Pierre Sonigo, Caroline Petit, Nathalie Jane Arhel
Des travaux de développement accélérés ainsi que des investissements exceptionnels ont permis en 2020 de faire face à l’urgence sanitaire en accélérant la mise au point et l’évaluation de vaccins contre la Covid-19 [1]. Paradoxalement au regard de cette prouesse technologique et médicale, la rapidité de leur mise en place et les enjeux financiers ont contribué à enflammer et insécuriser l’opinion
Biologie cellulaire et moléculaireGénétiqueBiostatistiques et épidémiologieLicence : https://creativecommons.org/licenses/by/4.0/
Jawad Laaguili, Abad Cherif El Asri, Miloud Gazzaz, Moulay Rachid El Hassani, Brahim El Mostarchid
Nous rapportons un cas d'anévrysme post-traumatique de l'artère carotide interne chez un enfant de 11 ans, ayant présenté une ophtalmoplégie droite. Un faux anévrisme de la carotide interne droite a été diagnostiqué par angiographie cérébrale. Le malade a bénéficié d'un traitement endovasculaire et l’évolution fut favorable. Malgré leur rareté, le diagnostic des anévrysmes post traumatiques devrait être évoqué chez tout traumatisé crânien en cas d'aggravation clinique secondaire, afin de réaliser une exploration angiographique avant d'envisager un traitement radical soit chirurgical soit par voie endovasculaire.
PédiatrieLicence : 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.
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.
Le pseudo anévrysme de l'arcade palmaire superficielle est une entité rare et seuls quelques cas ont été décrits dans la littérature. La majorité se développe après une lésion de l'artère suite à un traumatisme pénétrant, à une intervention chirurgicale antérieure ou à une ponction artérielle. Le diagnostic repose sur une suspicion clinique élevée, notamment en présence d'une masse pulsatile. Ci-dessous, nous présentons le cas d'un faux anévrisme de l'arcade palmaire superficielle chez un enfant de 3 ans à la suite d'une blessure par du verre brisé.
PédiatrieLicence : 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
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.
Depuis ces dernières années, nous assistons à une révolution technologique en génétique moléculaire avec l’avènement du séquençage de nouvelle génération (NGS). Lors des consultations médicales de génétique à l’hôpital, le patient est confronté à la question difficile de la recherche et de la divulgation des données dites additionnelles, qui ne sont pas en lien avec sa pathologie, la donnée primaire. Il peut s’agir de données incidentes (la découverte est fortuite) ou de données secondaires, c’est-à-dire des données recherchées activement dans une liste de gènes définie. Comment s’assurer de l’autonomie suffisante des patients face à cette question? Quel est le rôle de l’équipe soignante? Peut-on harmoniser les pratiques relativement à ces données? Nous proposons une stratégie de l’échelle variable appliquée à la génétique qui consiste à adapter le degré d’autonomie exigé en fonction de l’impact médical et du niveau de fiabilité des données génétiques transmises au patient. Nous apportons également des éléments pour favoriser l’autonomie du patient. Il nous paraît nécessaire de dissocier distinctement la donnée primaire des données additionnelles, de développer les moyens visant à délivrer une information adéquate au patient et enfin d’accompagner le patient dans sa démarche par un soutien psychologique et de respecter un délai de réflexion. De manière ultime, il appartient à l’équipe médicale d’évaluer au cas par cas du bienfondé de la recherche de ces données et de leur révélation au patient.
Biologie cellulaire et moléculaireGénétiqueLicence : https://creativecommons.org/licenses/by/4.0/
BackgroundA multi-country, community-based trial on scheduled screening and treatment for malaria in pregnancy was conducted in Benin, The Gambia and Burkina Faso. Despite standardized procedures and outcomes, the study became subject to rumours and accusations of placenta being sold for mystical and financial gain by trial staff, leading to drop-out rates of 30% and the consequent halting of placental biopsy sampling in Benin. This paper explores the role of socio-cultural beliefs related to placenta and identified additional factors contributing these rumours.MethodsA qualitative comparative emergent-theory design was used to assess social factors related to trial implementation and uptake in the three countries. Data from participant observation, informal conversations, group discussions and interviews were triangulated and analysed with NVivo Qualitative Analysis software.ResultsDespite similar sociocultural beliefs about the sacred nature of the placenta in all three study countries, these beliefs did not affect participation rates in Burkina Faso and The Gambia and placenta-related rumours only emerged in Benin. Therefore, the presence of beliefs is not a sufficient condition to have generated placenta-selling fears. The rumours in Benin reflected the confluence of placenta-related beliefs and factors related to the implementation of the trial (including a catalysing adverse event and miscommunication during the informed consent procedure). Furthermore, distinct socio-political factors contributed to the emergence of rumours, including the historical distrust in governmental organizations and the tense relationship between some of the actors involved in the trial.ConclusionTransdisciplinary social science research designs should accompany the implementation of the trial. The integration of multiple stakeholders’ knowledge and involvement is required to define and solve upcoming barriers.
Parasitologie et mycologieMaladies infectieuses et tropicalesGynécologie-obstétriqueLicence : Open Access http://creativecommons.org/licenses/by/4.0/ http://creativecommons.org/publicdomain/zero/1.0/ This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (), which permits unrestricted use, distribution, and reproduction in any medium, provid
(1) Background: Effective malaria case management relies on World Health Organization (WHO) recommended artemisinin-based combination therapies (ACTs), but partial resistance to artemisinin has emerged and is spreading, threatening malaria control and elimination efforts. The strategy of deploying multiple first-line therapies (MFT) may help mitigate this threat and extend the therapeutic life of current ACTs. (2) Methods: A district-wide pilot quasi-experimental study was conducted, deploying three different ACTs at the public health facility (PHF) level for uncomplicated malaria treatment from December 2019 to December 2020 in the health district (HD) of Kaya, Burkina Faso. Mixed methods, including household and health facility-based quantitative and qualitative surveys, were used to evaluate the pilot programme. (3) Results: A total of 2008 suspected malaria patients were surveyed at PHFs, of which 79.1% were tested by rapid diagnostic test (RDT) with 65.5% positivity rate. In total, 86.1% of the confirmed cases received the appropriate ACT according to the MFT strategy. The adherence level did not differ by study segment (p = 0.19). Overall, the compliance level of health workers (HWs) with MFT strategy was 72.7% (95% CI: 69.7–75.5). The odds of using PHF as the first source of care increased after the intervention (aOR = 1.6; 95% CI, 1.3–1.9), and the reported adherence to the 3-day treatment regimen was 82.1%; (95% CI: 79.6–84.3). Qualitative results showed a high acceptance of the MFT strategy with positive opinions from all stakeholders. (4) Conclusions: Implementing an MFT strategy is operationally feasible and acceptable by stakeholders in the health systems in Burkina Faso. This study provides evidence to support the simultaneous use of multiple first-line artemisinin combination therapies in malaria-endemic countries such as Burkina Faso.
Biostatistiques et épidémiologieMicrobiologie (bactériologie, virologie)Parasitologie et mycologieLicence : 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 ().
Patricia Akweongo, Peter Agyei-Baffour, Morankar Sudhakar, Bertha N Simwaka, Amadou T Konaté, Philip B Adongo, Edmund NL Browne, Ayalew Tegegn, Doreen Ali, Abdoulaye Traoré, Mary Amuyunzu-Nyamongo, Franco Pagnoni, Guy Barnish
BackgroundThe community case management of malaria (CCMm) is now an established route for distribution of artemisinin-based combination therapy (ACT) in rural areas, but the feasibility and acceptability of the approach through community medicine distributors (CMD) in urban areas has not been explored. It is estimated that in 15 years time 50% of the African population will live in urban areas and transmission of the malaria parasite occurs in these densely populated areas.MethodsPre- and post-implementation studies were conducted in five African cities: Ghana, Burkina Faso, Ethiopia and Malawi. CMDs were trained to educate caregivers, diagnose and treat malaria cases in < 5-year olds with ACT. Household surveys, focus group discussions and in-depth interviews were used to evaluate impact.ResultsQualitative findings: In all sites, interviews revealed that caregivers' knowledge of malaria signs and symptoms improved after the intervention. Preference for CMDs as preferred providers for malaria increased in all sites.Quantitative findings: 9001 children with an episode of fever were treated by 199 CMDs in the five study sites. Results from the CHWs registers show that of these, 6974 were treated with an ACT and 6933 (99%) were prescribed the correct dose for their age. Fifty-four percent of the 3,025 children for which information about the promptness of treatment was available were treated within 24 hours from the onset of symptoms.From the household survey 3700 children were identified who had an episode of fever during the preceding two weeks. 1480 (40%) of them sought treatment from a CMD and 1213 of them (82%) had received an ACT. Of these, 1123 (92.6%) were administered the ACT for the correct number of doses and days; 773 of the 1118 (69.1%) children for which information about the promptness of treatment was available were treated within 24 hours from onset of symptoms, and 768 (68.7%) were treated promptly and correctly.ConclusionsThe concept of CCMm in an ur
Biostatistiques et épidémiologieParasitologie et mycologieMaladies infectieuses et tropicalesLicence : 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.
Current climate projections estimate a further rise of mean ambient temperatures of 1.5°C until 2040. However, the understanding of heat stress’s impact on health and labor capacity, especially in vulnerable regions such as sub-Saharan Africa, remains limited. In turn, no long-term investigations monitoring and uniting both individual-level subject and environmental data have been yet conducted in this region. To address this knowledge gap, we evaluated the feasibility and acceptability of research-grade wearables for continuous, direct, individual-level monitoring of physiological parameters in a population of subsistence farmers (one woman and one man per n=20 households) in rural Burkina Faso. We conducted a four-week pilot study, investigating data completeness and quality of heart rate and core body temperature, and data completeness for physical activity, and GPS individual tracking, simultaneously monitoring outdoor and indoor wet-bulb-globe temperature. Additionally, participants were surveyed regarding their acceptance of employed wearables. Regarding environmental indoor monitoring, we collected 85% of completed data, whereas for outdoor, it was 100%. An average of 97.5% of viable data sets were retrieved for all wearables (heart rate: 97.5%, core body temperature: 97.5%, physical activity: 97.5%, GPS: 97.5%). Individual data point completeness was > 92% for all sensors, except GPS, where it was 67% on average. Acceptance of wearables was positive, with a range of 79% to 95%. The main challenges perceived by participants were missing personalized sensor feedback (70%) and uncertainty regarding the meaning of the wearables (47.5%). We show that the implementation of research-grade wearables in sub-Saharan Africa is technically feasible and socially accepted. Further, we point out current challenges and provide a solid framework for future research in this region.
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.
IkeOluwapo O. Ajayi, Jesca Nsungwa-Sabiiti, Mohamadou Siribié, Catherine O. Falade, Luc Sermé, Andrew Balyeku, Chinenye Afonne, Armande K. Sanou, Vanessa Kabarungi, Frederick O. Oshiname, Zakaria Gansane, Josephine Kyaligonza, Ayodele S. Jegede, Alfred B. Tiono, Sodiomon B. Sirima, Amidou Diarra, Oyindamola B. Yusuf, Florence Fouque, Joëlle Castellani, Max Petzold, Jan Singlovic, Melba Gomes
Background. Malaria-endemic countries are encouraged to increase, expedite, and standardize care based on parasite diagnosis and treat confirmed malaria using oral artemisinin-based combination therapy (ACT) or rectal artesunate plus referral when patients are unable to take oral medication.Methods. In 172 villages in 3 African countries, trained community health workers (CHWs) assessed and diagnosed children aged between 6 months and 6 years using rapid histidine-rich protein 2 (HRP2)–based diagnostic tests (RDTs). Patients coming for care who could take oral medication were treated with ACTs, and those who could not were treated with rectal artesunate and referred to hospital. The full combined intervention package lasted 12 months. Changes in access and speed of care and clinical course were determined through 1746 random household interviews before and 3199 during the intervention.Results. A total of 15 932 children were assessed: 6394 in Burkina Faso, 2148 in Nigeria, and 7390 in Uganda. Most children assessed (97.3% [15 495/15 932]) were febrile and most febrile cases (82.1% [12 725/15 495]) tested were RDT positive. Almost half of afebrile episodes (47.6% [204/429]) were RDT positive. Children eligible for rectal artesunate contributed 1.1% of episodes. The odds of using CHWs as the first point of care doubled (odds ratio [OR], 2.15; 95% confidence interval [CI], 1.9–2.4; P < .0001). RDT use changed from 3.2% to 72.9% (OR, 80.8; 95% CI, 51.2–127.3; P < .0001). The mean duration of uncomplicated episodes reduced from 3.69 ± 2.06 days to 3.47 ± 1.61 days, Degrees of freedom (df) = 2960, Student's t (t) = 3.2 (P = .0014), and mean duration of severe episodes reduced from 4.24 ± 2.26 days to 3.7 ± 1.57 days, df = 749, t = 3.8, P = .0001. There was a reduction in children with danger signs from 24.7% before to 18.1% during the intervention (OR, 0.68; 95% CI, .59–.78; P < .0001).Conclusions. Provision of diagnosis and treatment via trained CHWs increases access to
Parasitologie et mycologieMaladies infectieuses et tropicalesPédiatrieLicence : http://creativecommons.org/licenses/by/3.0/igo/legalcode This is an open access article distributed under the terms of the Creative Commons Attribution IGO License (), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. In any r
Jeannette Bassimbié Kakou Danho, Yao Nicaise Atiméré, Daouda Koné, Donafologo Daouda Yéo, Line Couitchéré
Sickle cell disease is a hereditary disease that predominantly affects black people. It is very widespread in sub-Saharan Africa, particularly at the Lehmann “sickle belt” level, where the prevalence of the hemoglobin S involves at least 10% of the population in West Africa and can reach 40% in Central Africa. In Côte d'Ivoire, the prevalence of the hemoglobin S is about 12–14% in the general population and about 11.71% in the child population in Abidjan. On the other hand, its coexistence with other hemoglobin phenotypes such as AC (6.2%) and β-thalassemia (2.7%) traits may also cause composite heterogeneous sickle cell disease, e.g., SC or S/β-thalassemia in this study. Since 2009, sickle cell disease has been recognized as a public health problem; however, much still remains to be performed despite the progress achieved. The objective of this study is thus to promote a rapid screening for the struggling against sickle cell disease in Côte d'Ivoire. This study was carried out over 6 months (April–September 2019) and has included 336 children, of which 236 all-comers, recruited in the municipality of Treichville in Abidjan and 100 other children with already known hemoglobin phenotype followed up in the Hematology Department of the University Hospital of Treichville. Two tests were used: the HemoTypeSC™ for rapid screening and the hemoglobin electrophoresis which is the reference method used for confirming the diagnosis in the laboratory. The findings confirmed the reliability of the HemoTypeSC™ with a sensitivity and specificity at 100% for the detection of hemoglobin A, S, and C. On the other hand, this sensitivity and specificity drop to 98.2% and 99.7%, respectively, when we analyze all the 336 children together, including the cases with HbF detected by hemoglobin electrophoresis. Hence, the importance of performing certainty tests following the HemoTypeSC™ screening test in order to determine the accurate phenotypes and proportions of the types of hemoglobin.
Biostatistiques et épidémiologieHématologiePédiatrieLicence : This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
BackgroundThe World Health Organization Safe Childbirth Checklist tool was specifically designed for developing countries such as sub-Saharan African countries, to ensure safety and security of the couple mother and newborn around the time of childbirth. However, the implementation of the Safe Childbirth Checklist tool requires a good knowledge of the context setting to face challenges. Our study objectives were (1) to assess the acceptability of the WHO SCC tool and (2) to identify conditions and strategies for a better introduction and use of the WHO SSC tool.MethodsThis was a pilot multi-country study conducted from January to March 2019 in Burkina Faso and Côte d’Ivoire, respectively, in the health regions of central-North and Agnéby-Tiassa-Mé. In each health region, 5 health facilities of different levels within the health system pyramid were selected through a purposive sampling. The study was conducted in 2 phases: 38 healthcare providers and 15 managers were first trained to use the Safe Childbirth Checklist tool; secondly, the trained providers were allowed to use the tool in real-life conditions for 2 weeks. Then, semi-structured interviews were conducted among healthcare providers and managers. The topics covered by the interview guides were acceptability of the tool, barriers and facilitators to its use, as well as strategies for better introduction and use within the healthcare system. Analysis was carried out using the Nvivo 12 software.ResultsRespondents reported an overall good acceptance of using the tool. However, they suggested minor content adaptation. The design of the tool and increased workload were the main barriers to its use. Potential facilitators to its introduction were managers’ commitment, healthcare providers’ motivation, and the availability of supplies. The best strategies for optimal use were its attachment to existing tool such as partograph or/and its display in the maternity ward.ConclusionsThe findings showed that the implement
PédiatrieGynécologie-obstétriqueSanté 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
As the epidemiological transition progresses throughout sub-Saharan Africa, life lived with diseases is an increasingly important part of a population’s burden of disease. The burden of disease of climate-sensitive health outcomes is projected to increase considerably within the next decades. Objectively measured, reliable population health data is still limited and is primarily based on perceived illness from recall. Technological advances like non-invasive, consumer-grade wearable devices may play a vital role in alleviating this data gap and in obtaining insights on the disease burden in vulnerable populations, such as heat stress on human cardiovascular response. The overall goal of this study is to investigate whether consumer-grade wearable devices are an acceptable, feasible and valid means to generate data on the individual level in low-resource contexts. Three hundred individuals are recruited from the two study locations in the Nouna health and demographic surveillance system (HDSS), Burkina Faso, and the Siaya HDSS, Kenya. Participants complete a structured questionnaire that comprises question items on acceptability and feasibility under the supervision of trained data collectors. Validity will be evaluated by comparing consumer-grade wearable devices to research-grade devices. Furthermore, we will collect demographic data as well as the data generated by wearable devices. This study will provide insights into the usage of consumer-grade wearable devices to measure individual vital signs in low-resource contexts, such as Burkina Faso and Kenya. Vital signs comprising activity (steps), sleep (duration, quality) and heart rate (hr) are important measures to gain insights on individual behavior and activity patterns in low-resource contexts. These vital signs may be associated with weather variables—as we gather them from weather stations that we have setup as part of this study to cover the whole Nouna and Siaya HDSSs—in order to explore changes in behavio
Biostatistiques et épidémiologieMédecine interne (cardiologie, endocrinologie, néphrologie…)Santé 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.
Anselme Millogo, Ahmed Loukil, Coralie L’Ollivier, Diakourga Arthur Djibougou, Sylvain Godreuil, Michel Drancourt
Mycobacterium leprae was detected by optical microscopy, fluorescent in situ hybridization, and molecular detection in feces collected for the diagnosis of Entamoeba coli enteritis in a leprosy patient in Burkina Faso. This observation raises questions about the role of fecal excretion of M. leprae in the natural history and diagnosis of leprosy.
Microbiologie (bactériologie, virologie)Maladies infectieuses et tropicalesSanté publiqueLicence : This is a publication of the U.S. Government. This publication is in the public domain and is therefore without copyright. All text from this work may be reprinted freely. Use of these materials should be properly cited.
Santé publiqueLicence : This is a publication of the U.S. Government. This publication is in the public domain and is therefore without copyright. All text from this work may be reprinted freely. Use of these materials should be properly cited.
AbstractObjectivesPrevious research on subjective age (SA), that is, how young or old a person feels relative to their chronological age, has shown that older adults tend to feel younger than they are (by about 15%–20%), but the extent of this effect depends, in part, on their health. However, as most of the studies have been conducted in Western countries, it is unclear how well these results generalize to culturally different samples. Objectives, therefore, were to examine SA in middle-aged and older adults from a very low-income setting in rural Burkina Faso, to examine associations between SA and health/quality of life-related measures, and to compare findings with Western studies.MethodsRepresentative, cross-sectional sample of N = 3,028 adults (≥40 years, recruited in 2018) from north-western Burkina Faso. Data included questionnaires on depression (Patient Health Questionnaire-9) and quality of life (World Health Organization Quality of Life scale, including subjective health) as well as performance-based and objective health-related measures (Community Screening Instrument for Dementia as cognitive screening, walking speed).ResultsRespondents felt on average 3% younger (SD = 0.13) than their chronological age, with 48% (95% confidence interval: 0.46–0.50) feeling younger—27 percentage points lower than seen in representative Western studies. Lower depression, better walking speed, cognition, and quality of life were all associated with younger SA.DiscussionMiddle-aged and older adults in Nouna felt less young than similar age groups in Western studies. One of the reasons may be that youthfulness is less of a value outside Western cultures. As in Western studies, parts of the variation in SA can be explained by health parameters.
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Abdul-Aziz Seidu, Richard Gyan Aboagye, Barbara Sakyi, Collins Adu, Edward Kwabena Ameyaw, Joycelyn Boatemaa Affum, Bright Opoku Ahinkorah
BackgroundThere is evidence that women who have had their genitals cut suffer substantial difficulties during and/or after childbirth, including the need for a caesarean section, an episiotomy, an extended hospital stay, post-partum bleeding, and maternal fatalities. Whether or not women in sub-Saharan Africa who have undergone female genital mutilation utilize the services of skilled birth attendants during childbirth is unknown. Hence, we examined the association between female genital mutilation and skilled birth attendance in sub-Saharan Africa.MethodsThe data for this study were compiled from 10 sub-Saharan African countries’ most recent Demographic and Health Surveys. In the end, we looked at 57,994 women between the ages of 15 and 49. The association between female genital mutilation and skilled birth attendance was investigated using both fixed and random effects models.ResultsFemale genital mutilation and skilled birth attendance were found to be prevalent in 68.8% and 58.5% of women in sub-Saharan Africa, respectively. Women with a history of female genital mutilation had reduced odds of using skilled birth attendance (aOR = 0.91, 95% CI = 0.86–0.96) than those who had not been circumcised. In Ethiopia, Guinea, Liberia, Kenya, Nigeria, Senegal, and Togo, women with female genital mutilation had reduced odds of having a trained delivery attendant compared to women in Burkina Faso.ConclusionThis study shed light on the link between female genital mutilation and skilled birth attendance among sub-Saharan African women. The study's findings provide relevant information to government agencies dealing with gender, children, and social protection, allowing them to design specific interventions to prevent female genital mutilation, which is linked to non-use of skilled birth attendance. Also, health education which focuses on childbearing women and their partners are necessary in enhancing awareness about the significance of skilled birth attendance and the health
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
Teresa Buitrago-García, N Hélène Sawadogo, Aurélia Souares, Jean-Louis Koulidiati, Ali Sié, Till Bärnighausen, Sarah Langlotz, Shannon A McMahon
BackgroundAn absence of gender-sensitive sanitation facilities in schools and the negative effects this has on girls has been widely discussed among advocacy groups, though less examined in academic spheres. Drawing on triangulated data, we outline current challenges and respondent-driven solutions to enhance the female-friendly nature of toilets in a context of extreme poverty.MethodsThis mixed-methods study was informed by the tenets of human-centred design. We first quantitatively assessed facilities in 14 secondary schools in the Kossi Province of Burkina Faso. We then collected qualitative data, including 15 focus group discussions and 53 in-depth interviews among schoolgirls, mothers, teachers and key informants. We applied photo-elicitation, a novel method, to explore perceptions of facilities and the desirability and feasibility of interventions to improve gender-friendly sanitation facilities.ResultsNo school met international water, sanitation and hygiene (WASH) standards for schools. Roughly one third of schools did not have water and, when present, there was no reliable way to use it within the toilet complex. Schoolgirls shared feelings of shame and stress when menstruating at school, and said that they would avoid using school toilets, if possible. Schoolgirls described water access as the most urgent need to address, followed by fostering privacy and facilitating cleanliness within facilities. Mothers and teachers mostly aligned with these priorities, while key informants additionally emphasised the need to raise awareness on both general and menstrual hygiene and to develop maintenance systems. Photo-elicitation engaged and empowered participants to pinpoint priorities and concrete solutions, namely a need for doors and locks, water containers and cleaning materials.ConclusionsWASH needs in many schools remain unmet. Women and girls should be involved in decision-making across stages of intervention design and implementation. Young women’s voices mer
Santé publiqueLicence : This work is licensed under a Creative Commons Attribution 4.0 International License.
Les fentes oro-faciales sont des malformations congénitales fréquentes. La classification la plus utilisée est celle de Tessier qui comprend 30 variantes. Dont les fentes mandibulaires médianes (fente n°30 de Tessier) isolées ou accompagnées d´une fente de la lèvre inférieure, de la langue ou rarement du sternum. Elles sont très rares, moins de 70 cas (toutes formes confondues) ont été décrits dans la littérature. Nous rapportons un cas exceptionnel d´une fente mandibulo-sternale et nous faisons une revue de la littérature.
Licence : 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
Daniel Sylvère OUAÏMON, Valère NDOMA NGATCHOUKPO, Jacob Israël Junior SOPIO, Arnaud Rodrigue BOROHOUL
RésuméLa fente palatine est l'absence de substance de la voûte buccale aboutissant à une communication entre le nez et la bouche. Il s'agit d'une malformation congénitale fréquente dont les facteurs étiologiques incriminés sont exogènes et génétiques. Le diagnostic est clinique et la recherche des étiologies repose généralement sur des analyses de sang. La prise en charge de la fente palatine s'organise dorénavant dans un cadre multidisciplinaire où la coordination de chaque spécialité permettra d'harmoniser les différents traitements. L'attitude actuelle repose sur le principe d'une prise en charge précoce permettant de restaurer le plus rapidement possible la fonctionnalité des sangles musculaires vélopalatines réduisant les risques de séquelles phonatoires et auditives. Concernant les fentes palatines, les données sont parcellaires et quasi inexistantes en République centrafricaine, d'où l'intérêt de mettre à la lumière du jour ce cas clinique présent chez une adolescente de 13 ans découverte au décours d'une campagne de dépistage et traitement des fentes labiopalatines au Centre hospitalier universitaire pédiatrique de Bangui.
Biologie cellulaire et moléculaireGénétiquePédiatrieLicence : 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 ().
Cedrick Milindi Sangwa, Olivier Mukuku, Christian Tshisuz, Jules Mulefu Panda, Mireille Kakinga, Marius Feruzi Kitembo, Jean-Felix Mutomb, Bwana Fwamba Odimba
Les fentes labiopalatines sont les malformations les plus rencontrées de la sphère orofaciale. L'objectif est de décrire le profil épidémiologique, anatomoclinique et thérapeutique des fentes labiopalatines observées dans la province minière du Katanga au sud-est de la République Démocratique du Congo. Il s'agit d'une étude transversale réalisée dans quatre institutions hospitalières de la province du Katanga dans des districts sanitaires différents (Hôpital Jason Sendwe à Lubumbashi, Hôpital Gécamines Panda à Likasi, Hôpital Gécamines du personnel à Kolwezi, Hôpital General de référence de Kamina) et qui a porté sur 154 cas de fentes labiopalatines enregistrés au cours de la période allant du 1er mai 2010 au 30 septembre 2012. L'âge moyen de consultation était de 11,8 ans et une prédominance masculine (55,2%) était notée. Un pic était noté chez les deux premiers nés de la famille (55,8%). Nous avons enregistré 20,7% des cas de consanguinité dont 54,2% de premier degré. La fréquence des différents types de fentes labiopalatines diminue au fur à mesure que la fente s'étend de la lèvre supérieure au palais en passant par l'alvéole : 72% (labiales), 21,4% (labiopalatines) et 7,7% (palatines). Les variétés unilatérales sont plus fréquentes (76,7%) que les bilatérales (16,1%). Dans les formes unilatérales, le côté gauche est plus concerné (47,1%) par rapport au côté droit (38,6%). L'évaluation de la gravité selon Anastassov montre que 50,6% de nos patients étaient de degré moyen et 16,2% étaient à un degré sévère. Les malformations associées ont été retrouvées dans 5% des cas et elles sont à prédominance squelettique. C'est la technique de Millard qui a été la plus pratiquée (72/130). Les résultats étaient excellents dans 71,5% contre 1,5% de mauvais. Le séjour d'hospitalisation était de 3 jours et le taux de complications post opératoire était de 2,98%.
Biostatistiques et épidémiologieSanté publiqueLicence : 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.
Les aliments fermentés existent depuis des milliers d’années. L’optimisation et la diversification des procédés fermentaires, menées en diverses parties du monde, l’ont été sans que l’homme n’ait la moindre conscience de l’existence et du rôle des microorganismes dans ces transformations. L’enjeu était de sécuriser l’approvisionnement en nourriture en allongeant la durée de conservation des matières premières, d’en améliorer les gouts et les textures et parfois même de les rendre simplement comestibles alors qu’elles ne l’étaient originellement pas. C’est en 1865 seulement que Pasteur lève le voile sur les acteurs microscopiques de ces fermentations. Jusqu’en 1990 environ, les approches biochimiques et pasteuriennes prévalent, et permettent de décrire divers aliments fermentés, ainsi que les techniques d’ensemencement traditionnelles, tout en étant limitées par la complexité des écosystèmes et des cascades métaboliques en présence. La deuxième grande révolution est celle des outils moléculaires à partir des années 1990 et plus récemment encore des «omics». En faisant « parler » l’ADN et l’ARN présent dans les matrices, ainsi que le génome de nombreuses espèces fermentaires, ces outils permettent enfin d’entrer au coeur de ce dialogue, ancestral, entre microorganismes et aliments. Pour autant, de nouvelles questions se posent et constituent les challenges de demain pour la conception de ferments sûrs, sains et fonctionnels.
Biologie cellulaire et moléculaireGénétiqueMicrobiologie (bactériologie, virologie)Licence : https://creativecommons.org/licenses/by/4.0/
Objectifs L’endométriose est une pathologie chronique multifactorielle, définie par la présence de tissu endométrial ectopique et présente chez 25-40% des patientes infertiles, c’est pourquoi un certain nombre de femmes atteintes d’endométriose auront recours à l’AMP (Procréation médicalement assistée). En France depuis la loi de bioéthique de 2014 les femmes atteintes d’endométriose peuvent bénéficier de techniques de Préservation de la Fertilité (PF). Il existe cependant peu de données à ce jour sur cette population, notamment sur les modifications de la réserve ovarienne et la qualité ovocytaire propre à l’endométriose. L’objectif de cette étude est d’évaluer la fertilité (spontanée ou en AMP) des femmes ayant eu recours à une PF dans un contexte d’endométriose. Matériel et méthodes Il s’agissait d’une étude observationnelle, rétrospective et bicentrique au sein des services de médecine de la reproduction des Centres hospitaliers Antoine Beclere et Jean Verdier entre 2013 et 2019. Les patientes présentant une endométriose confirmée par imagerie et ayant réalisées un ou plusieurs cycles de stimulation ovarienne en vue d’une congélation de gamète pour une PF ont été incluses. Les données ont été recueillies de manière rétrospective par consultation du dossier médical et des comptes rendus de suivi de l’endométriose à l’aide du logiciel MEDIFIRST. Après avoir réalisé une technique de préservation de la fertilité, les patientes ont été reçues régulièrement dans le service pour un suivi de leur fertilité. Résultats Notre population était composée de 220 patientes atteintes. Le nombre de gamètes congelés par patiente était de 14,7 ± 7,6. Les femmes atteintes d’endométriose qui ont tenté d’être enceintes au minimum 2 ans après la PF (41,3 %) avaient le plus souvent un partenaire lors de la première consultation (70,7 % vs. 25,7 %, p<0,0001). Elles étaient plus susceptibles d’avoir un enfant avant la PF (35,5% vs. 1,8 %, p<0,0001) que celles qui n'ont pas essayé d’
Biostatistiques et épidémiologieSémiologieMaladies infectieuses et tropicalesLicence : https://creativecommons.org/licenses/by/4.0/