N.I. Lengane, R. Nacanabo, A. Goueta, S. Maiga, E.E.M. Nao, Y.M.C. Gyebre, M. Ouattara, K. Ouoba
RésuméUn patient de 68 ans présente une otorrhée chronique droite associée à une hypoacousie et une toux chronique. L’otoscopie mettait en évidence des perforations multiples du tympan droit. La recherche de bacilles acido-alcoolo-résistants était positive à l’examen direct des crachats et négative à l’examen du pus d’oreille. Un traitement antituberculeux par voie générale a été initié.
Microbiologie (bactériologie, virologie)Maladies infectieuses et tropicalesLicence : 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 ().
Idrissa Beogo, Nicole Huang, Marie-Pierre Gagnon, Djesika D. Amendah
BackgroundConventional wisdom suggests that out-of-pocket (OOP) expenditure reduces healthcare utilization. However, little is known about the expenditure borne in urban settings with the current development of the private health sector in sub-Saharan Africa. In an effort to update knowledge on medical expenditure, this study investigated the level and determinants of OOP among individuals reporting illness or injury in Ouagadougou, Burkina Faso and who either self-treated or received healthcare in either a private or public facility.MethodsA cross-sectional study was conducted with a representative sample of 1017 households (5638 individuals) between August and November 2011. Descriptive statistics and multivariate techniques including generalized estimating equations were used to analyze the data.ResultsAmong the surveyed sample, 29.6 % (n = 1666) persons reported a sickness or injury. Public providers were the single most important providers of care (36.3 %), whereas private and informal providers (i.e.: self-treatment, traditional healers) accounted for 29.8 and 34.0 %, respectively. Almost universally (96 %), households paid directly for care OOP. The average expenditure per episode of illness was 8404XOF (17.4USD) (median 3750XOF (7.8USD). The total expenditure was higher for those receiving care in private facilities compared to public ones [14,613.3XOF (30.3USD) vs. 8544.1XOF (17.7USD); p < 0.001], and the insured patients’ bill almost tripled uninsured (p < 0.001). Finally, medication was the most expensive component of expenditure in both public and private facilities with a mean of 8022.1XOF (16.7USD) and 12,270.5 (25.5USD), respectively.ConclusionOOP was the principal payment mechanism of households. A significant difference in OOP was found between public and private provider users. Considering the importance of private healthcare in Burkina Faso, regulatory oversight is necessary. Furthermore, an extensive protection policy to shield households from ca
Biostatistiques et épidémiologieSanté publiqueLicence : 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
ObjectiveTo estimate the out-of-pocket expenditures linked to Road Traffic Injuries in Ouagadougou, Burkina Faso, as well as the prevalence of catastrophic expenditures among those out-of-pocket payments, and to identify the socio-economic determinants of catastrophic expenditures due to Road Traffic Injuries.MethodsWe surveyed every admission at the only trauma unit of Ouagadougou between January and July 2015 at the time of their admission, 7 days and 30 days later. We estimate a total amount of out-of-pocket expenditures paid by each patient. We considered an expense as catastrophic when it represented 10% at least of the annual global consumption of the patient’s household. We used linear models to determine if socio-economic characteristics were associated to a greater or smaller ratio between out-of-pocket payment and global annual consumption.FindingsWe surveyed 1323 Road injury victims three times (admission, Days 7 and 30). They paid in average 46,547 FCFA (83.64 US dollars) for their care, which represent a catastrophic expenditure for 19% of them. Less than 5% of the sample was covered by a health insurance scheme. Household economic status is found to be the first determinant of catastrophic health expenditure occurrence, exhibiting a significant and negative on the ratio between road injury expenditures and global consumption.ConclusionOur findings highlight the importance of developing health insurance schemes to protect poor households from the economic burden of road traffic injuries and improve equity in front of health shocks.
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
Ivlabèhiré Bertrand Meda, Adama Baguiya, Valéry Ridde, Henri Gautier Ouédraogo, Alexandre Dumont, Seni Kouanda
BackgroundIn April 2016, Burkina Faso introduced a free health care policy for women. Instead of reimbursing health facilities, as many sub-Saharan countries do, the government paid them prospectively for covered services to avoid reimbursement delays, which are cited as a reason for the persistence of out-of-pocket (OOP) payments. This study aimed to (i) estimate the direct expenditures of deliveries and covered obstetric care, (ii) determine the OOP payments, and (iii) identify the patient and health facility characteristics associated with OOP payments.MethodsA national cross-sectional study was conducted in September and October 2016 in 395 randomly selected health facilities. A structured questionnaire was administered to women (n = 593) who had delivered or received obstetric care on the day of the survey. The direct health expenditures included fees for consultations, prescriptions, paraclinical examinations, hospitalization and ambulance transport. A two-part model with robust variances was performed to identify the factors associated with OOP payments.ResultsA total of 587 women were included in the analysis. The median direct health expenses were US$5.38 [interquartile range (IQR):4.35–6.65], US$24.72 [IQR:16.57–46.09] and US$136.39 [IQR: 108.36–161.42] for normal delivery, dystocia and cesarean section, respectively. Nearly one-third (29.6%, n = 174) of the women reported having paid for their care. OOP payments ranged from US$0.08 to US$98.67, with a median of US$1.77 [IQR:0.83–7.08]). Overall, 17.5% (n = 103) of the women had purchased drugs at private pharmacies, and 11.4% (n = 67) had purchased cleaning products for a room or equipment. OOP payments were more frequent with age, for emergency obstetric care and among women who work. The women’s health region of origin was also significantly associated with OOP payments. For those who made OOP payments, the amounts paid decreased with age but were higher in urban areas, in hospitals, and among the most
Biostatistiques et épidémiologiePharmacologieGynécologie-obstétriqueLicence : Open Access http://creativecommons.org/licenses/by/4.0/ 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, provided you give appropriate credit to the original aut
Maureen C. Ashe, Isis Kelly dos Santos, Hadil Alfares, Anna M. Chudyk, Elham Esfandiari
AbstractIntroduction:Previous social prescribing work highlights a range in the types and number of outcomes used in published studies. We aimed to describe social prescribing outcome core areas and instruments to build capacity for future research and program evaluation.Methods:This was a modified umbrella review following standard guidelines. We registered the study and searched multiple databases (all languages and years); inclusion criteria were peer-reviewed publications containing outcomes for self-described social prescribing for adults aged 18 years and older. The last search date was 9 July 2023. From the included systematic reviews, we identified primary studies using the same inclusion criteria. For primary studies, we sorted extracted outcomes and instruments into six core areas using a published taxonomy. We located information on instruments’ description and measurement properties and conducted two rating rounds for (1) the quality of systematic reviews and (2) reporting of instruments in primary studies. We conducted a narrative synthesis of reviews, primary studies and outcomes (PROSPERO 2023 CRD42023434061).Results:We identified 10 systematic reviews and 33 primary studies for inclusion in our review. Outcomes covered most core taxonomy areas, with an emphasis on psychosocial factors (e.g. well-being) and less emphasis on cognition, physical activity, and caregivers and volunteers. We noted few studies provided detailed information on demographic data of participants or measurement properties of instruments.Conclusion:This synthesis provides an overview and identifies knowledge gaps for outcomes and instruments used in social prescribing interventions. This work forms the basis of our next step of identifying social prescribing–related outcomes that matter most across interested parties, such as individuals providers and decision makers.
Licence : This work is licensed under a Creative Commons Attribution 4.0 International License
Introduction and HypothesisThe objective was to characterize psychosocial–economic outcomes after obstetric-related vesicovaginal fistula repair (OFR) and completing a comprehensive psychosocial–economic reintegration service at a dedicated fistula center (Association Renaissance, ARENA) compared with women receiving both services in a multispecialty country hospital (Larry Ebert Medical Center, LEMC).Materials and MethodsThis retrospective study included women who underwent OFR and re-integration training at ARENA fistula center, Ouagadougou, Burkina Faso, from January 2022 through July 2023, and at LEMC from July 2020 through March 2022. A standardized questionnaire assessing areas of household/income/employment/finance experiences, support resources, and patients’ feelings was completed by in-person interview or phone. Analyses included Wilcoxon’s rank sum tests, Chi-squared, or Fisher’s exact test. Logistic regression models adjusting for age, time living with fistula, and time from surgery were performed to evaluate associations of selected outcomes.ResultsMedian age and time having a fistula between the ARENA center (N=134) and LEMC (N=146) participants were similar: (age, years, median, [IQR] 32.0 [25, 40] vs 34.0 [27, 41] respectively, p = 0.30; time with fistula, years 1.6 [0.2, 10.0] vs 2.5 [0.8, 11] respectively, p = 0.06). Women undergoing treatment at a dedicated fistula center had greater odds of self-satisfaction (aOR4.6, 95% CI 1.4,15.2), being a person of worth (aOR 12.6, 95% CI 3.7, 42.4), and having income-generating assets (aOR 5.1, 95% CI 1.7, 14.9).ConclusionsOverall, psychosocial and economic outcomes for women after OFR reflected greater improvement when post-OFR reintegration services were at a dedicated fistula center.Supplementary InformationThe online version contains supplementary material available at 10.1007/s00192-025-06361-1
Gynécologie-obstétriqueSanté 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
Taylor Bradbury, Justin J. Lang, Stephanie A. Prince, Gary S. Goldfield, Louise de Lannoy, Mark S. Tremblay, Jean-Philippe Chaput
AbstractIntroduction:The objective of this article is to examine the association between outdoor physical activity (OPA) and mental health, life satisfaction, happiness and life stress among Canadian adolescents aged 12 to 17 years.Methods:This cross-sectional and nationally representative study used self-reported data from the 2019 Canadian Health Survey on Children and Youth (n=10413). The survey categorized OPA into six groups (from 0 to ≥14 hours/week). Logistic regression analyses examined the associations between OPA levels and outcomes, with adjustments for relevant covariates.Results: In adjusted models, OPA was not significantly associated with anxiety or depressive symptoms. Compared to adolescents with no OPA, those who engaged in ≥14 hours/week had higher odds of positive mental health (odds ratio [OR] = 1.64; 95% confidence interval [CI]: 1.13–2.38), high life satisfaction (OR = 1.75; 95% CI: 1.24–2.46) and high happiness (OR = 2.36; 95% CI: 1.59–3.50), independent of covariates including indoor physical activity. A positive dose–response relationship was observed between higher levels of OPA and life satisfaction and happiness.Conclusion:Independent of indoor physical activity and other covariates, OPA was associated with positive mental health, high life satisfaction and high happiness, with levels of OPA of ≥14 hours/week (highest category) showing the strongest associations. Further studies are needed to elucidate the mechanisms linking OPA with higher life satisfaction and happiness.
Biostatistiques et épidémiologiePédiatrieSanté publiqueLicence : This work is licensed under a Creative Commons Attribution 4.0 International License
Le jeu sérieux VirtuAlz est conçu pour fournir, aux professionnels en gériatrie, un module de formation au raisonnement clinique et aux compétences de communication non verbales en proposant différents scénarii de situations critiques fréquemment rencontrées et de prise, en charge délicate (i.e refus de prise de médicaments, déambulation), dans un cadre sécurisé.
PharmacologieSémiologieMaladies infectieuses et tropicalesLicence : https://creativecommons.org/publicdomain/zero/1.0/
L’étude de la solubilité des protéines requiert des outils de criblage performants afin de cartographier leurs états d’assemblage en fonction des conditions physico-chimiques. Pour cela, nous avons développé un circuit millifluidique à gouttes tubulaire permettant de déterminer le diagramme de phases de protéines seules ou en mélange. Ce circuit couplé à un système d’acquisition d’image permet (i) de générer un mélange homogène de protéines/tampon et/ou protéines/biopolymères en un délai court (~s), (ii) de varier la composition des mélanges par simple ajustement des débits, et (iii) de déterminer la turbidité de la goutte par analyse du niveau de gris. La preuve de concept de ce circuit, i.e. efficacité de mélange, calibration turbidité vs niveau de gris, a été réalisée à partir de dispersions colloïdales de dioxyde de titane (TiO2). Il a ensuite été validé à travers l’établissement d’un diagramme de phases connu d’un couple de biopolymères β-lactoglobuline / Gomme d’acacia. L’utilisation de la millifluidique a permis de réduire la quantité de matière requise d’un facteur supérieur à dix et le temps d’expérimentation d’un facteur cinq par rapport à une approche conventionnelle en tube.
BiochimieBiologie cellulaire et moléculaireLicence : https://creativecommons.org/licenses/by-sa/4.0/
Avec l'essor de l'espace romanesque, le XIXème siècle a inventé une nouvelle forme de problématisation de la question de l'alcool et des drogues : celle de la narration littéraire des conduites addictives. Cette problématisation est rarement analysée en tant que telle alors même qu'au fil du XXème siècle, elle s'est à la fois autonomisées et amplifiée jusqu'à faire pièce aux problématisations morales ou médicales qui continuent de concentrer l'attention quasi exclusive des chercheurs du champ. Cette évolution est particulièrement sensible aux Etats-Unis où la narration des conduites addictives est devenue un axe majeur de la littérature américaine depuis le livre-témoignage de William S. Burroughs publié en 1953 : "Junky". Dans cette perspective, le présent article a pour ambition d'élargir les débats actuels sur la question des drogues et des dépendances en y introduisant des dimensions inédites issues des problématisations littéraires des addictions. Il s'appuie sur une analyse détaillée du roman-fleuve de David Foster Wallace, "Infinite Jest", publié aux Etats-Unis en 1996 et qui synthétise à sa manière les principaux courants de la littérature américaine contemporaine relatifs à la narration des conduites addictives. Se dégage de cette somme littéraire une problématisation complexe des addictions qui entre en résonance avec la situation du champ scientifique américain au seuil des années 90 et confirme la possibilité d'une vision profondément démédicalisée et dépsychiatrisée des phénomènes addictifs.
SémiologieMaladies infectieuses et tropicalesMédecine interne (cardiologie, endocrinologie, néphrologie…)Licence : https://creativecommons.org/publicdomain/zero/1.0/
Sickle cell disease (SCD) is a monogenic hemoglobinopathy in which hemoglobin S (HbS) polymerizes on deoxygenation, leading to sickling of red blood cells (RBCs) and driving the acute vaso-occlusive crisis (VOC). With curative (transformative) therapies inaccessible to most patients in sub-Saharan Africa and the Caribbean, where burden is highest, optimizing acute VOC care is a priority; yet oxygen is given reactively, after hypoxemia is documented, not at symptom onset when polymerization is most interruptible. We conducted a structured narrative review integrating HbS polymerization kinetics, clinical studies of oxygen-based therapies, trial protocols, and home-care implementation evidence (PubMed, Scopus, Google Scholar; 1974–2026). When RBCs release oxygen, HbS does not solidify at once: a brief pause, the nucleation delay phase (tD), precedes polymerization and sickling. Because tD falls steeply as deoxygenated hemoglobin rises (inversely, to its ~30th–50th power), a small early gain in oxygen saturation (~5–10%) lengthens it many-fold, opening a short window, roughly 30 min from onset, during which oxygen may abort a crisis. The clinical message is that timing, not dose, is decisive: oxygen at the first symptoms may prevent a crisis that the same oxygen, given later, cannot. Standard, high-flow, hyperbaric, and inhaled nitric-oxide modalities help in selected hospital settings, and the DREPADOM model shows community delivery before hospital arrival is feasible and safe. The central argument is precision in timing, not quantity: starting oxygen at symptom onset could turn a low-cost, universally available treatment into a crisis-aborting one for patients beyond the reach of curative therapy. We advance this as a mechanistically grounded but clinically untested hypothesis; regional implementation trials in the Caribbean and sub-Saharan Africa are urgently warranted.
HématologieLicence : Creative Commons Attribution (CC BY) license Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the.
La panendoscopie des voies aérodigestives supérieures sous ventilation spontanée en sédation procédurale impose un équilibre délicat entre exposition chirurgicale optimale et sécurité respiratoire. L’oxygénothérapie conventionnelle à faible débit présente des limites physiologiques, notamment en termes de FiO₂ délivrée et d’absence d’effet sur l’espace mort ou la pression positive. À l’inverse, l’oxygénothérapie nasale à haut débit (OHD) permet l’administration d’un mélange chauffé et humidifié à haut débit, améliorant l’oxygénation, réduisant le travail respiratoire et générant une pression positive modérée. L’étude OPTINOSE est un essai prospectif randomisé monocentrique comparant l’OHD (Optiflow™) à une oxygénothérapie conventionnelle par sonde nasotrachéale en ventilation spontanée lors de panendoscopies Oto-rhino-laryngologie (ORL) diagnostiques. Le critère principal était l’incidence des désaturations (SpO₂ <95%). Les objectifs secondaires incluaient le temps d’apnée non hypoxémique, le recours à des techniques de ventilation de secours, les complications et la satisfaction opérateur. Les résultats ne montrent pas de différence significative sur le critère principal, mais une amélioration significative de la satisfaction des chirurgiens avec l’OHD. Ces données suggèrent que l’OHD constitue une alternative pertinente à la technique standard.
SémiologieMaladies infectieuses et tropicalesMédecine interne (cardiologie, endocrinologie, néphrologie…)Licence : https://creativecommons.org/licenses/by/4.0/
L'oxygénothérapie hyperbare (OHB) est un procédé thérapeutique dans la prise en charge des lésions chroniques menaçant le pied chez les patients diabétiques. Dans le but d'évaluer ce traitement, les auteurs proposent une analyse rétrospective des patients diabétiques présentant une ou plusieurs lésions chroniques aux niveaux des membres inférieurs et ayant bénéficier de l'OHB. Il s'agit de 80 patients, hospitalisés dans un service de médecine interne sur une période de 10 entre janvier 2006 et décembre 2016. Ces patients ont bénéficié de 20 ± 5 séances d'OHB à raison de 2,5 atmosphères absolues sous oxygène pur pendant 90 minutes par séance et par jour associées à une insulinothérapie, une antibiothérapie adaptée, des soins locaux quotidiens. L'évolution des lésions a été évaluée par l'examen clinique avec des mesures répétées de la taille des lésions à la cinquième, quinzième et vingtième séance d'OHB. Notre étude a inclus 80 patients dont 72 hommes et 8 femmes, leur age moyen était de 56,2 ± 4,62 ans, 77,5% présentaient un diabète type 2, évoluant depuis 13,9±3,3 ans. Ils avaient des lésions chroniques du pied (grade 2, 3 ou 4 de Wagner). Une réduction significative de la surface de la plaie a été observée dés la dixième séance avec cicatrisation complète et guérison chez 56 (70%) de nos patients au terme de 20 séances d'OHB. L'amputation a été notée chez 20 (25%) patients. L'OHB est reconnue dans le traitement des lésions chroniques du pied chez le diabétique, elle permet de réduire considérablement l'incidence des amputations.Hyperbaric Oxygen Therapy (HOT) is a therapeutic procedure for treatment of chronic foot-threatening lesions in diabetic patients. We conducted a retrospective study of patients with diabetes with one or several chronic lower limb lesions having undergone HOT in order to evaluate this treatment. The study involved 80 patients hospitalized in a Department of Internal Medicine during a period of 10 years, between January 2006 and December 201
Microbiologie (bactériologie, virologie)PharmacologieMédecine interne (cardiologie, endocrinologie, néphrologie…)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.
Sesh A Sundararaman, Ellora Daley, Tonimarie Ruggiero, Osheiza Abdulmalik, Audrey John
AbstractBackgroundMalaria is a major contributor to the morbidity and mortality of sickle cell anemia (SCA) in Africa. However, patients with SCA are protected against some manifestations of severe malaria including hyperparasitemia and cerebral malaria. This protection is thought to result from the inhibition of parasite growth in the setting of red cell sickling. Novel SCA therapies that decrease red cell sickling are currently in clinical trials. The development of these therapies raises important questions about how SCA treatments modulate malaria infection and risk of severe disease.MethodsUsing dose response and longitudinal growth assays, we examine the effects of two sickle cell therapies: hydroxyurea (HU), and hemoglobin polymerization inhibitors (voxoletor and osivelator) on Plasmodium falciparum growth in sickle cell (HbSS) and non-sickle cell (HbAA) red blood cells in vitro.ResultsHU inhibited P. falciparum growth at concentrations that are typically achieved in patients receiving daily therapy. However, parasites developed partial resistance to HU treatment under continuous culture. While the hemoglobin polymerization inhibitors, voxoletor and osivelator, also inhibited parasite growth, this inhibition was only observed at supertherapeutic concentrations. Moreover, treatment of HbSS red blood cells with therapeutic concentrations of either voxoletor or osivelator significantly increased parasite growth under hypoxic conditions.ConclusionOur findings highlight the importance of considering risks of infection associated with therapies for SCA. Malaria chemoprevention could be considered as an adjunctive therapy in clinical trials of hemoglobin polymerization inhibitors in malaria endemic countries. While HU therapy has been shown to decrease the risk of malaria in clinical trials in Africa, the development of HU resistance in P. falciparum could offset these gains. Longitudinal studies are necessary to determine if resistance can develop in real world set
Microbiologie (bactériologie, virologie)Parasitologie et mycologieHématologieLicence : https://creativecommons.org/licenses/by/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution License (), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited.
Mehreen S Datoo, Sandi Yen, Nick Edwards, Ousmane Traore, Athanase Some, Hamtandi M Natama, Jethro Johnson, Adrian V S Hill, Halidou Tinto
AbstractBackgroundR21/Matrix-M™ malaria vaccine was recently licensed in young children following good vaccine efficacy and induction of high titre antibody responses to the central repeat (NANP) of the P. falciparum circumsporozoite protein. Variability in NANP responses and efficacy was noted in the populations assessed and according to age.Links between the gut microbiome and the immune system mean early life gut microbiome is an important consideration when understanding vaccine responses. We investigated the relationship of these and participant factors with the gut microbiome in Burkinabe infants in the R21/Matrix-M™ phase IIb trial.MethodsA phase IIb double-blind, randomised controlled trial assessing safety, immunogenicity and efficacy of R21/Matrix-M™ in 5-17 month olds took place in Nanoro, Burkina Faso from 2019 to 2023. Rectal swabs were collected at baseline and a year later, for both malaria vaccine (n=223) and control participants (n=77). Participant factors (i.e. age, gender, feeding, number of siblings, and Z-score), malaria episodes, and anti-NANP antibody responses were measured. Microbiome was assessed using 16S rRNA gene sequencing. Microbiome alpha- and beta- diversity were characterized, and microbial abundances were analysed using univariate and multivariate models.ResultsParticipant microbiomes showed two discernible compositional phenotypes at baseline and follow-up timepoints. The microbiome of majority of participants (93%) were predominantly Firmicutes (39%) and Bacteroidetes (37%) and low in Proteobacteria (13%). However, a subset of participants (7%) had microbiomes that were mainly Proteobacteria (63%). Within-individual alpha-diversity significantly varied with age, but not other participant factors. Relative abundances of certain bacteria were associated with age. Microbial abundances will be analysed and presented against antibody responses, as well as the number of clinical malaria episodes in the first two years.ConclusionWe desc
Biologie cellulaire et moléculaireGénétiqueParasitologie et mycologieLicence : https://creativecommons.org/licenses/by/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution License (), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited.
HématologieLicence : 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.
FW Nikiema, I Zongo, F Some, J-B Ouedraogo, L Penali
Parasitologie 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.
Biostatistiques et épidémiologieSanté 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.
Microbiologie (bactériologie, virologie)Maladies infectieuses et tropicalesLicence : 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.
La pachyonychie congénitale (PC) est une maladie héréditaire rare, essentiellement caractérisée par une kératodermie palmoplantaire douloureuse, un épaississement des ongles, des kystes et une muqueuse buccale blanchâtre. Sa présentation clinique est très variable, elle peut apparaître de la naissance à l'âge adulte. Cette observation rapporte l'association d'une pachyonychie congénitale avec une dilatation des bronches (DDB) et une sténose de l'artère rénale chez une enfant. le diagnostic de la pachyonychie était retenu sur les données cliniques et histologiques. Cependant l'existence d'une sténose de l'artère rénale et d'une DDB soulève la question d'une éventuelle association dans le cadre d'un groupe syndromique particulier.
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.
The purpose of this study was to establish audiology referral protocols for post meningitis paediatric populations in two academic hospitals in Gauteng, South Africa. Specific objectives of this study included determining if audiological assessment referrals were made following infection; determining the time of referral post meningitis diagnosis; establishing what audiological assessments were conducted on this population, as well as determining any correlations between signs and symptoms of meningitis and referrals for audiology assessments. Medical records of 47 children admitted to hospital with a diagnosis of meningitis between the ages of birth and 6 years were reviewed following a retrospective record review design. Data relevant to the current study were obtained from hospital records and this was captured in a data spreadsheet. Both descriptive and inferential statistics were implemented in analysis of the data. Inferential statistics in the form of logistic regression analysis was used to establish any significant factor that may predict referral for audiological assessment. The findings indicated that almost half (40%) of the cases were not referred for audiological services. Of those cases referred for assessment, 89% were referred as in-patients before hospital discharge, with minimal referrals occurring after discharge from hospital. Screening, rather than diagnostic audiology measures were conducted on a majority of the cases. Logistic regression analysis identified fever as the only predictor variable (p<0.01) for audiological assessment referral. Results from this study highlight the need for the establishment of audiology referral protocols for paediatric meningitis populations to ensure that early identification and early intervention occurs.
Microbiologie (bactériologie, virologie)Maladies infectieuses et tropicalesPédiatrieLicence : 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.
BackgroundPharmacovigilance programmes monitor and help ensuring the safe use of medicines which is critical to the success of public health programmes. The commonest method used for discovering previously unknown safety risks is spontaneous notifications. In this study we examine the use of data mining algorithms to identify signals from adverse events reported in a phase IIIb/IV clinical trial evaluating the efficacy and safety of several Artemisinin-based combination therapies (ACTs) for treatment of uncomplicated malaria in African children.MethodsWe used paediatric safety data from a multi-site, multi-country clinical study conducted in seven African countries (Burkina Faso, Gabon, Nigeria, Rwanda, Uganda, Zambia, and Mozambique). Each site compared three out of four ACTs, namely amodiaquine-artesunate (ASAQ), dihydroartemisinin-piperaquine (DHAPQ), artemether-lumefantrine (AL) or chlorproguanil/dapsone and artesunate (CD+A). We examine two pharmacovigilance signal detection methods, namely proportional reporting ratio and Bayesian Confidence Propagation Neural Network on the clinical safety dataset.ResultsAmong the 4,116 children (6–59 months old) enrolled and followed up for 28 days post treatment, a total of 6,238 adverse events were reported resulting into 346 drug-event combinations. Nine signals were generated both by proportional reporting ratio and Bayesian Confidence Propagation Neural Network. A review of the manufacturer package leaflets, an online Multi-Drug Symptom/Interaction Checker (DoubleCheckMD) and further by therapeutic area experts reduced the number of signals to five. The ranking of some drug-adverse reaction pairs on the basis of their signal index differed between the two methods.ConclusionsOur two data mining methods were equally able to generate suspected signals using the pooled safety data from a phase IIIb/IV clinical trial. This analysis demonstrated the possibility of utilising clinical studies safety data for key pharmacovigilan
Parasitologie et mycologiePharmacologieMaladies infectieuses et tropicalesLicence : 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.
RÉSUMÉLes auteurs rapportent des actions menées dans les années 90 en Côte d’Ivoire utilisant des méthodes originales de prévention du sida. Ces actions sont basées sur l'utilisation des pagnes. Le pagne est un tissu imprimé très prisé en Afrique. Il présente la caractéristique essentielle d’être approprié par les acheteuses pour manifester principalement les questions de relations entre femmes et hommes. Cette appropriation se manifeste par le fait que les pagnes sortent de la fabrique avec un nom commercial et que le plus souvent les utilisatrices les dénomment autrement en rapport avec leurs préoccupations.Des études sur le terrain ont été réalisées pour recenser les caractéristiques des pagnes les plus vendus sur les marchés d’Abidjan. Par ailleurs, des entretiens et activités ont été réalisés avec des lycéens d’Abidjan et de Dabou (ville à 50 km d’Abidjan) qui ont permis la fabrication d'un pagne dénommé « entre nous » qui reprend les logos de prévention du sida et qui a fait l'objet de plusieurs manifestations de sensibilisation. Un autre projet porté par une association féminine de lutte contre le sida et basé sur la modification d'un pagne à la mode, n'a pas pu aboutir.Le pagne reste un objet très présent dans les sociétés africaines, avec des développements commerciaux et artistiques; il est logique de penser que son utilisation en prévention a de l'avenir.
ImmunologieMaladies infectieuses et tropicalesLicence : 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 ().