traditionnelle constitue une ressource en soins de sante peu exploree alors que pres de 80 % des populations africaines y ont recours. L’objectif de cette etude etait de decrire l’offre de soins apportes par les tradipraticiens de sante (TPS). Methodologie Il s’agit d’une etude transversale descriptive ayant porte sur 150 TPS de la ville de Bobo-Dioulasso, realisee du 16 au 26 avril 2015. Resultats Tous les profils de TPS etaient rencontres, les herboristes etaient les plus representes (37 %). Parmi les TPS enquetes, 83,9 % avaient acquis leurs savoirs par transmission d’un maitre, pendant une duree moyenne de 10,22 ans, avec une experience professionnelle moyenne de 16,57 ans. La prevention secondaire etait le type de soins le plus commun aux TPS (96,7 %). Des rendez-vous de controle etaient donnes chez 84 % des TPS. L’arret des symptomes etait un critere de guerison commun a tous. Parmi les TPS enquetes, 84,5 % ont rapporte des cas d’echec, devant lesquels ils orientaient les patients vers un centre de sante (40,1 %) ou leurs pairs (30,3 %). Les symptomes pris en charge etaient principalement : maux de ventre, regles douloureuses, impuissance sexuelle. Les principales pathologies prises en charge etaient : paludisme, hemorroides, ulcere d’estomac. Un examen du patient etait pratique chez 85,3 % des TPS et comprenait l’interrogatoire (toujours) et un examen physique (67,3 %). Des examens complementaires etaient demandes par 43,3 % des TPS. Le principal but du traitement etait l’arret des symptomes. Les moyens therapeutiques utilises etaient des parties de plantes et d’animaux, des mineraux, des formules mystiques, sous formes de decoction, de poudre et de pommades. Quelques medicaments modernes ont ete cites, ainsi que des moyens chirurgicaux rudimentaires. Les doses des remedes etaient fixees par tranche d’âge, selon la gravite et la corpulence, a l’aide de cuilleres, de calebasses, de verres de the.

Starting from two cubic pieces of a MgO crystal ((3 x 3 x 3) and (5 x 5 x 5)), both containing a central oxygen atom, two clusters are simulated with the help of a DFT-LDA method. These clusters are charged in order to be equivalent to pieces of a neutral crystal. In each cluster, a neutral vacancy analogous to a F center is created by removing the central oxygen atom. Then, F + and F + + centers are simulated by removing one and two electrons. The main differences and similarities between the two sizes of clusters are studied: geometries, Mulliken charges, electronic distributions, gaps, ionisation potentials. An important result is that in any case, when a F center is simulated, the vacancy does not accept more than about one electron, the second one being spread in the rest of the cluster.

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.

Study of an α-Al2O3 single crystal by electron-induced x-ray emission spectroscopy and cathodoluminescence is reported. The relative intensities of optical emissions due to F+ and F centers have been determined as a function of the parameters of the electron beam and the annealing of the sample. It is shown that the F+ centers, i.e., the oxygen vacancies with one trapped electron, are predominant when the density of the incident electron beam increases. Similar variation is observed when the electron energy varies from 1 to 4 keV. From the comparison between x-ray and optical spectra, the F+ centers are determined to be stable defects in the bulk of the sample.

With the help of ab initio methods the clusters [(MgO)13Mg] Q+ are simulated for Q = 0, 1, 2. Then, vacancy clusters [(MgO)12Mg2] Q+ obtained by removing one oxygen atom are computed for Q running from 0 to 4. These clusters exhibit a slight sphericity and generally shorter interatomic distances than in the crystal. The electronic densities variations are studied in function of Q. In particular, it is observed that the electronic density in the oxygen vacancy goes to a maximum when Q = 2. The ionisation potentials vary from approximately 4 to 14 eV when Q varies from 0 to 3, with a more rapid increase from Q = 1 to Q = 2. The stability study of vacancy clusters show that they experience a phase transition when their charge becomes equal to 2, in accordance with the features mentioned above.

When an insulating material is subjected to electron irradiation, it produces a secondary emission the yield of which varies from a few percent to very high values (up to 24 per incoming electron) depending on the material and the experimental conditions. If the secondary electron emission yield is less than one, a net negative charge remains trapped in the sample. In this case, the study of the electric charges trapping properties of the material becomes possible. This article describes how it is possible to use a secondary electron microscope (SEM) as a device to perform such a study. In Sec. II, the effect of a net negative trapped charge resulting (from the injection of typically 50 pC) on the imaging process of the SEM has been described. It has been shown that when the trapped charge is high enough, it acts as a mirror reflecting the incoming electron beam which is deflected somewhere in the vacuum chamber of the microscope. A global qualitative description of the image displayed on the screen is fi...

The interdiffusion of Y films deposited onto Cu substrate by flash evaporation and sputtering was studied (concentration profiles, X-ray and electron diffraction patterns) in the temperature range 373–553 K. In samples deposited by flash evaporation the first phase to be detected is CuY at 393 K. At higher temperatures an intermediate phase, close to the Cu3Y2 compound, is formed before the Cu2Y stoichiometric phase is produced at 513 K. Crystallographic data confirm the formation of this intermediate Cu3Y2 phase (orthorhombic unit-cell) as resulting from the reaction CuY+Cu2Y→Cu3Y2. The results are identical for sputtered Y films deposited under a cryogenic vacuum (2−5×10−7 Pa). When Y is deposited under a standard vacuum (2−5×10−6 Pa), the influence of a diffusion barrier at the Cu–Y interface is noticed. This influence is characterized in the concentration profiles by an Y concentration hump at the Cu–Y interface and a depletion of Y at the front of the profile. Three main phases are observed. They correspond to the Cu5Y2, Cu2Y and Cu3Y2 compounds.

The consequence of the coupling of a charged particle with a polarization field is the formation of a quasi-particle called the 'polaron'. The degree of 'localization' of such charge depends on the nature of this coupling. In this way, trapping at an atomic scale is described as resulting from the evolution of a coupling involving successively: the electronic polarization field, the infrared polarization field, and the quasi-static ionic polarization field. The internal energy stored in the surrounding medium polarized by the charge is high because the charge is so well localized. The maximum of this energy is obtained for the quasi-static polarization field; its magnitude is of the order of 5 to 10 eV per trapped charge. This work addresses the physics of aging and of the breakdown process on the basis of an unsustainable increase in local internal energy within the material, due to charge trapping-the polarization around a trapped charge increases the local energy; the relaxation of the material lattice then follows a rapid detrapping of charges from their sites, releasing the local excess site region energy into the material. Such a release executes transient virtual work on the material, producing macroscopic dielectric damage, and when critical, unstable conditions are achieved in the time domain, this is followed by electrical breakdown. This interpretation of electrical material breakdown is related to bulk breakdown as observed in thin film laminate structures (/spl sim//spl mu/m) and surface flashover as seen in large structures (/spl sim/mm to cm).