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Background Optimal nutrition is crucial during the critical period of the first 1,000 days from conception to 2 years after birth. Prenatal and postnatal supplementation of mothers with multimicronutrient-fortified balanced energy-protein (BEP) supplements is a potential nutritional intervention. However, evidence on the long-term effects of BEP supplementation on child growth is inconsistent. We evaluated the efficacy of daily fortified BEP supplementation during pregnancy and lactation on infant growth in rural Burkina Faso. Methods and findings A 2 x 2 factorial individually randomized controlled trial (MISAME-III) was implemented in 6 health center catchment areas in Houndé district under the Hauts-Bassins region. From October 2019 to December 2020, 1,897 pregnant women aged 15 to 40 years with gestational age Conclusions This study provides evidence that the benefits obtained from prenatal BEP supplementation on size at birth are sustained during infancy in terms of linear growth. Maternal BEP supplementation during lactation may lead to a slightly better linear growth towards the second half of infancy. These findings suggest that BEP supplementation during pregnancy can contribute to the efforts to reduce the high burden of child growth faltering in low- and middle-income countries. Trial registration ClinicalTrials.gov: NCT03533712., Author(s): Alemayehu Argaw 1,2, Brenda de Kok 1, Laeticia Celine Toe 1,3, Giles Hanley-Cook 1, Trenton Dailey-Chwalibóg 1, Moctar Ouédraogo 4, Anderson Compaoré 4, Katrien Vanslambrouck 1, Rasmané Ganaba 4, [...]

Background Providing balanced energy-protein (BEP) supplements is a promising intervention to improve birth outcomes in low- and middle-income countries (LMICs); however, evidence is limited. We aimed to assess the efficacy of fortified BEP supplementation during pregnancy to improve birth outcomes, as compared to iron-folic acid (IFA) tablets, the standard of care. Methods and findings We conducted an individually randomized controlled efficacy trial (MIcronutriments pour la SAnté de la Mère et de l'Enfant [MISAME]-III) in 6 health center catchment areas in rural Burkina Faso. Pregnant women, aged 15 to 40 years with gestational age (GA) Conclusions The MISAME-III trial did not provide evidence that fortified BEP supplementation is efficacious in reducing SGA prevalence. However, the intervention had a small positive effect on other birth outcomes. Additional maternal and biochemical outcomes need to be investigated to provide further evidence on the overall clinical relevance of BEP supplementation. Trial registration ClinicalTrials.gov NCT03533712., Author(s): Brenda de Kok 1, Laeticia Celine Toe 1,2, Giles Hanley-Cook 1, Alemayehu Argaw 1,3, Moctar Ouédraogo 4, Anderson Compaoré 4, Katrien Vanslambrouck 1, Trenton Dailey-Chwalibóg 1, Rasmané Ganaba 4, [...]

Cysticercosis is a neglected tropical disease caused by the larval stage of the zoonotic tapeworm (Taenia solium). While there is a clear spatial component in the occurrence of the parasite, no geostatistical analysis of active human cysticercosis has been conducted yet, nor has such an analysis been conducted for Sub-Saharan Africa, albeit relevant for guiding prevention and control strategies. The goal of this study was to conduct a geostatistical analysis of active human cysticercosis, using data from the baseline cross-sectional component of a large-scale study in 60 villages in Burkina Faso. The outcome was the prevalence of active human cysticercosis (hCC), determined using the B158/B60 Ag-ELISA, while various environmental variables linked with the transmission and spread of the disease were explored as potential explanatory variables for the spatial distribution of T. solium. A generalized linear geostatistical model (GLGM) was run, and prediction maps were generated. Analyses were conducted using data generated at two levels: individual participant data and grouped village data. The best model was selected using a backward variable selection procedure and models were compared using likelihood ratio testing. The best individual-level GLGM included precipitation (increasing values were associated with an increased odds of positive test result), distance to the nearest river (decreased odds) and night land temperature (decreased odds) as predictors for active hCC, whereas the village-level GLGM only retained precipitation and distance to the nearest river. The range of spatial correlation was estimated at 45.0 [95%CI: 34.3; 57.8] meters and 28.2 [95%CI: 14.0; 56.2] km for the individual- and village-level datasets, respectively. Individual- and village-level GLGM unravelled large areas with active hCC predicted prevalence estimates of at least 4% in the south-east, the extreme south, and north-west of the study area, while patches of prevalence estimates below 2% were seen in the north and west. More research designed to analyse the spatial characteristics of hCC is needed with sampling strategies ensuring appropriate characterisation of spatial variability, and incorporating the uncertainty linked to the measurement of outcome and environmental variables in the geostatistical analysis. Trial registration: ClinicalTrials.gov; NCT0309339. Author summary: Cysticercosis is a serious, yet neglected disease caused by the larval stage of a zoonotic tapeworm, prevalent in many developing countries, including Burkina Faso. Being able to predict where the disease occurs is essential for running targeted prevention and control activities. In our study, we aimed to describe whether human cysticercosis cases in three provinces in Burkina Faso were clustered, and investigated whether there was a link between this clustering and some land and weather variables. Finally, we aimed to generate high-resolution prediction maps for the occurrence of the infection. We found that there was clustering at 45 meters for the individual- and 28.2 km for the village-level datasets, respectively. Increasing rainfall and proximity to a river were linked with this clustering. The generated prediction maps indicated there were important cysticercosis hotspots in the study area, especially in the extreme south and north-west, where the disease is thought to be more important. Further research should expand the use of spatial techniques to predict the occurrence of cysticercosis, the results of which can aid in the design of intervention programmes. [ABSTRACT FROM AUTHOR]

Low coverage of effective nutrition interventions in many high‐burden countries, due to service provision and demand factors, result in poor uptake of recommended practices and nutrition outcomes. We examined the factors that influence maternal nutrition and early breastfeeding practices and determined the extent that the key factors could improve these practices in two regions in Burkina Faso. We used household survey data among pregnant (n = 920) and recently delivered women (n = 1840). Multivariable regression analyses were conducted to identify the determinants of a diverse diet and iron‐folic acid (IFA) supplement consumption, weight monitoring during pregnancy and early initiation of breastfeeding (EIBF). Population attributable risk analysis was used to estimate how much the outcomes can be improved under optimal conditions of interventions that address the modifiable determinants. During pregnancy, 21% of women achieved minimum diet diversity (MDD‐W), 70% consumed 90+ IFA tablets and 65% were weighed 4+ times; EIBF was 40%. Nutrition knowledge was associated with MDD‐W (odds ratio [OR]: 3.2), 90+ IFA (OR: 1.5) and EIBF (OR: 1.9). Positive social norms and family support were associated with 90+ IFA (OR: 1.5). Early and 4+ ANC visits were associated with 90+ IFA (OR: 1.5 and 10) and 4+ weight monitoring (OR: 6.2). Nutrition counselling was associated with 90+ IFA (OR: 2.5) and EIBF (OR: 1.5). Under optimal programme conditions, 41% of women would achieve MDD‐W, 93% would consume 90+ IFA, 93% would be weighed 4+ times and 57% would practice EIBF. Strengthening the delivery and uptake of interventions targeted at these modifiable factors has the potential to improve maternal nutrition practices. Key messages: In our Burkina Faso study, maternal nutrition practices were low to moderate, with 21% of pregnant women consuming at least 5 food groups, 70% of women consuming at least 90 daily iron and folic acid (IFA) tablets and 65% weighed at least 4 times during their last pregnancy, and 40% of women initiating breastfeeding within 1 h after birth.Various individual, household and health service level factors were modifiable through interventions for improving maternal nutrition and breastfeeding practices, but practices were associated with different combinations of factors.Under optimal conditions of interventions that address the modifiable determinants, we estimated that nearly all women would be able to achieve consumption of 90+ IFA tablets and receipt of weight monitoring 4+ times, and nearly half or more of the women would be able to achieve minimum dietary diversity and early initiation of breastfeeding. [ABSTRACT FROM AUTHOR]

This article reports on a cluster-randomised controlled trial conducted in rural Burkina Faso evaluating a multifaceted intervention, SELEVER, that seeks to increase poultry production by delivering training and strengthening of village-level institutions providing veterinary and credit services. Households exposed to the intervention significantly increase their use of poultry inputs (veterinary services, enhanced feeds, and deworming), and report more poultry sold and higher revenue. However, there is no evidence of an increase in profits. This evidence is consistent with the hypothesis that the return to inputs may not be sufficient to counterbalance the market costs of these inputs. [ABSTRACT FROM AUTHOR]

Abstract Background Little is known about the reproductive health of women who survive obstetric complications in poor countries. Our aim was to determine how severe obstetric complications in Burkina Faso affect reproductive events in the first year postpartum. Methods Data were collected from a prospective cohort of women who either experienced life threatening (near-miss) pregnancy-related complications or an uncomplicated childbirth, followed from the end of pregnancy to one year postpartum or post-abortum. Documented outcomes include menses resumption, sexual activity resumption, dyspareunia, uptake of contraceptives, unmet needs for contraception and women's reproductive intentions. Participants were recruited in seven hospitals between December 2004 and March 2005 in six towns in Burkina Faso. Results Reproductive events were associated with pregnancy outcome. The frequency of contraceptive use was low in all groups and the method used varied according to the presence or not of a live baby. The proportion with unmet need for contraception was high and varied according to the time since end of pregnancy. Desire for another pregnancy was highest among near-miss women with perinatal death or natural abortion. Women in the near-miss group with induced abortion, perinatal death and natural abortion had significantly higher odds of subsequent pregnancy. Unintended pregnancies were observed mainly in women in the near-miss group with live birth and the uncomplicated delivery group. Conclusions Considering the potential deleterious impact (on health and socio-economic life) of new pregnancies in near-miss women, it is important to ensure family planning coverage includes those who survive a severe complication.

Poor maternal nutrition contributes to poor birth outcomes, including low birth weight and small for gestational age births. Fortified balanced energy protein (BEP) supplements may be beneficial, although evidence is limited. This mixed method study, conducted among pregnant women in Burkina Faso, is part of a larger clinical trial that seeks to understand the impact of fortified BEP supplements on pregnancy outcomes and child growth. The formative research reported here, a single‐meal rapid assessment of 12 product formulations, sought to understand product preferences for provision of BEP supplements and contextual factors that might affect product acceptability and use. Results indicate a preference for products perceived as sweet rather than salty/savoury and for products perceived as familiar, as well as a sensitivity to product odours. Women expressed a willingness and intention to use the products even if they did not like them, because of the health benefits for their babies. Data also indicate that household food sharing practices may impact supplement use, although most women denied any intention to share the products. Sharing behaviour should therefore be monitored, and strategies to avoid sharing should be developed during the succeeding parts of the research. [ABSTRACT FROM AUTHOR]