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• Article libreArticleEn anglais

  Exploring Mechanisms of Multiple Insecticide Resistance in a Population of the Malaria Vector Anopheles funestus in Benin

  BackgroundThe insecticide resistance status of the malaria vector Anopheles funestus and the underlying resistance mechanisms remain uncharacterised in many parts of Africa, notably in Benin, West Africa. To fill this gap in our knowledge, we assessed the susceptibility status of a population of this species in Pahou, Southern Benin and investigated the potential resistance mechanisms.Methodology/Principal FindingsWHO bioassays revealed a multiple resistance profile for An. funestus in Pahou. This population is highly resistant to DDT with no mortality in females after 1h exposure to 4%DDT. Resistance was observed against the Type I pyrethroid permethrin and the carbamate bendiocarb. A moderate resistance was detected against deltamethrin (type II pyrethroids). A total susceptibility was observed against malathion, an organophosphate. Pre-exposure to PBO did not change the mortality rates for DDT indicating that cytochrome P450s play no role in DDT resistance in Pahou. No L1014F kdr mutation was detected but a correlation between haplotypes of two fragments of the Voltage-Gated Sodium Channel gene and resistance was observed suggesting that mutations in other exons may confer the knockdown resistance in this species. Biochemical assays revealed elevated levels of GSTs and cytochrome mono-oxygenases in Pahou. No G119S mutation and no altered acetylcholinesterase gene were detected in the Pahou population. qPCR analysis of five detoxification genes revealed that the GSTe2 is associated to the DDT resistance in this population with a significantly higher expression in DDT resistant samples. A significant over-expression of CYP6P9a and CYP6P9b previously associated with pyrethroid resistance was also seen but at a lower fold change than in southern Africa.ConclusionThe multiple insecticide resistance profile of this An. funestus population in Benin shows that more attention should be paid to this important malaria vector for the implementation and management of current

  Biologie cellulaire et moléculaireGénétiqueMicrobiologie (bactériologie, virologie)Licence : This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are properly credited.

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  Exploring risk factors of drive for muscularity and muscle dysmorphia in male adolescents from a resource-limited setting in Burkina Faso

  Valentin Terhoeven, Christoph Nikendei, Mamadou Bountogo, Hans-Christoph Friederich, Lucienne Ouermi, Ali Sié, Guy Harling, Till Bärnighausen

  In low-income countries, Muscle Dysmorphia (MD) has only been investigated in adult south African amateur-bodybuilders. To date, there is no epidemic study about MD or its cardinal symptom “drive for muscularity” (DFM) and its impact on young men’s lives in African low-income settings. We analyzed a population-representative cross-sectional study of 838 adolescent males aged 12–20 in the rural northwestern Burkina Faso. Participants were assessed for MD with the research criteria of Pope and its cardinal symptom DFM based on the DFM scale (DMS). Since DFM has not been studied in a comparable sample so far, all possible influencing variables were examined exploratively in a linear regression model. Many respondents were underweight (41.5%) and few overweight (1.3%). No-one met standard clinical MD criteria. While 60.1% of 837 wished to be more muscular, only 8.7% of 824 desired a lower body-fat percentage. Regression analysis revealed that higher DMS scores were associated with greater internalization of the muscular body ideal, going to school, living in a rural area, older age, and a history of having faced sexual harassment or assault, but not with media exposure. Our results show that levels of DMS in Burkinabe adolescents were elevated. Risk factors for DFM in environmental circumstances where undernutrition and poverty are common are discussed.

  Biostatistiques et épidémiologieSanté publiqueLicence : Open Access http://creativecommons.org/licenses/by/4.0/ This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original autho

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• Article libreArticleEn anglais

  Exploring support for medicalized female genital mutilation/cutting: A study on migrant women living in Italy

  The medicalization of female genital mutilation/cutting (FGM/C) as a harm reduction strategy is a highly debated issue, although largely unexplored among migrants living outside practising countries. This study investigates the extent of the support for FGM/C conditioned on its medicalization among migrant women from FGM/C-practising countries residing in Italy, and the characteristics of women supporting the practice. Data are from a national survey on FGM/C conducted in Italy in 2016, covering a representative sample of 1,378 women aged 18 + who were born in Nigeria, Egypt, Eritrea, Senegal, Burkina Faso, Somalia, and Ivory Coast. A discrete choice framework and a multinomial probit choice model are adopted to analyze women’s preferences about FGM/C continuation and medicalization. Findings indicate that, compared with women who support the practice unconditionally, the requirement of medicalization correlates with higher educational level, age, being in a couple, and being from a country where FGM/C is more commonly medicalized. Perceived benefits linked to increased support for FGM/C medicalization include religious approval, better marriage prospects, cleanliness, and conformity to traditional cultural values. Our data show that higher education is a critical, but not unique, factor in understanding the support for FGM/C in its medicalized form.

  Biostatistiques et épidémiologieSanté publiqueLicence : Creative Commons Attribution License This is an open access article distributed under the terms of the, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

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  Exploring the association between the proximity to and density around schools of retailers selling IQOS products and youth use of heated tobacco products: evidence from the 2020-2021 COMPASS study

  Hunter Mott, Scott T. Leatherdale, Adam G. Cole

  AbstractIntroduction:Heated tobacco products (HTPs) are novel tobacco products that may appeal to youth. This study explored whether HTP retailer proximity and density to secondary schools were associated with youth use of HTPs in four Canadian provinces.Methods:An online search between November 2020 and March 2021 identified retailers selling IQOS devices and HEETS (tobacco sticks used in IQOS) within 500m, 1000m and 1500m radius circular buffer zones around high schools (N=120) participating in the COMPASS study in 2020–2021. Retailer proximity/density data were linked to cross-sectional student-level data (N=40636 students), and multilevel regression models examined the association between HTP retailer proximity and density and current HTP use, controlling for relevant covariates.Results:While only 10.0% of schools had at least one retailer selling IQOS devices within 1000m of the school, 65.0% of schools had at least one retailer selling HEETS. The school a student attended accounted for 23.7% of the variability in the likelihood of currently using an HTP. However, HTP retailer proximity to and density around schools were not significantly associated with the likelihood of students currently using HTPs.Conclusion:While the school a student attended accounted for a significant amount of variability in HTP use, these findings suggest that students may be obtaining HTPs through other, non-retail sources. Continued monitoring is warranted as HTP use among youth may change.

  Licence : This work is licensed under a Creative Commons Attribution 4.0 International License

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• Article libreArticleEn anglais

  Exploring the Current Situation and Developing Strategies for Behavior Change to Improve Antibiotic Use in West Africa: Protocol for a Multidisciplinary Interventional Research Project

  BackgroundAntimicrobial resistance (AMR) is recognized as a global concern, with particularly severe consequences in low- and middle-income countries. Although it may occur naturally, it is also an anthropogenic problem linked to the irrational use of antibiotics in humans and animal husbandry and the use of pesticides in plant agriculture. Generally, data on AMR and evidence of effective and feasible multifaceted interventions are limited in many African countries.ObjectiveThis study aims at (1) assessing baseline data on AMR pathogens in Burkina Faso and Ghana; (2) understanding perceptions and quantifying use of antibiotics among health care workers, communities, and livestock farmers; and (3) defining and refining an AMR intervention using a design thinking approach.MethodsThis multidisciplinary study will be conducted in two rural districts and will consist of two phases. First, baseline data will be collected on AMR pathogens along dominant food production chains. extended-spectrum beta-lactamase (ESBL)–producing Escherichia coli and Klebsiella pneumoniae will be selected as indicator mechanisms for AMR because of their high occurrence among animals and humans. The perception and understanding of AMR and antibiotic use among different stakeholders and community members will be assessed using epidemiologic and socio-anthropological methods. Qualitative methods will include participant observations, in-depth and key informant interviews, and focus group discussions. The quantitative part will consist of the development of an inventory of circulating antibiotics and a household survey. Second, key informant and in-depth interviews will be conducted with One Health stakeholders in preparation for the intervention development. Subsequently, multidisciplinary “design teams” will develop ideas for an intervention on AMR using a design thinking approach.ResultsData collection started in April 2022. The analysis of microbiological, anthropological, and socio-epidemiolo

  Biologie cellulaire et moléculaireGénétiqueBiostatistiques et épidémiologieLicence : https://creativecommons.org/licenses/by/4.0/ https://www.researchprotocols.org This is an open-access article distributed under the terms of the Creative Commons Attribution License (), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first pu

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  Exploring the effects of task shifting for HIV through a systems thinking lens: the case of Burkina Faso

  Fadima Yaya Bocoum, Seni Kouanda, Bocar Kouyaté, Sennen Hounton, Taghreed Adam

  BackgroundWhile the impact of task shifting on quality of care and clinical outcomes has been demonstrated in several studies, evidence on its impact on the health system as a whole is limited. This study has two main objectives. The first is to conceptualize the wider range of effects of task shifting through a systems thinking lens. The second is to explore these effects using task shifting for HIV in Burkina Faso as a case study.MethodsWe used a case study approach, using qualitative research methods. Data sources included document reviews, reviews of available data and records, as well as interviews with key informants and health workers.ResultsIn addition to the traditional measures of impact of task shifting on health outcomes, our study identified 20 possible effects of the strategy on the system as a whole. Moreover, our analysis highlighted the importance of differentiating between two types of health systems effects. The first are effects inherent to the task shifting strategy itself, such as job satisfaction or better access to health services. The second are effects due to health system barriers, for example the unavailability of medicines and supplies, generating a series of effects on the various components of the health system, e.g., staff frustration.Among the health systems effects that we found are positive, mostly unintended, effects and synergies such as increased health workers' sense of responsibility and worthiness, increased satisfaction due to using the newly acquired skills in other non-HIV tasks, as well as improved patient-provider relationships. Among the negative unintended effects are staff frustration due to lack of medicines and supplies or lack of the necessary infrastructure to be able to perform the new tasks.ConclusionOur analysis highlights the importance of adopting a systems thinking approach in designing, implementing and evaluating health policies to mitigate some of the design issues or system bottle-necks that may impede t

  ImmunologieMaladies infectieuses et tropicalesSanté publiqueLicence : http://creativecommons.org/licenses/by/2.0 This is an open access article distributed under the terms of the Creative Commons Attribution License (), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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  Exploring the host factors affecting asymptomatic Plasmodium falciparum infection: insights from a rural Burkina Faso study

  Peter J. Neyer, Bérenger Kaboré, Christos T. Nakas, Britta Hartmann, Annelies Post, Salou Diallo, Halidou Tinto, Angelika Hammerer-Lercher, Carlo R. Largiadèr, Andre J. van der Ven, Andreas R. Huber

  BackgroundAsymptomatic Plasmodium falciparum parasitaemia forms a reservoir for the transmission of malaria disease in West Africa. Certain haemoglobin variants are known to protect against severe malaria infection. However, data on the potential roles of haemoglobin variants and nongenetic factors in asymptomatic malaria infection is scarce and controversial. Therefore, this study investigated the associations of iron homeostasis, inflammation, nutrition, and haemoglobin mutations with parasitaemia in an asymptomatic cohort from a P. falciparum-endemic region during the high transmission season.MethodsA sub-study population of 688 asymptomatic individuals (predominantly children and adolescents under 15 years, n = 516) from rural Burkina Faso previously recruited by the NOVAC trial (NCT03176719) between June and October 2017 was analysed. Parasitaemia was quantified with conventional haemocytometry. The haemoglobin genotype was determined by reverse hybridization assays targeting a selection of 21 HBA and 22 HBB mutations. Demographics, inflammatory markers (interleukins 6 and 10, hepcidin), nutritional status (mid upper-arm circumference and body mass index), and anaemia (total haemoglobin, ferritin, soluble transferrin receptor) were assessed as potential predictors through logistic regression.ResultsMalaria parasites were detected in 56% of subjects. Parasitaemia was associated most strongly with malnutrition. The effect size increased with malnutrition severity (OR = 6.26, CI95: 2.45–19.4, p < 0.001). Furthermore, statistically significant associations (p < 0.05) with age, cytokines, hepcidin and heterozygous haemoglobin S were observed.ConclusionsAccording to these findings, asymptomatic parasitaemia is attenuated by haemoglobin S, but not by any of the other detected genotypes. Aside from evidence for slight iron imbalance, overall undernutrition was found to predict parasitaemia; thus, further investigations are required to elucidate causality and inform str

  Biologie cellulaire et moléculaireGénétiqueBiostatistiques et épidémiologieLicence : Open Access http://creativecommons.org/licenses/by/4.0/ http://creativecommons.org/publicdomain/zero/1.0/ This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as

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  Exploring the Impact of Mining on Community Health and Health Service Delivery: Perceptions of Key Informants Involved in Gold Mining Communities in Burkina Faso

  Sub-Saharan Africa is rich in natural resources but also faces widespread poverty. The United Nations’ Sustainable Development Goals brought increased attention to resource extraction projects, emphasizing their development potential in extraction regions. While mining companies are required to conduct environmental impact assessments, their effect on the project-affected communities’ health mostly lacks systematic management, and their consideration of community perspectives is insufficient. Between March and May 2019, qualitative research was conducted at three industrial gold mines in Burkina Faso. Thirty-six participants, including community leaders, healthcare providers, and mining officials, were interviewed through key informant interviews about their perceptions on the impacts of mining operations on health, health determinants, and health service delivery. Disparities in perceptions were a key focus of the analysis. Mining officials reported mainly positive effects, while healthcare providers and community leaders described enhancing and adverse health impacts without clear trends observed regarding the extent of the impacts on health determinants. The perception of predominantly positive health impacts by mining officials represents a potential risk for insufficient acknowledgement of stakeholders’ concerns and mining-related effects on community health in affected populations. Overall, this study enhances comprehension of the complex interplay between mining operations and health, emphasizing the need for comprehensive assessments, stakeholder involvement, and sustainable practices to mitigate negative impacts and promote the well-being of mining communities.

  Santé publiqueLicence : https://creativecommons.org/licenses/by/4.0/ Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license ().

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• Article libreArticleEn anglais

  Exploring the Patterns of Use and Acceptability of Mobile Phones Among People Living With HIV to Improve Care and Treatment: Cross-Sectional Study in Three Francophone West African Countries

  BackgroundThe use of mobile technology in health care (mobile health [mHealth]) could be an innovative way to improve health care, especially for increasing retention in HIV care and adherence to treatment. However, there is a scarcity of studies on mHealth among people living with HIV (PLHIV) in West and Central Africa.ObjectiveThe aim of this study was to assess the acceptability of an mHealth intervention among PLHIV in three countries of West Africa.MethodsA cross-sectional study among PLHIV was conducted in 2017 in three francophone West African countries: Côte d’Ivoire, Burkina Faso, and Togo. PLHIV followed in the six preselected HIV treatment and care centers, completed a standardized questionnaire on mobile phone possession, acceptability of mobile phone for HIV care and treatment, preference of mobile phone services, and phone sharing. Descriptive statistics and logistic regression were used to describe variables and assess factors associated with mHealth acceptability.ResultsA total of 1131 PLHIV—643 from Côte d’Ivoire, 239 from Togo, and 249 from Burkina Faso—participated in the study. Median age was 44 years, and 76.1% were women (n=861). Almost all participants owned a mobile phone (n=1107, 97.9%), and 12.6% (n=140) shared phones with a third party. Acceptability of mHealth was 98.8%, with the majority indicating their preference for both phone calls and text messages. Factors associated with mHealth acceptability were having a primary school education or no education (adjusted odds ratio=7.15, 95% CI 5.05-10.12; P<.001) and waiting over one hour before meeting a medical doctor on appointment day (adjusted odds ratio=1.84, 95% CI 1.30-2.62; P=.01).ConclusionsThe use of mHealth in HIV treatment and care is highly acceptable among PLHIV and should be considered a viable tool to allow West and Central African countries to achieve the Joint United Nations Programme on HIV/AIDS 90-90-90 goals.

  ImmunologieMaladies infectieuses et tropicalesSanté publiqueLicence : https://creativecommons.org/licenses/by/4.0/ http://mhealth.jmir.org/ This is an open-access article distributed under the terms of the Creative Commons Attribution License (), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published i

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  Exploring the possibilities and limitations of climate-smart agriculture for SDG 2 in West Africa

  Edidiong Samuel Akpabio, Kehinde Oluwaseun Omotoso, Samuel Olawale, Adeola Oluwakemi Ogunbadeniyi

  Climate change continues to exacerbate food insecurity across West Africa, posing a major threat to the achievement of Sustainable Development Goal 2 (SDG 2: Zero Hunger). Despite the multifarious interventions implemented to mitigate its effects, climate vagaries such as floods, erratic weather patterns, droughts, and farmer-herder conflict, as well as weak policy implementation, have coincided with continued population growth, thereby worsening food insecurity in the sub-region. This study examines the possibilities and limitations of engaging climate-smart technologies to achieve SDG 2 in West Africa. The study utilized secondary data sources with the aid of a qualitative methodology grounded in an integrative review, guided by the PRISMA 2020 guidelines. The study narrowed its analysis to 85 relevant studies retrieved from electronic databases such as Scopus, Google Scholar, and EBSCOhost. The entire body of literature on the research was synthesized and consolidated through three theoretical frameworks: Climate Resilience Theory, the Sustainable Food Systems (SFS) Framework, and Agricultural Innovation Diffusion Theory. Findings indicate that while climate-smart agriculture (CSA) recorded a wide range of successes in countries such as Mali, Ghana, Nigeria, Senegal, and Burkina Faso, its adoption rates were notably low in the sub-continent due to the challenges of technological know-how, illiteracy, and weak government policies, among other factors. We concluded that achieving SDG 2 requires a holistic ecosystem approach that integrates digital literacy and climate-smart outputs into regional initiatives such as the WAICSA framework, strengthens regional cooperation, and encourages culturally sensitive technologies to mitigate the sub-region’s vulnerability to persistent food deficit fueled by a worsening climate trajectory.

  Santé publiqueLicence : Creative Commons Attribution License (CC BY) This is an open-access article distributed under the terms of the. The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journa

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  Exploring the relationship between Plasmodium falciparum genetic diversity and antimalarial drugs resistance markers in a malaria-endemic region of Burkina Faso

  Moustapha Nikiema, Issiaka Soulama, Charles Quaye, Hamidou Ilboudo, Seni Nikiema, Justine Kabore, Clarisse Dah, Ali Sie, Athanase Badolo, Awa Gneme

  Introductionthe diversity of Plasmodium falciparum genotypes affects the dynamics of malaria transmission and is thought to be one of the factors hampering malaria control efforts. This study aimed to investigate the relationship between Plasmodium falciparum genetic diversity and chloroquine and sulfadoxine-pyrimethamine resistance markers in malaria endemic areas of Burkina Faso.Methodsin a cross-sectional study, populations residing in Nouna health district were randomly recruited. Blood samples were used for microscopic malaria diagnosis, and genetic polymorphism alleles of msp1 and msp2 genotyping by nested PCR. Restricted fragment length polymorphism analysis was used to identify antimalarial resistance markers. Logistic regression analysis explored the association between msp1/msp2 alleles and antimalarial drug resistance markers. ANOVA was used to explore the association between the mean complexity of infection (mCOI) and prevalence of resistance markers.Resultsthe overall prevalence of Plasmodium falciparum infection was 27.1%. The proportions of K1, MAD20, RO33, FC27, 3D7 individuals with mutations in the pfcrt76T gene were 4.3%, 6.9%, 7.0%, 6.8% and 7.1% respectively. Those with mutations in pfmdr1 were 2.7%, 2%, 2.3%, 6.8% and 7.1%. No significant associations were detected between msp1/msp2 alleles and chloroquine or sulfadoxine-pyrimethamine resistance markers. However, the mean complexity of infection (mCOI) was significantly higher in individuals with the pfcrt76T mutation.Conclusionoverall, this study showed that the genetic diversity of Plasmodium falciparum does not significantly affect the presence of antimalarial drug resistance genes. The competition between different strains (polyclonality) of the parasite within the host was probably unfavorable for mutant strains.

  Biologie cellulaire et moléculaireGénétiqueBiostatistiques et épidémiologieLicence : https://creativecommons.org/licenses/by/4.0/ The Pan African Medical Journal (ISSN: 1937-8688). This is an Open Access article distributed under the terms of the Creative Commons Attribution International 4.0 License (), which permits unrestricted use, distribution, and reproduction in any medium, p

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  Exploring the West African forest island phenomenon: scientific insights gained, successes achieved and capacities strengthened

  Vincent Logah, Jamiu O. Azeez, Halidou Compaore, Samuel Ayodele Mesele, Caleb Melenya Ocansey, Amelie B. Bougma, Erasmus Narteh Tetteh, Elmar Veenendaal, Jon Lloyd

  Anthropogenic activities around local villages in mesic savanna landscapes of West Africa have resulted in soil improvement and forest establishment outside their climatic zones. Such unique ‘forest islands’ have been reported to provide ecosystem services including biodiversity conservation. However, the science underpinning their formations is limitedly studied. In 2015 and with funding support from the Royal Society-DFID (now FCDO), we set out to investigate the biogeochemistry of the forest islands in comparison with adjacent natural savanna and farmlands across 11 locations in Burkina Faso, Ghana and Nigeria. Our results showed that the forest islands do not differ significantly from the adjoining ecosystems in soil mineralogy implying that their formation was anthropogenically driven. We observed greater soil organic carbon and nutrient distributions in the forest islands, which also had more stable macro (>500 μm) and meso-aggregates (500–250 μm) than the adjoining agricultural lands. We found that soil micro-aggregate (250–53 μm) stability was climate (precipitation) driven in the West African ecosystems while meso- and macro-aggregate stability was land-use driven. In one of the unique forest islands we studied in the Mole National Park of Ghana, we found its mineral-associated organic carbon over 40% greater than the adjoining natural savanna with potential implications for the achievement of the global initiative of the ‘4p1000’ in West Africa. We conclude that the North–South–South research collaboration has established clearly, the science underlying the age-long West African forest island phenomenon and has, among many successes, led to capacity building of young scientists driving cutting-edge research in climate change adaptation and food systems transformation in the sub-region.

  Santé publiqueLicence : http://creativecommons.org/licenses/by/4.0/ Published by the Royal Society under the terms of the Creative Commons Attribution License, which permits unrestricted use, provided the original author and source are credited.

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  Exploring Upward and Downward Provider Biases in Family Planning: The Case of Parity

  Brooke W. Bullington, Nathalie Sawadogo, Katherine Tumlinson, Ana Langer, Abdramane Soura, Pascal Zabre, Ali Sié, Leigh Senderowicz

  The authors conceptualize a distinction between “upward” provider bias that occurs when providers pressure or encourage clients to adopt contraception and “downward” provider bias in family planning that discourages contraceptive use. Key Findings “Upward” and “downward” provider biases are distinct manifestations of provider bias when providers pressure or encourage clients to adopt contraception (upward bias) or when providers hinder family planning access (downward bias).Seeking to expand the understanding of provider bias, we analyzed cross-sectional survey data of reproductive-aged women in Burkina Faso and found that 16% of women reported that providers had encouraged them to use contraception because of high parity (upward provider bias) and 1% of women reported providers had discouraged them from using contraception because of low parity (downward provider bias).Age, marital status, number of children, rurality, and attendance at a 45th-day postpartum visit were all associated with provider encouragement to use contraception due to high parity.Key Implication Further research is needed to understand the mechanisms through which upward provider bias operates and develop interventions to address provider bias to ensure contraceptive autonomy for all people. ABSTRACTIntroduction:Provider bias has become an important topic of family planning research over the past several decades. Much existing research on provider bias has focused on the ways providers restrict access to contraception. Here, we propose a distinction between the classical “downward” provider bias that discourages contraceptive use and a new conception of “upward” provider bias that occurs when providers pressure or encourage clients to adopt contraception.Methods:Using cross-sectional data from reproductive-aged women in Burkina Faso, we describe lifetime prevalence of experiencing provider encouragement to use contraception due to provider perceptions of high parity (a type of upward provider b

  Biostatistiques et épidémiologiePédiatrieSanté publiqueLicence : https://creativecommons.org/licenses/by/4.0/ https://doi.org/10.9745/GHSP-D-22-00470 This is an open-access article distributed under the terms of the Creative Commons Attribution 4.0 International License (CC BY 4.0), which permits unrestricted use, distribution, and reproduction in any medium, pro

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  Exposition au mercure et état de santé des médecins dentistes de deux régions du centre du Maroc: enquête transversale descriptive

  Nourdine Attiya, Rkia Fattahi, Ahmed El-Haidani, Nadia Lahrach, Mohamed-Yassine Amarouch, Younes Filali-Zegzouti

  Introductionl´exposition au mercure est un problème de santé publique mondialement reconnu. Si les intoxications aiguës ou subaiguës par ce métal font l´objet d´un consensus diagnostique, l´impact d´une exposition chronique à de faibles doses est encore sujet à débat. En dentisterie, le mercure est utilisé pour la réalisation des amalgames dentaires. De ce fait, les professionnels de la médecine dentaire et spécialement des médecins dentistes représentent une population exposée à ce facteur de risque. Dans ce contexte, une enquête épidémiologique descriptive, transversale et exhaustive a été réalisée afin d´évaluer cette exposition chez les médecins dentistes dans deux régions du centre du Maroc. Parallèlement, leur état de santé globale a été relevé afin de juger de la pertinence d´une enquête étiologique ultérieure pour étudier l´impact probable de l´exposition à ce facteur de risque.Méthodesla présente étude a été réalisée par le biais d´un questionnaire auto-renseigné par les participants. L´exposition professionnelle des médecins dentistes a été évaluée en déterminant la fréquence d´utilisation de l´amalgame dentaire. Les différentes sources de mercure qui modulent la pollution de fond ou qui provoquent des pics d´exposition et qui sont en rapport avec l´environnement ou les habitudes du travail ont aussi été étudiés. Les sources d´exposition non professionnelle prises en compte sont le tabagisme, la vaccination, la consommation de poisson et la présence des amalgames dentaire en bouche. Enfin, l´état de santé des praticiens recrutés dans l´étude a été sondé globalement en se basant sur leurs déclarations.Résultatscent quatre-vingt douze (192) médecins dentistes ont été recrutés dans cette étude. Parmi lesquels, 76,04% déclarent utiliser l´amalgame dans leur pratique avec une fréquence variable. De plus, plusieurs sources de surexposition en rapport avec les conditions ou les habitudes du travail ont été mises en évidence. La principale source d´exposition non

  Biostatistiques et épidémiologieImmunologieSanté publiqueLicence : https://creativecommons.org/licenses/by/4.0/ The Pan African Medical Journal (ISSN: 1937-8688). This is an Open Access article distributed under the terms of the Creative Commons Attribution International 4.0 License (), which permits unrestricted use, distribution, and reproduction in any medium, p

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  Exposition aux PFAS pendant la grossesse

  Sadia Khan, Marion Ouidir, Nadia Alfaidy, Claire Philippat

  Biostatistiques et épidémiologieGynécologie-obstétriqueSanté publiqueLicence : https://creativecommons.org/licenses/by/4.0/

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  Exposition aux poussières de manioc, maïs, soja, et santé respiratoire des meuniers artisanaux de Lubumbashi (République démocratique du Congo)

  Léon Kabamba NGOMBE, Nlandu Roger NGATU, Kazadi Sha NGOMBE, Stanislas Wembonyama OKITOTSHO, Michel Nzaji KABAMBA, Jean-Baptiste Kakoma SAKATOLO, Oscar Luboya NUMBI

  RÉSUMÉObjectifsCe travail avait pour objectif de déterminer la prévalence des symptômes respiratoires, leurs déterminants, ainsi que l’état de la fonction respiratoire des meuniers exposés aux poussières de manioc, maïs et soja à Lubumbashi, en République démocratique du Congo (RDC), en comparaison avec un groupe des travailleurs non-exposés.MéthodesUne étude transversale descriptive et analytique a été menée en 2015 à laquelle ont pris part 288 meuniers et 118 agents (n = 406) d'une agence de sécurité (groupe contrôle) à Lubumbashi, en RDC. Les participants ont été examinés sur leur lieu de travail. Les informations obtenues concernant la santé respiratoire ont été recueillies sur la base d'un questionnaire standardisé. Une spirométrie a été réalisée chez chaque participant.RésultatsL’âge moyen était de 27,6 ± 9 années chez les meuniers et 28,5 ± 7 chez les témoins. La durée journalière de travail était de 12,1±1,7 heures pour les meuniers contre 14,4±6,2 heures chez les témoins. Aucune différence significative n'a été trouvée en comparant les deux groupes. Cependant la prévalence des symptômes respiratoires était plus élevée chez les meuniers que chez le groupe contrôle, notamment pour les sifflements (1,9 fois plus), la sensation de gêne respiratoire (2,1 fois), l'essoufflement au repos (6 fois plus), l'essoufflement à l'effort (6,4 fois plus), la bronchite chronique (6,2 fois plus), la toux (5,3 fois plus) et la présence d'expectorations le matin (5,1 fois plus). Une association a donc été trouvée entre la profession meunière et tous les symptômes respiratoires. Les données spirométriques ont montré que le volume expiratoire maximal à la seconde (VEMS), le débit expiratoire de pointe (DEP) (p<0,05) et le rapport de Tiffeneau (VEMS/CVF) (p<0,001) étaient significativement réduits chez les meuniers comparés aux témoins.ConclusionCette étude a montré une prévalence élevée des symptômes respiratoires avec atteinte de la fonction pulmonaire chez les meuniers de Lubum

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  Exposition aux Poussières et Santé Respiratoire des Broyeurs de Pierres dans la Province du Haut-Katanga en R. D. Congo

  L.-K. Ngombe, R.-N. Nlandu, S.-N. Kazadi, B.-K. Ilunga, S.-W. Okitotsho, J.-B. K. Sakatolo, O.-L. Numbi, B. Danuser

  RésuméLe but de ce travail était de déterminer la prévalence des symptômes et pathologies respiratoires, d'évaluer la fonction respiratoire, ainsi que d'élaborer des mesures préventives chez les broyeurs de pierres dans la province du Haut-Katanga, en République démocratique du Congo (RDC). Une étude transversale à visée analytique a été réalisée dans deux carrières. Au total, 293 broyeurs de pierres et 295 agents administratifs des bureaux communaux (sujets contrôles) ont participé à cette étude. Un questionnaire standardisé a été utilisé pour recueillir les données. La fonction respiratoire a été explorée à l'aide d'un débitmètre de pointe. Les particules fines (PM 2,5) et les composés organiques volatils (COV) dans les différents milieux de travail ont été également mesurés. La prévalence des symptômes respiratoires rapportée chez les broyeurs de pierres a été supérieure à celle du groupe contrôle. Une concentration élevée de PM 2,5 [197,5 μg/m3(185-210 μg/m3)] et des COV [1,95 mg/m3(1,5-2,4 mg/m3)] a été notée chez les broyeurs de pierres par rapport au groupe contrôle [respectivement 33,5 μg/m3(22-45 μg/m3); 0,75 mg/m3(0,6-0,9 mg/m3)]. Le débit expiratoire de pointe (DEP en l/mn) a été significativement réduit chez les broyeurs de pierres (421,84±88,18 l/mn) par rapport aux contrôles (450,37±70,90 l/min) (p<0,05). Il est donc impératif d'améliorer l'environnement et les conditions de travail des broyeurs des pierres.

  Biostatistiques et épidémiologieSanté publiqueLicence : https://creativecommons.org/licenses/by/4.0/ Cet article en libre accès est distribué selon les termes de la licence Creative Commons CC BY 4.0 ().

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  Exposition aux radiofréquences et santé des enfants

  Jean-Francois Dore, Martine Hours, Joel Lelong, Thierry Letertre, Frederique Moati, Mustapha Nadi, Fabien Ndagijimana, Anne Pereira de Vasconcelos, Catherine Yardin, Francine Behar-Cohen, Pierre Ducimetiere, Jean-Marc Bertho, Jean-Marc Bertho, Jean-Pierre Cesarini, Frederic Couturier, Aicha El Khatib, Nicolas Feltin, Alexandre Bounouh, Brigitte Debuire, Emmanuel Flahaut, Alain Muzet, Murielle Lafaye, Philippe Lepoutre, Christophe Martinsons, Catherine Mouneyrac, Yves Sicard, Alain Soyez, Esko Toppila, Laurent Beugnet, Thierry Douki, Olivia Roth-Delgado, Johanna Fite, Olivier Merckel

  En 2009, dans son rapport d’expertise « Mise à jour de l’expertise relative aux radiofréquences » (Afsset, 2009), l’Agence précisait que la caractérisation de l’exposition des enfants aux radiofréquences et les effets sanitaires éventuels restaient méconnus. En 2013, l’Agence insistait à nouveau sur la nécessité de surveiller les effets éventuels des radiofréquences sur la santé des enfants (Anses, 2013). Il existe de nombreux appareils radioélectriques à destination des enfants. Ceux-ci peuvent être à usage récréatif, tels que les jouets radiocommandés, ou à usage de surveillance, tels que les veille-bébés. Ces appareils doivent être conformes aux directives 1999/5/CE1 (dite « R&amp;TTE ») et 2006/95/CE2 (dite « basse tension ») pour être placés sur le marché européen et ainsi porter obligatoirement un marquage de conformité « CE 3». Les États membres de l’Union européenne ne peuvent à ce jour interdire, restreindre, ou entraver la libre circulation de ces produits dès lors qu’ils sont conformes aux prescriptions réglementaires, à moins de justifier de leur dangerosité. Dans le contexte du Grenelle de l’environnement, une controverse scientifique et sociétale sur le niveau de protection qu’apportent ces directives eu égard à l’exposition des enfants a abouti à l’introduction, par la loi du 10 juillet 2010, de l’article L.5231-4 du code de la santé publique (CSP) stipulant que « la distribution à titre onéreux ou gratuit d'objets contenant un équipement radioélectrique dont l'usage est spécifiquement dédié aux enfants de moins de six ans peut être interdite par arrêté du ministre chargé de la santé, afin de limiter l'exposition excessive des enfants ». La saisine soulève ainsi la question de savoir si les directives « R&amp;TTE » et « basse tension » sont suffisamment protectrices en matière de santé et de sécurité vis-à-vis des enfants de moins de six ans. Dès lors que certains équipements radioélectriques à destination des enfants présenteraient un danger pour eux

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  Exposition de l’homme aux éléments traces métalliques et altération du sperme: étude menée dans les zones minières du Haut-Katanga en République Démocratique du Congo

  Richard-A-Mutshimbe Mukendi, Célestin Lubaba Nkulu Banza, Clarence-A-Kaut Mukeng, Jules Thaba Moyambe Ngwe, Albert Ntambwe-A-Nkoy Mwembo, Prosper Muenze Kayamba Kalenga

  IntroductionL'exposition à l'arsenic et au cadmium entraine des effets néfastes importants. L'objectif de cette étude est de déterminer les concentrations urinaires en arsenic et en cadmium chez les hommes et d'analyser leur profil en rapport avec les éléments du spermogramme.MéthodesIl s'agit d'une étude analytique exposés-non exposés où les hommes exposés ont été recrutés dans une zone minière du Haut-Katanga, en RDC et les hommes non-exposés dans une zone loin de toute activité minière.RésultatsNos résultats montrent que 48% des sujets exposés ont un pH du sperme en dessous de la valeur seuil de 7,2 contre seulement 16% des sujets non-exposés. Le risque d'abaissement du pH en deçà des normes étant de plus de 4 fois supérieur (OR=4,85 [1,9-12,39]) chez les exposés. La différence est statistiquement significative entre les moyennes du nombre global des spermatozoides à l'avantage des sujets non-exposés et celles des spermatozoides anormaux beaucoup plus chez les sujets exposés. On note une dégradation plus rapide de la mobilité des spermatozoides chez les sujets exposés. Par ailleurs, 44% des hommes exposés ont une concentration urinaire en arsenic > 20 µg/l contre 8% des sujets non-exposés, le risque d'accumulation excessive d'arsenic est neuf fois plus élevé chez les hommes exposés que chez ceux non exposées (OR=9,04 [2,82-28,96]). Soixante pourcents des hommes exposés ont une concentration urinaire en cadmium ≥ 0,5 µg/ml contre 38% des sujets non-exposés avec un Odd Ratio de 2,45 [1,1-5,47], traduisant un risque d'accumulation excessive de cadmium chez les hommes exposés. D'autre part, on constate chez les hommes exposés que les fortes concentrations urinaires en arsenic et en cadmium entrainent une dégradation proportionnelle des éléments du spermogramme.ConclusionLe présent travail montre bien d'une part de fortes concentrations urinaires d'arsenic et de cadmium et d'autre part l'altération plus rapide et plus sévère des éléments du spermogramme chez les homme

  Licence : The Pan African Medical Journal - ISSN 1937-8688. This is an Open Access article distributed under the terms of the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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  Exposure to cooking emissions in kitchens and chronic obstructive pulmonary disease in women: a population-based case-control study in Ouagadougou, Burkina Faso

  Adama Sana, Benoit Kafando, Nicolas Meda, Catherine Bouland

  Introductionwomen exposed to smoke are three times more likely to suffer from chronic obstructive pulmonary disease than women who cook with clean fuels. The present study aims to compare the level of exposure to particulate matter (PM2.5), carbon monoxide (CO), and total volatile organic compounds (VOCs) inside kitchens, between women with chronic obstructive pulmonary disease (COPD) and healthy women, in Ouagadougou, Burkina Faso.Methodsa pilot case-control study was conducted from January 7th to 25th, 2020, in 2 neighborhoods of Ouagadougou. Cases were women diagnosed with COPD and controls were women without COPD. The diagnosis of COPD was made on the basis of a standardized questionnaire administered and followed by a spirometry test. The sample comprised 9 cases and 9 controls. Exposure was assessed by using a multi-pollutant hand-held device, over a 24-hour period. Exposures of cases and controls were compared using the independent Student's t-test and in cases where the distribution was not normal, the Kruskal-Wallis test was used.Resultsthe mean age was 59 ± 9.86 years in the cases group and 58.56 ± 7.45 years in the control group and there is no significant difference (p = 0.757). The mean concentrations of PM2.5 measured in the 2 groups were above the World Health Organization (WHO) recommended threshold of 15 µg/m3 for 24 h exposure. The mean PM2.5 concentration was 127.10 µg/m3 in the cases and 16.23 µg/m3 in the control group (p= 0.133). Concentrations of CO and VOCs were also higher in the kitchens of the cases than in those of the controls. However, no differences were statistically significant.Conclusionalthough no statistically significant differences were observed, pollutant concentrations were higher in the kitchens of women with COPD. In addition, PM2.5 levels measured in both groups exceeded WHO-recommended thresholds, underlining the need to reduce household exposure to pollutants. Further research is needed to better understand these impacts.

  Santé publiqueLicence : https://creativecommons.org/licenses/by/4.0/ The Pan African Medical Journal (ISSN: 1937-8688). This is an Open Access article distributed under the terms of the Creative Commons Attribution International 4.0 License (), which permits unrestricted use, distribution, and reproduction in any medium, p

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  Exposure to interparental violence and justification of intimate partner violence among women in sexual unions in sub-Saharan Africa

  Richard Gyan Aboagye, Abdul-Aziz Seidu, Bernard Yeboah-Asiamah Asare, Prince Peprah, Isaac Yeboah Addo, Bright Opoku Ahinkorah

  BackgroundJustification of intimate partner violence (IPV) is one of the critical factors that account for the high prevalence of IPV among women. In this study, we examined the association between exposure to interparental violence and IPV justification among women in sexual unions in sub-Saharan Africa (SSA).MethodsData for this study were obtained from the most recent Demographic and Health Surveys (DHS) of 26 countries in SSA conducted between 2010 and 2020. A total of 112,953 women in sexual unions were included in this study. A multivariable binary logistic regression analysis was carried out. The results of the regression analysis were presented using crude odds ratios (cOR) and adjusted odds ratios (aOR) with their respective 95% confidence intervals (CIs).ResultsThe prevalence of interparental violence in the countries considered in this study was 23.8%, with the highest (40.8%) and lowest (4.9%) in Burundi and Comoros, respectively. IPV justification was 45.8%, with the highest and lowest prevalence in Mali (80.9%) and South Africa (4.6%) respectively. Women who were exposed to interparental violence were more likely to justify IPV compared to those who were not exposed [aOR = 1.53, 95% CI = 1.47–1.59]. We found higher odds of justification of IPV among women who were exposed to interparental violence compared to those who were not exposed in all the countries, except Burkina Faso, Comoros, Gambia, and Rwanda.ConclusionThe findings call for several strategies for addressing interparental violence. These may include empowerment services targeting both men and women, formation of stronger social networks to improve women’s self-confidence, and the provision of evidence-based information and resources at the community level. These interventions should pay critical attention to young people exposed to interparental violence. Public health education and messaging should emphasise on the negative health and social implications of interparental violence and IPV.

  Biostatistiques et épidémiologieSanté publiqueLicence : Open Access http://creativecommons.org/licenses/by/4.0/ http://creativecommons.org/publicdomain/zero/1.0/ This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as

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  Exposure to Livestock Feces and Water Quality, Sanitation, and Hygiene (WASH) Conditions among Caregivers and Young Children: Formative Research in Rural Burkina Faso

  Francis Ngure, Aulo Gelli, Elodie Becquey, Rasmané Ganaba, Derek Headey, Lieven Huybregts, Abdoulaye Pedehombga, Armande Sanou, Abdoulaye Traore, Florence Zongo, Amanda Zongrone

  Abstract.Livestock farming is common in low-income settings as a source of income and animal-sourced food. However, there is growing evidence of the harmful health effects of proximity of animals to infants and young children, especially through exposure to zoonotic pathogens. Poultry ownership is almost universal in rural Burkina Faso. Poultry feces are a significant risk factor for enteric diseases that are associated with child undernutrition. To investigate the extent of exposure to livestock feces among young children and caregivers, we conducted direct observations of 20 caregiver–child dyads for a total of 80 hours (4 hours per dyad) and recorded water quality, sanitation, and hygiene (WASH)-related behaviors. We also undertook in-depth interviews with these caregivers and focus group discussions with separate groups of men and women who were poultry farmers. Poultry and other livestock feces were visible in all 20 and 19 households, respectively, in both kitchen areas and in the household courtyards where children frequently sit or crawl. Direct soil ingestion by young children was observed in almost half of the households (45%). Poor handwashing practices were also common among caregivers and children. Although latrines were available in almost all households, child feces disposal practices were inadequate. This body of research suggests an urgent need to adapt conventional WASH and livestock interventions to reduce the exposure of infants and young children to livestock feces.

  PédiatrieSanté publiqueLicence : Creative Commons Attribution License This is an open-access article distributed under the terms of the, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

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  Expression de NF-κB, EGFR et HER3 dans l’adénocarcinome prostatique résistant à la castration: étude clinique et moléculaire chez 88 patients marocains

  Ilham Sadaoui, Imane Sadaoui, Hanaa Amrani Hassani Joutei, Hakima Benomar, Sellama Nadifi

  La progression de l'adénocarcinome prostatique (CaP) vers la résistance à la castration implique des dérèglements moléculaires complexes. Cette étude évalue l'implication de NF-κB et des récepteurs à l'EGF (EGFR, HER3) dans l'agressivité tumorale chez des patients marocains. Une étude rétrospective avec analyse immunohistochimique a été réalisée sur les tissus de 88 patients atteints de CaP. L'expression des sous-unités de NF-κB (p65, p50, RelB), de l'EGFR et de HER3 a été corrélée au statut de résistance à la castration et au score de Gleason (tests du Chi-carré et régression logistique). Une forte localisation nucléaire de NF-κB a été observée dans les cellules cancéreuses résistantes à la castration (p = 0,0005), constituant un marqueur prédictif de progression. Parallèlement, une surexpression de l'EGFR a été identifiée chez les patients hormono-réfractaires (OR = 5,37; p = 0,0010). L'expression nucléaire de HER3 était significativement corrélée à un grade de Gleason élevé (≥ 7) dans les tumeurs résistantes (p = 0,0064). L'activation nucléaire de NF-κB et de HER3, ainsi que la surexpression de l'EGFR, jouent un rôle clé dans l'évolution vers l'échappement hormonal. Ces molécules représentent des cibles thérapeutiques et des biomarqueurs pronostiques prometteurs pour la prise en charge du CaP à haut risque au Maroc.

  Microbiologie (bactériologie, virologie)ImmunologiePharmacologieLicence : https://creativecommons.org/licenses/by/4.0/ The Pan African Medical Journal (ISSN: 1937-8688). This is an Open Access article distributed under the terms of the Creative Commons Attribution International 4.0 License (), which permits unrestricted use, distribution, and reproduction in any medium, p

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  Expression génitale isolée du syndrome de Stevens-Johnson

  Idriss Ziani, Ahmed Ibrahimi

  Stevens-Johnson syndrome (SJS) is a dermatological and systemic disease. It is a potentially life-threatening condition, almost always triggered by medications, and characterized by extensive skin destruction. It is sometimes associated with the involvement of other epithelia. Its immunological mechanisms are only partially elucidated. Current hypothesis is: delayed-type drug hypersensitivity involving drug-specific cytotoxic T lymphocytes in the blood and skin of patients. Clinically, symptoms occur 1 to 3 weeks after the incriminated drug is started. The patient develops prodromal symptoms including a feeling of discomfort, fever, headache, cough, and keratoconjunctivitis. Macules, often showing a “cockade” pattern, suddenly appear. These lesions appear simultaneously elsewhere on the body, coalesce into large flaccid bullae and slough over a period of 1 to 3 days. Diagnosis is often based on lesions occurrence and rapid progression of symptoms. Histological examination of sloughed skin shows typical necrotic epithelium. Treatment is based on supportive care, cyclosporin, plasmapheresis or IV immunoglobulins, early corticotherapy and TNF (tumor necrosis factor)-alpha inhibitors. Mortality rate is high. The particularity of this case is the isolated genital involvement, 6 days after the intake of a non-steroidal anti-inflammatory drug. Despite prompt management in the Intensive Care Unit, the patient had multi-visceral failure. He died due to refractory shock.

  ImmunologiePharmacologieLicence : https://creativecommons.org/licenses/by/4.0/ The Pan African Medical Journal (ISSN: 1937-8688). This is an Open Access article distributed under the terms of the Creative Commons Attribution International 4.0 License (), which permits unrestricted use, distribution, and reproduction in any medium, p

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