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9415 ressources
Chama Daoudi, Rajae Daoudi
Yassine Abaloun, Yousra Ajhoun
Kawtar Bouirig, Lalla ouafae Cherkaoui
Heithem Chemchik, Mohamed Ben Hassen, Mohamed Turki, Ghazi Aissaoui, Karim Gahbiche, Walid Naija, Imen Mgarrech, Chokri Kortas, Rachid Said
Le monitorage hémodynamique par cathéter de Swan-Ganz est utile surtout en cas de fonction cardiaque altérée. La mise en place de ce cathéter peut être accompagnée par des complications sévères dans 3 à 4,4% des cas tel que la rupture de l'artère pulmonaire, l'atteinte valvulaire, les troubles de la conduction, le pneumothorax, l'hémothorax et rarement la formation d'un nœud intracardiaque. Nous rapportons un cas de cathéter de Swan-Ganz compliqué d'un nœud formé à son extrémité et nous discutons les éventuels moyens diagnostiques et thérapeutiques de cette complication.
The scientific literature on noma (Cancrum Oris) has clearly increased in recent decades, but there seems to have been limited analysis of issues around the psycho-social impacts of this disease. Even when these issues have been addressed, the focus has tended to be on patient experiences, whereas the community dimension of the disease and the role of healthcare professionals and community leaders in mitigating these impacts remain largely unexplored. A study in the form of semi-directed interviews with 20 noma survivors and 10 healthcare professionals and community leaders was conducted between January and March 2021 in Burkina Faso with the aim of describing the experiences of noma survivors, generating knowledge about living with the burden of the disease and understanding the attitudes of community leaders towards the disease. The results reveal that noma is a disease that affects economically vulnerable populations and leads to extreme household poverty. As far as treatment is concerned, patients tend to turn to practitioners of both traditional and modern medicine. Within communities, noma survivors face discrimination and stigma. The study highlighted a lack of information and knowledge about noma. However, surgical operations lead to patient satisfaction and these remain one of the coping strategies used to tackle the stigma and discrimination. The recommendations set out in this article are aimed firstly at stepping up research into the psycho-social impacts of noma, and secondly at considering these impacts in regional programmes and national plans to combat the disease.
The expected growth in NCDs in cities is one of the most important health challenges of the coming decades in Sub-Saharan countries. This paper aims to fill the gap in our understanding of socio-economic differentials in NCD mortality and risk in low and middle income neighborhoods in urban Africa. We use data collected in the Ouagadougou Health and Demographic Surveillance System. 409 deaths were recorded between 2009–2011 among 20,836 individuals aged 35 years and older; verbal autopsies and the InterVA program were used to determine the probable cause of death. A random survey asked in 2011 1,039 adults aged 35 and over about tobacco use, heavy alcohol consumption, lack of physical activity and measured their weight, height, and blood pressure. These data reveal a high level of premature mortality due to NCDs in all neighborhoods: NCD mortality increases substantially by age 50. NCD mortality is greater in formal neighborhoods, while adult communicable disease mortality remains high, especially in informal neighborhoods. There is a high prevalence of risk factors for NCDs in the studied neighborhoods, with over one-fourth of the adults being overweight and over one-fourth having hypertension. Better-off residents are more prone to physical inactivity and excessive weight, while vulnerable populations such as widows/divorced individuals and migrants suffer more from higher blood pressure. Females have a significantly lower risk of being smokers or heavy drinkers, while they are more likely to be physically inactive or overweight, especially when married. Muslim individuals are less likely to be smokers or heavy drinkers, but have a higher blood pressure. Everything else being constant, individuals living in formal neighborhoods are more often overweight. The data presented make clear the pressing need to develop effective programs to reduce NCD risk across all types of neighborhoods in African cities, and suggest several entry points for community-based prevention
John Williams, Fanta Njie, Matthew Cairns, Kalifa Bojang, Sheick Oumar Coulibaly, Kassoum Kayentao, Ismaela Abubakar, Francis Akor, Khalifa Mohammed, Richard Bationo, Edgar Dabira, Alamissa Soulama, Moussa Djimdé, Etienne Guirou, Timothy Awine, Stephen L. Quaye, Jaume Ordi, Ogobara Doumbo, Abraham Hodgson, Abraham Oduro, Pascal Magnussen, Feiko O. ter Kuile, Arouna Woukeu, Paul Milligan, Harry Tagbor, Brian Greenwood, Daniel Chandramohan
BackgroundNon-Plasmodium falciparum malaria infections are found in many parts of sub-Saharan Africa but little is known about their importance in pregnancy.MethodsBlood samples were collected at first antenatal clinic attendance from 2526 women enrolled in a trial of intermittent screening and treatment of malaria in pregnancy (ISTp) versus intermittent preventive treatment (IPTp) conducted in Burkina Faso, The Gambia, Ghana and Mali. DNA was extracted from blood spots and tested for P. falciparum, Plasmodium vivax, Plasmodium malariae and Plasmodium ovale using a nested PCR test. Risk factors for a non-falciparum malaria infection were investigated and the influence of these infections on the outcome of pregnancy was determined.ResultsP. falciparum infection was detected frequently (overall prevalence by PCR: 38.8 %, [95 % CI 37.0, 40.8]), with a prevalence ranging from 10.8 % in The Gambia to 56.1 % in Ghana. Non-falciparum malaria infections were found only rarely (overall prevalence 1.39 % [95 % CI 1.00, 1.92]), ranging from 0.17 % in the Gambia to 3.81 % in Mali. Ten non-falciparum mono-infections and 25 mixed falciparum and non-falciparum infections were found. P. malariae was the most frequent non-falciparum infection identified; P. vivax was detected only in Mali. Only four of the non-falciparum mono-infections were detected by microscopy or rapid diagnostic test. Recruitment during the late rainy season and low socio-economic status were associated with an increased risk of non-falciparum malaria as well as falciparum malaria. The outcome of pregnancy did not differ between women with a non-falciparum malaria infection and those who were not infected with malaria at first ANC attendance.ConclusionsNon-falciparum infections were infrequent in the populations studied, rarely detected when present as a mono-infection and unlikely to have had an important impact on the outcome of pregnancy in the communities studied due to the small number of women infected wi
John Whitaker, Guy Harling, Ali Sie, Mamadou Bountogo, Lisa R Hirschhorn, Jennifer Manne-Goehler, Till Bärnighausen, Justine Davies
ObjectivesThis study aimed to evaluate the epidemiology of injury as well as patient-reported health system responsiveness following injury and how this compares with non-injured patient experience, in older individuals in rural Burkina Faso.DesignCross-sectional household survey. Secondary analysis of the CRSN Heidelberg Ageing Study dataset.SettingRural Burkina Faso.Participants3028 adults, over 40, from multiple ethnic groups, were randomly sampled from the 2015 Nouna Health and Demographic Surveillance Site census.Primary and secondary outcome measuresPrimary outcome was incidence of injury. Secondary outcomes were incidence of injury related disability and patient-reported health system responsiveness following injury.Results7.7% (232/3028) of the population reported injury in the preceding 12 months. In multivariable analyses, younger age, male sex, highest wealth quintile, an abnormal Generalised Anxiety Disorder score and lower Quality of Life score were all associated with injury. The most common mechanism of injury was being struck or hit by an object, 32.8%. In multivariable analysis, only education was significantly negatively associated with odds of disability (OR 0.407, 95% CI 0.17 to 0.997). Across all survey participants, 3.9% (119/3028) reported their most recent care seeking episode was following injury, rather than for another condition. Positive experience and satisfaction with care were reported following injury, with shorter median wait times (10 vs 20 min, p=0.002) and longer consultation times (20 vs 15 min, p=0.002) than care for another reason. Injured patients were also asked to return to health facilities more often than those seeking care for another reason, 81.4% (95% CI 73.1% to 87.9%) vs 54.8% (95% CI 49.9% to 53.6%).ConclusionsInjury is an important disease burden in this older adult rural low-income and middle-income country population. Further research could inform preventative strategies, including safer rural farming methods, exp
Myrna Norman
Pegdwendé A. Kaboré, Orokiatou B. Zanga, Bénédicte Schepens
BackgroundThe management of nonspecific chronic low back pain (NCLBP) is complex because of its multifactorial origin.ObjectivesTo investigate NCLBP care by evaluating patients’ condition and therapeutic management of health practitioners.MethodA cross-sectional survey was carried out among 92 patients with NCLBP, 30 medical practitioners (MP) and 20 physiotherapists (PT) from four public health institutions in Burkina Faso. Patients completed the Visual Analogue Scale, Roland Morris Disability Questionnaire and Fear-Avoidance Beliefs Questionnaire. Practitioners were asked about therapy and continuing professional training.ResultsPain was moderate to intense for 80% of participants with NCLBP. They were functionally affected and showed fear-avoidance beliefs related to physical and work activities. The majority (97%) of medical practitioners prescribed analgesics and 53% prescribed nonsteroidal anti-inflammatory drugs (NSAIDs). Physiotherapy was the most frequently recommended nonpharmacological treatment. Forty-three per cent of medical practitioners referred to physiotherapy; 20% never did. Physiotherapists practised both passive treatments, such as massage (50%), electrotherapy (55%) and thermotherapy (50%), as well as active treatments, such as general exercises (55%), specific exercises (70%), functional revalidation (50%) and back school (40%). Having had recent continuing professional training and assessing risk factors for chronicity were associated with MPs’ and PTs’ therapeutic choices.ConclusionParticipants with NCLBP showed fear-avoidance beliefs, correlated with their algo-functional status. Prescribing habits of MPs were drug-based. Treatments by PTs were passive and active. Continuing professional training of healthcare practitioners and assessment of risk factors had a positive impact on therapeutic choices.Clinical implicationsOur study is an invitation to the health care system to improve the relationship between a patient’s NCLBP and therapeutic
Guy Harling, Mamadou Bountogo, Ali Sié, Till Bärnighausen, David P. Lindstrom
PurposeAccurate measures of violence are difficult to obtain from self-reported data because of stigmatization and social undesirability of the topic. Most methods that attempt to reduce such biases require literacy and either remove the benefits of interviewer guidance or do not give individual-level results. We tested a low-tech nonverbal response card that avoids revealing interviewees' responses to interviewers while retaining interviewer support among adolescents in communities with very low educational attainment.MethodsAs part of a broader health questionnaire, we asked a sample of 1,644 adolescents, aged 12–20 years, in northwestern Burkina Faso about their experiences of physical and sexual violence. We randomized participants to either a conventional verbal response arm or a nonverbal response card arm where respondents' answers were unspoken and not displayed to interviewers. We first evaluated response validity and reliability in each arm, then compared prevalence rates across arms and evaluated whether any differences varied by respondent characteristics using regression models.ResultsThe level of internal reliability of responses among nonverbal respondents was similar to or greater than that of verbal respondents. Nonverbal respondents reported similar patterns of physical assault and sexual debut as verbal respondents but significantly higher levels of sexual assault and forced sex. These differences were broadly similar across sample subgroups defined by age, gender, proneness to social desirability, and mental health.ConclusionsNonverbal response cards offer a practical and beneficial method for reducing underreporting of stigmatized and traumatic experiences while maintaining data quality in low-literacy populations.
Y. Rönnelid, I. J. O. Bonkoungou, N. Ouedraogo, N. Barro, L. Svensson, J. Nordgren
Several studies report norovirus as the new leading cause of severe gastroenteritis in children after the global introduction of rotavirus vaccines. Burkina Faso introduced general rotavirus vaccination with the oral pentavalent vaccine RotaTeq in November 2013 and quickly reached a vaccine coverage of >90%. This study describes detection rates, clinical profiles and the molecular epidemiology of norovirus and rotavirus infections in 146 children aged <5 years with severe acute gastroenteritis in Ouagadougou, consecutively enrolled from a hospital between January 2015 and December 2015. Virus detection was performed with an antigen test or real-time polymerase chain reaction (PCR) and genotyping was performed by nucleotide sequencing or multiplex PCR. Rotavirus was found in 14% and norovirus in 20% of faecal samples. Norovirus infection was significantly more associated with severe dehydration compared to rotavirus (P < 0.001). Among genotyped norovirus samples 48% (12/25) belonged to GII.4 which caused significantly more diarrhoeal episodes than non-GII.4 genotypes (P = 0.01). The most common rotavirus genotypes were G2P[4] (30%), G12P[6] (25%) and G12P[8] (20%). Fifty percent of the rotavirus positive children were infected with fully or partly heterotypic strains. In conclusion, this study found a higher proportion of norovirus causing more severe symptoms in children with diarrhoea in Burkina Faso after the introduction of rotavirus vaccination.
Annette Treebhoobun, Monica Pudaruth, Dolorès Pourette, Chiarella Mattern, Michaella Dinaniaina Razaf, Christian Dagenais
Aurélia Lépine, Carole Treibich, Ben D’Exelle
RationaleSocial desirability bias, which is the tendency to under-report socially, undesirable health behaviours, significantly distorts information on sensitive behaviours, gained from self-reports and prevents accurate estimation of the prevalence of those, behaviours. We contribute to a growing body of literature that seeks to assess the performance of the list experiment method to improve estimation of these sensitive health behaviours.MethodWe use a double-list experiment design in which respondents serve as the treatment group for one list and as the control group for the other list to estimate the prevalence of two sensitive health behaviours in different settings: condom use among 500 female sex workers in urban Senegal and physical intimate partner violence among 1700 partnered women in rural Burkina Faso. First, to assess whether the list experiment improves the accuracy of estimations of the prevalence of sensitive behaviours, we compare the prevalence rates estimated from self-reports with those elicited through the list experiment. Second, we test whether the prevalence rates of the sensitive behaviours obtained using the double-list design are similar, and we estimate the reduction in the standard errors obtained with this design. Finally, we compare the results obtained through another indirect elicitation method, the polling vote method.ResultsWe show that the list experiment method reduces misreporting by 17 percentage points for condom use and 16–20 percentage points for intimate partner violence. Exploiting the double-list experiment design, we also demonstrate that the prevalence estimates obtained through the use of the two lists are identical in the full sample and across sub-groups and that the double-list design reduces the standard errors by approximately 40% compared to the standard errors in the simple list design. Finally, we show that the list experiment method leads to a higher estimation of the prevalence of sensitive behaviours than t
Eric Le Bourg
Le problème des retraites fait l'actualité depuis des décennies. Malgré cette durée, les acteurs Successifs ont souvent une connaissance limitée des questions de biologie humaine et de démographie en rapport direct avec le vieillissement individuel et ce qu'on appelle, improprement, Une Publication de la fondation Gabriel Péri Page: 2 le vieillissement des populations, qui sont des questions essentielles liées aux retraites. Dans ces conditions, des peurs irrationnelles et des propositions peu pertinentes peuvent être exprimées. Cet article fait le point sur ces questions, afin que, dans les futures discussions ou négociations, les acteurs ne se basent pas sur des erreurs flagrantes pour prendre leurs décisions.
Alioune Badara Thiam, Yannick Canton Kessely, Mbaye Thioub, Maguette Mbaye, Mouhamed Faye, El Hadj Cheikh Ndiaye Sy, Ndaraw Ndoye, Momar Codé Ba, Youssoupha Sakho, Seydou Boubacar Badiane
Les méningiomes sont des tumeurs bénignes extra parenchymateuses développées aux dépens des villosités arachnoïdiennes. Ils tirent leur gravité de leur localisation dans des zones hyperfonctionnelles. Le but de cette étude est d’évaluer la prise en charge des méningiomes intracrâniens depuis la réhabilitation du service de neurochirurgie en 2007. Les auteurs rapportent une série rétrospective portant sur 50 patients admis et opérés d'un méningiome intracrânien d'octobre 2007 à Juin 2013 dans leur service. Ont été inclus les patients ayant un dossier complet. Les patients étaient âgés de 08 à 70 ans avec une moyenne d’âge de 47,3 ans, 68% avaient plus de 40 ans. La sex-ratio était de 0,76. Les manifestations cliniques étaient essentiellement l'hypertension intracrânienne (46%), le déficit moteur (30%) et la comitialité (48%). La tomodensitométrie cérébrale était réalisée chez 41 patients et l'IRM chez 23. Le méningiome était localisé sur la convexité chez 24 patients. L'imagerie postopératoire immédiate était réalisée chez 15 patients. L'exérèse a consisté dans 44% des cas à un Sympson II, et dans 30% des cas à un Sympson III. L'anatomopathologie a conclu à une prédominance du type méningothélial (38%) et 60% des méningiomes étaient de grade I selon la classification de l'O.M.S. Aucun patient n'a bénéficié d'une radiothérapie. La mortalité était de 16%. Les pays d'Afrique subsaharienne continuent d'accuser un retard malgré les efforts réalisés dans les domaines diagnostic et thérapeutique des méningiomes intracrâniens. Le pronostic s'est considérablement amélioré à mesure de l'amélioration du plateau technique dans notre pays.
Bernard Thibault, André Belouin, A. Masseron, C. Hilaire
Nouveaux hybrides de poiriers peu sensibles au Feu bactérien
Zinar Aslan
Le rôle du pharmacien d'officine connaît une évolution majeure avec l'intégration de la dispensation d'antibiotiques conditionnée par la réalisation de tests rapides d'orientation diagnostique (TROD) dans la prise en charge de la cystite aiguë simple et l'angine bactérienne. Cette mission s'inscrit pleinement dans les priorités de santé publique, en particulier la lutte contre l’antibiorésistance. L'analyse croisée d'enquêtes auprès de pharmaciens et de patients, met en évidence une forte adhésion à ce dispositif, qui conforte la place centrale du pharmacien dans le parcours de soins et souligne l'intérêt des TROD pour optimiser l'usage des antibiotiques et améliorer la qualité de la prise en charge.
Pierre Vidal, May C Morris, Laurent Chaloin, Frédéric Heitz, Gilles Divita
Le problème majeur rencontré lors du transfert de gène et/ou d'oligonucléotides dans les cellules de mammifères tient à la faible perméabilité des cellules aux acides nucléiques. Dans ce travail nous avons développé une nouvelle stratégie pour la vectorisation d'acides nucléiques, basée sur l'utilisation d'un peptide court (MPG) associant les propriétés d'une séquence de fusion dérivant de la protéine gp41 de VIH avec celle d'une séquence de signalisation nucléaire dérivant de l'antigène T de SV40. Ce vecteur peptidique diffuse rapidement dans les fibroblastes humain (HS-68) en culture, avec une localisation majoritairement nucléaire en moins de trois minutes. MPG présente une forte affinité pour l'ARNm codant pour la sous-unité de 66 kDa de la transcriptase inverse du VIH (Kd =100 nM). La formation du complexe peptide/acide nucléique se fait majoritairement par des interactions électrostatiques impliquant les résidus basiques du peptide et les charges négatives des groupements phosphates de l'ARN. Ce vecteur permet a lui seul de transférer rapidement (1 h) et avec un rendement supérieur à 80 % cet ARNm dans des fibroblastes en culture. De plus, MPG n'affecte pas la traduction de l'ARNm transféré et présente l'avantage d'être non cytotoxique aux concentrations utilisées pour le transfert d'ARN. Ce nouveau vecteur constitue un excellent outil pour développement du transfert de gênes.
Claude L. Charvet, Elise Courtot, Abdallah Harmache, Fabrice Guégnard, Cédric Neveu
Les méthodes de luttes employées contre les nématodes parasites qui impactent la santé humaine ou animale sont remises en cause par l’émergence d’isolats capables de développer des résistances aux vermifuges (anthelminthiques). Dans ce contexte, la compréhension des mécanismes moléculaires à l’origine de ce phénomène ainsi que l’identification de nouvelles cibles pharmacologiques pour la découverte de nouveaux anthelminthiques sont indispensables au développement de stratégies de gestion du parasitisme efficaces et plus durables.
Côme Brondel
La pharmacie d’officine évolue sous l’impulsion des réformes récentes et de la convention pharmaceutique, redéfinissant le rôle du pharmacien. Désormais acteur clé dans la prévention, le dépistage et la vaccination, le pharmacien participe à la prise en charge de la santé publique, notamment dans un contexte de désertification médicale. Ces nouvelles missions visent à désengorger les cabinets médicaux et à offrir un accès rapide aux soins de proximité. Pour accompagner cette transformation, les laboratoires pharmaceutiques et les groupements de pharmacies apportent un soutien essentiel. Les laboratoires développent des outils digitaux et des solutions pour faciliter l'intégration des nouvelles missions. Les groupements, quant à eux, fournissent des services mutualisés, des formations et des stratégies d’accompagnement pour optimiser l’organisation interne des officines. Malgré les défis organisationnels et économiques, ces nouveaux rôles représentent une opportunité majeure pour les pharmaciens d’élargir leurs compétences et de renforcer leur position dans le système de santé. Grâce à ces collaborations avec les laboratoires et les groupements, les officinaux peuvent mieux répondre aux besoins de santé de la population, tout en affirmant leur place au coeur du parcours de soins, devenant ainsi un pilier de santé publique incontournable.
Enzo Bailly
L’alopécie androgénétique (AAG), également connue sous le nom de calvitie, est la cause la plus fréquente de perte de cheveux chez les hommes comme chez les femmes. Elle résulte d’interactions complexes entre des facteurs androgéniques, génétiques et environnementaux, affectant la qualité de vie des patients en raison de ses répercussions psychosociales importantes. Cette pathologie capillaire, bien que bénigne d’un point de vue médical, entraîne une miniaturisation progressive des follicules pileux, modifiant le cycle pilaire et aboutissant à une réduction significative de la densité capillaire. Ce travail de thèse explore en profondeur la physiopathologie de l’AAG, en décrivant les mécanismes moléculaires sous-jacents, notamment le rôle des androgènes (testostérone et DHT), des enzymes comme la 5-alpha réductase, et des prédispositions génétiques. Les traitements classiques, tels que le minoxidil et le finastéride, sont analysés en mettant en lumière leurs bénéfices, leurs limites et leurs effets secondaires. Par ailleurs, cette thèse met en avant des thérapies en développement, comme les PROTACs, les inhibiteurs de Janus Kinases, et les thérapies cellulaires, qui promettent de nouvelles approches pour contrer les effets de l’AAG. En offrant une synthèse complète des options thérapeutiques actuelles et des innovations potentielles, ce travail vise à améliorer la prise en charge globale des patients, tout en ouvrant la voie à des recherches futures pour des traitements plus efficaces et durables.
Palwende Romuald Boua, Jean-Tristan Brandenburg, Ananyo Choudhury, Scott Hazelhurst, Dhriti Sengupta, Godfred Agongo, Engelbert A. Nonterah, Abraham R. Oduro, Halidou Tinto, Christopher G. Mathew, Hermann Sorgho, Michèle Ramsay
IntroductionAtherosclerosis is a key contributor to the burden of cardiovascular diseases (CVDs) and many epidemiological studies have reported on the effect of smoking on carotid intima-media thickness (cIMT) and its subsequent effect on CVD risk. Gene-environment interaction studies have contributed towards understanding some of the missing heritability of genome-wide association studies. Gene-smoking interactions on cIMT have been studied in non-African populations (European, Latino-American, and African American) but no comparable African research has been reported. Our aim was to investigate smoking-SNP interactions on cIMT in two West African populations by genome-wide analysis.Materials and methodsOnly male participants from Burkina Faso (Nanoro = 993) and Ghana (Navrongo = 783) were included, as smoking was extremely rare among women. Phenotype and genotype data underwent stringent QC and genotype imputation was performed using the Sanger African Imputation Panel. Smoking prevalence among men was 13.3% in Nanoro and 42.5% in Navrongo. We analyzed gene-smoking interactions with PLINK after adjusting for covariates: age and 6 PCs (Model 1); age, BMI, blood pressure, fasting glucose, cholesterol levels, MVPA, and 6 PCs (Model 2). All analyses were performed at site level and for the combined data set.ResultsIn Nanoro, we identified new gene-smoking interaction variants for cIMT within the previously described RCBTB1 region (rs112017404, rs144170770, and rs4941649) (Model 1: p = 1.35E-07; Model 2: p = 3.08E-08). In the combined sample, two novel intergenic interacting variants were identified, rs1192824 in the regulatory region of TBC1D8 (p = 5.90E-09) and rs77461169 (p = 4.48E-06) located in an upstream region of open chromatin. In silico functional analysis suggests the involvement of genes implicated in biological processes related to cell or biological adhesion and regulatory processes in gene-smoking interactions with cIMT (as evidenced by chromatin interac
Valentina D. Mangano, Youssouf Kabore, Edith C. Bougouma, Federica Verra, Nuno Sepulveda, Cyrille Bisseye, Federica Santolamazza, Pamela Avellino, Alfred B. Tiono, Amidou Diarra, Issa Nebie, Kirk A. Rockett, Sodiomon B. Sirima, David Modiano
Although hemoglobin S (HbS) and hemoglobin C (HbC) are well known to protect against severe Plasmodium falciparum malaria, conclusive evidence on their role against infection has not yet been obtained. Here we show, in 2 populations from Burkina Faso (2007–2008), that HbS is associated with a 70% reduction of harboring P. falciparum parasitemia at the heterozygous state (odds ratio [OR] for AS vs AA, 0.27; 95% confidence interval [CI], .11–.66; P = .004). There is no evidence of protection for HbC in the heterozygous state (OR for AC vs AA, 1.49; 95% CI, .69–3.21; P = .31), whereas protection even higher than that observed with AS is observed in the homozygous and double heterozygous states (OR for CC + SC vs AA, 0.04; 95% CI, .01–.29; P = .002). The abnormal display of parasite-adhesive molecules on the surface of HbS and HbC infected erythrocytes, disrupting the pathogenic process of sequestration, might displace the parasite from the deep to the peripheral circulation, promoting its elimination at the spleen level.