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• Article libreArticleEn anglais

  Bacterial and viral etiology of childhood diarrhea in Ouagadougou, Burkina Faso

  Isidore Juste O Bonkoungou, Kaisa Haukka, Monica Österblad, Antti J Hakanen, Alfred S Traoré, Nicolas Barro, Anja Siitonen

  BackgroundDiarrhea is the most frequent health problem among children in developing countries. This study investigated the bacterial and viral etiology and related clinical and epidemiological factors in children with acute diarrhea in Ouagadougou, Burkina Faso.MethodsStool specimens were collected from 283 children under 5 years of age visiting hospital due to acute diarrhea and from 60 healthy controls of similar age. Pathogens were investigated by using conventional culture techniques, PCR and immunochromatographic testing. Salmonella and Shigella strains were serotyped and their susceptibility to 23 antimicrobial agents was determined by the agar dilution method.ResultsAt least one pathogen was detected in 64% of the 283 patients and in 8% of the 60 controls (p < 0.001). Rotavirus was found in 30% of the patients, followed by diarrheagenic Escherichia coli (24%), Salmonella enterica ssp. enterica (9%), Shigella spp. (6%), adenovirus (5%) and Campylobacter spp. (2%). Multiple pathogens were found in 11% of the patients and in 2% of the controls (p = 0.028). Viruses were found mainly in children of ≤ 2 years of age, whereas bacteria were equally prevalent among all the age groups. Viral infections occurred mostly during the cool dry season and the bacterial infections during the rainy season. Fever (64%) and vomiting (61%) were the most common symptoms associated with diarrhea. Only one Salmonella strain was resistant to nalidixic acid and ciprofloxacin. Of the Shigella strains, one was resistant to nalidixic acid but 81% to trimethoprim- sulfamethoxazole, 63% to streptomycin and 50% to ampicillin. Most of all the other Salmonella and Shigella strains were sensitive to all antimicrobials tested.ConclusionRotaviruses and diarrheal E. coli were the most predominant pathogens associated with acute diarrhea in Burkinabe children. Constant antimicrobial surveillance is warranted to observe for the emergence of enteric bacteria resistant to antimicrobials that are impor

  Biologie cellulaire et moléculaireGénétiqueBiostatistiques et épidémiologieLicence : http://creativecommons.org/licenses/by/2.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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• Article libreArticleEn anglais

  Bacterial associations reveal spatial population dynamics in Anopheles gambiae mosquitoes

  Moritz Buck, Louise K. J. Nilsson, Carl Brunius, Roch K. Dabiré, Richard Hopkins, Olle Terenius

  The intolerable burden of malaria has for too long plagued humanity and the prospect of eradicating malaria is an optimistic, but reachable, target in the 21st century. However, extensive knowledge is needed about the spatial structure of mosquito populations in order to develop effective interventions against malaria transmission. We hypothesized that the microbiota associated with a mosquito reflects acquisition of bacteria in different environments. By analyzing the whole-body bacterial flora of An. gambiae mosquitoes from Burkina Faso by 16 S amplicon sequencing, we found that the different environments gave each mosquito a specific bacterial profile. In addition, the bacterial profiles provided precise and predicting information on the spatial dynamics of the mosquito population as a whole and showed that the mosquitoes formed clear local populations within a meta-population network. We believe that using microbiotas as proxies for population structures will greatly aid improving the performance of vector interventions around the world.

  Biologie cellulaire et moléculaireGénétiqueParasitologie et mycologieLicence : http://creativecommons.org/licenses/by/4.0/ This work is licensed under a Creative Commons Attribution 4.0 International License. The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in the credit line; if the mat

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• Article libreArticleEn anglais

  Bacterial meningitis in Africa

  Tatiana Barichello, Carlos Henrique Rocha Catalão, Ursula K. Rohlwink, Martijn van der Kuip, Dan Zaharie, Regan S. Solomons, Ronald van Toorn, Marceline Tutu van Furth, Rodrigo Hasbun, Federico Iovino, Vivian Ssonko Namale

  Bacterial meningitis differs globally, and the incidence and case fatality rates vary by region, country, pathogen, and age group; being a life-threatening disease with a high case fatality rate and long-term complications in low-income countries. Africa has the most significant prevalence of bacterial meningitis illness, and the outbreaks typically vary with the season and the geographic location, with a high incidence in the meningitis belt of the sub-Saharan area from Senegal to Ethiopia. Streptococcus pneumoniae (pneumococcus) and Neisseria meningitidis (meningococcus) are the main etiological agents of bacterial meningitis in adults and children above the age of one. Streptococcus agalactiae (group B Streptococcus), Escherichia coli, and Staphylococcus aureus are neonatal meningitis's most common causal agents. Despite efforts to vaccinate against the most common causes of bacterial neuro-infections, bacterial meningitis remains a significant cause of mortality and morbidity in Africa, with children below 5 years bearing the heaviest disease burden. The factors attributed to this continued high disease burden include poor infrastructure, continued war, instability, and difficulty in diagnosis of bacterial neuro-infections leading to delay in treatment and hence high morbidity. Despite having the highest disease burden, there is a paucity of African data on bacterial meningitis. In this article, we discuss the common etiologies of bacterial neuroinfectious diseases, diagnosis and the interplay between microorganisms and the immune system, and the value of neuroimmune changes in diagnostics and therapeutics.

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

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• Article libreArticleEn anglais

  Bacterial Meningitis in Malawian Adults, Adolescents, and Children During the Era of Antiretroviral Scale-up and Haemophilus influenzae Type b Vaccination, 2000–2012

  Emma C. Wall, Dean B. Everett, Mavuto Mukaka, Naor Bar-Zeev, Nicholas Feasey, Andreas Jahn, Mike Moore, Joep J. van Oosterhout, Paul Pensalo, Kenneth Baguimira, Stephen B. Gordon, Elizabeth M. Molyneux, Enitan D. Carrol, Neil French, Malcolm E. Molyneux, Robert S. Heyderman

  Culture positive bacterial meningitis has fallen over a 12-year period in urban Malawi following Hib vaccination. Hib, NTS, and pneumococcal meningitis have fallen significantly in children. Pneumococcal meningitis has not fallen in adults; NTS and pneumococcal meningitis are seasonal. Background. We documented bacterial meningitis trends among adults and children presenting to a large teaching hospital in Malawi during introduction of Haemophilus influenzae type b (Hib) vaccination and the rollout of antiretroviral therapy (ART).Methods. We analyzed data from 51 000 consecutive cerebrospinal fluid (CSF) samples obtained from adults, adolescents, and children with suspected meningitis admitted to the Queen Elizabeth Central Hospital, Blantyre, Malawi, between 2000 and 2012.Results. There was a significant decline in the total number of CSF isolates over 12 years (incident rate ratio [IRR], 0.93; 95% CI, .92–.94; P < .001). This decline was entirely in children aged <5 years (IRR, 0.87; 95% CI, .85–.88; P < .001) and coincided with the introduction of Hib vaccination. The number of adult isolates has remained unchanged (IRR, 0.99; 95% CI, .97–1.0; P = .135) despite rapid scale-up of ART provision. In children aged <5 years, Streptococcus pneumoniae, nontyphoidal salmonellae (NTS), and Hib were the most frequently isolated pathogens, and have declined over this time period. Streptococcus pneumoniae was the most frequently isolated pathogen in older children and adults. Estimated incidence of bacterial meningitis in 2012 was 20 per 100 000 cases in children aged <14 years, 6 per 100 000 adolescents, and 10 per 100 000 adults.Conclusions. Rates of bacterial meningitis have declined in children, but not adults, coinciding with the introduction of Hib vaccination. The highly successful rollout of ART has not yet resulted in a reduction in the incidence in adults where the burden remains high. Long-term surveillance of bacterial meningitis outside of the epidemic “meningit

  Microbiologie (bactériologie, virologie)ImmunologieMaladies infectieuses et tropicalesLicence : http://creativecommons.org/licenses/by/3.0/ 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.

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• Article libreArticleEn anglais

  Bacterial meningitis in Sudanese children; critical evaluation of the clinical decision using clinical prediction rules

  Nada Abdelghani Abdelrahim, Imad Mohammed Fadl-Elmula, Hassan Mohammed Ali

  BackgroundSudan falls in the meningitis belt where most global cases of bacterial meningitis are reported. Highly accurate decision support tools have been developed by international specialized societies to guide the diagnosis and limit unnecessary hospital admissions and prolonged antibiotic use that have been frequently reported from countries around the world. The goals of this study are to critically evaluate the clinical decision of bacterial meningitis in children in Sudan using clinical prediction rules and to identify the current bacterial aetiology.MethodsThis cross-sectional hospital-based study was conducted in October to July of 2010 in a major referral pediatric hospital in Khartoum, Sudan. Febrile children age 1 day to 15 years who were provisionally diagnosed as having meningitis on admission were included (n = 503). Cerebrospinal fluid (CSF) specimens were obtained from all patients while clinical and demographic data were available for only 404. Conventional laboratory investigations were performed. The clinical decision was evaluated by the International Classification of Diseases–Clinical Modification code 320.9 and the Bacterial Meningitis Score. Ethical clearance and permissions were obtained.ResultsOut of 503 provisionally diagnosed bacterial meningitis patients, the final clinical confirmation was assigned to 55.9%. When codes were applied; 5.7% (23/404) with CSF pleocytosis were re-classified as High Risk for bacterial meningitis and 1.5% (6/404) with confirmed bacterial aetiology as Proven Bacterial Meningitis. Neisseria meningitidis was identified in 0.7% (3/404) and Streptococcus pneumoniae in another 0.7%. Typical laboratory findings (i.e. CSF pleocytosis and/or low glucose and high protein concentrations, Gram positive or Gram negative diplococcic, positive bacterial culture) were seen in 5 (83%). Clinically, patients showed fever, seizures, chills, headache, vomiting, stiff neck and bulging fontanelle. All confirmed cases were less tha

  Biostatistiques et épidémiologieMicrobiologie (bactériologie, virologie)PharmacologieLicence : 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

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• Article libreArticleEn anglais

  Bacterial Symbionts Associated with Wild Tsetse Flies (Diptera: Glossinidae) in Sub-Saharan Africa: A Systematic Review and Meta-Analysis

  Bacterial symbionts play a significant role in the biology of tsetse flies (genus Glossina). However, their infection prevalence in Glossina spp. is not well documented. Hence, the systematic review followed PRISMA guidelines to determine bacterial infection prevalence among different Glossina spp. across sub-Saharan Africa. Six databases were used to search for studies published between 1980 and 2024. The search was conducted from February to March 2025. Meta-analysis was conducted using estimated pooled infection prevalence of bacterial symbionts in different Glossina species. Spearman’s rank correlation coefficient was calculated to examine changes in bacterial infection prevalence between 2010 and 2024. A total of 30 studies from 19 countries met the inclusion criteria and were included in the final systematic review. Of the 30 studies, 173 records were extracted consisting of data from 14 Glossina species. Burkina Faso (n = 25) recorded highest number of studies and G. pallidipes (n = 27) was the most studied species. Significant associations were observed between bacterial infection prevalence and the tested variables (Glossina spp. and country). Temporal analysis results showed positive association in Spiroplasma infection prevalence over the years (rho = 0.418, p = 0.017) whilst Sodalis infections showed negative association (rho = −0.319. p = 0.008). Heterogeneity among different studies was substantially high (I2 > 75%) and evidence of publication bias was reported. The results indicated that bacterial infection prevalence was influenced by factors such as country, sample size and symbiont-specific species. However, heterogeneity remained high even after meta-regression analysis suggesting that other variables not included in the analysis or rather the combination of different variables are responsible for the high heterogeneity observed. Despite study limitations, the study provided the most comprehensive and complex results on the relationship between ba

  Biostatistiques et épidémiologieSanté publiqueLicence : 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.

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  Bactériémie à Kingella denitrificans chez un enfant suivi pour un syndrome d’insuffisance médullaire

  Abdeslam Hiddou, Yassine Zemmrani, Yassine Ahroui, Nabila Soraa

  Kingella denitrificans est un micro-organisme faisant partie de la flore oropharangienne non pathogène. Ce germe est récemment reconnu responsable d'infections invasives opportunistes qui surviennent essentiellement sur des terrains d'immunodépression. Ainsi, Il nous a paru intéressant de rapporter un cas de bactériémie due à Kingella denitrificans, bacilles gram négatif de culture difficile encore exceptionnellement décrit dans la littérature chez un enfant âgé de 3 ans et 7 mois suivi depuis l'âge de un an pour un syndrome d'insuffisance médullaire avec pancytopénie dont l'origine est restée indéterminée. Les cliniciens et les microbiologistes doivent penser davantage à ce germe surtout sur un terrain débilité. L'utilisation des flacons d'hémoculture contribue d'une façon significative à la détection de ce germe.

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

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  BactoTruf

  Aurélie Deveau

  Figure : Coupe de T. melanosporum illustrant la présence massive de bactéries (en rouge) à l'intérieur des ascocarpes de truffe (mycélium fongique en bleu). Photographie obtenue par hybridation in situ à l'aide d'un microscope confocal à balayage. Contexte-En se développant sous terre, la truffe est en contact permanent avec un très grand nombre de bactéries, dont certaines sont capables de coloniser la surface et les tissus internes du carpophore de la truffe. Les truffes abriteraient ainsi des communautés bactériennes extrêmement denses et complexes-jusqu'à 100 millions de bactéries par gramme de truffe. Les groupes bactériens colonisant la surface des truffes changent au cours du processus de maturation, suggérant des interactions fortes entre les bactéries et la truffe. Comment expliquer ces phénomènes de sélection ? Ces bactéries sont-elles de simples opportunistes qui se nourrissent de la truffe ou bien coopèrent-elles avec le champignon et participent-elles à son développement, en améliorant par exemple sa nutrition ? Objectifs

  Microbiologie (bactériologie, virologie)Parasitologie et mycologieLicence : https://creativecommons.org/licenses/by/4.0/

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• Article libreArticle

  Baisse de l'acuité visuelle majeure révélant un mélanome choroidien malin

  Rajae Derrar, Rajae Daoudi

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

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• Article libreArticle

  Baisse du HDL-cholestérol indicateur du stress oxydatif dans le diabète de type 2

  Arsène Tshikongo Kabamba, Salvius Amuri Bakari, Albert Otshudi Longanga, Zet Kalala Lukumwena

  L'hypercholestérolémie est étroitement liée au stress oxydatif. Lorsqu'il y a trop de cholestérol qui circule dans le sang, il n'est pas utilisé en totalité par les cellules et il risque de s'accumuler dans les vaisseaux sanguins. Cela peut entrainer la formation des plaques d'athérosclérose qui gênent la circulation sanguine et provoquent des accidents cardiovasculaires. Le stress oxydatif apparait très tôt dans l'histoire des complications du diabète de type 2, et est lié à l'oxydation du glucose mais aussi à la peroxydation lipidique. Le cholestérol-HDL est un marqueur important du stress oxydatif par sa capacité à faciliter la métabolisation du cholestérol, sa baisse est souvent considérée comme la source de beaucoup d'inquiétudes. L'objectif est l’évaluation de la variation du taux de cholestérol-HDL, marqueur du stress oxydatif, chez les patients diabétiques de type 2 dans la population congolaise. Nous avons inclus dans cette étude prospective des cas témoins des patients diabétiques de type 2 reconnus et diagnostiqués, et des témoins non diabétiques appariés selon l’âge et le sexe. Parallèlement au bilan biologique classique, une analyse d'un des facteurs de risque du stress oxydatif a été réalisée: baisse de HDL-Cholestérol. L’âge moyen des 30 patients diabétiques (47,77±10,78 ans) était comparable à celui des 30 témoins (48,83±10,73 ans). Une baisse significative du cholestérol-HDL dans le sang était observée chez 100% des diabétiques et 50% des témoins (p=0,0000). L'augmentation du HDL cholestérol permet d’éliminer le mauvais cholestérol en excès en nettoyant les tissus et en ramenant le cholestérol vers le foie. Lors du diabète de type 2 on constate une baisse sanguine sensible du taux de HDL-cholestérol, qui est signe indicateur du stress oxydatif.

  Médecine 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.

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• Article libreArticleEn anglais

  Baited-boats: an innovative way to control riverine tsetse, vectors of sleeping sickness in West Africa

  Jean-Baptiste Rayaisse, Ernest Salou, Fabrice Courtin, Wilfrid Yoni, Issiaka Barry, Fabien Dofini, Moise Kagbadouno, Mamadou Camara, Stephen J Torr, Philippe Solano

  BackgroundHuman African Trypanosomiasis (HAT) is an important neglected tropical disease caused by Trypanosoma spp. parasites transmitted by species of tsetse fly (Glossina spp). The most important vectors of HAT are riverine tsetse and these can be controlled by attracting them to stationary baits such as insecticide-impregnated traps or targets deployed along the banks of rivers. However, the geographical nature of some riverine habitats, particularly mangroves but also extensive lake and river networks, makes deployment of baits difficult and limits their efficacy. It is known that tsetse are attracted by the movement of their hosts. Our hypothesis was that mounting a target on canoes typically used in Africa (‘pirogues’) would produce an effective means of attracting-and-killing riverine tsetse in extensive wetland habitats.MethodsIn Folonzo, southern Burkina Faso, studies were made of the numbers of tsetse attracted to a target (75 × 50 cm) of blue cloth and netting mounted on a pirogue moving along a river, versus the same target placed on the riverbank. The targets were covered with a sticky film which caught tsetse as they contacted the target.ResultsThe pirogue-mounted target caught twice as many G. tachinoides and G. p. gambiensis, and 8 times more G. morsitans submorsitans than the stationary one (P < 0.001).ConclusionPirogues are common vehicle for navigating the rivers, lakes and swamps of West Africa. The demonstration that tsetse can be attracted to targets mounted on such boats suggests that pirogues might provide a cost-effective and convenient platform for deploying targets to control tsetse in the mangrove systems of West Africa where HAT persists. Further studies to assess the impact of pirogue-mounted targets on tsetse populations in HAT foci and the protective value of targets for pirogue passengers are recommended.

  Parasitologie et mycologieSanté publiqueLicence : http://creativecommons.org/licenses/by/4.0 http://creativecommons.org/publicdomain/zero/1.0/ 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

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  Barotraumatisme du sinus frontal à propos d’un cas et revue de la littérature

  Azeddine Lachkar, Ahmed Aabach, Fahd Elayoubi, Rachid Ghailan

  Le barotraumatisme sinusien est le deuxième en fréquence après celui de l'oreille moyenne. Le sinus frontal est le plus touché. C'est une pathologie rare et spécifique. Nous rapportons le cas d'un patient de 26 ans présentant suite à une plongée des douleurs frontales gauche intense avec épistaxis homolatérale. Le scanner a montré un hémosinus frontal gauche. L'évolution était bonne après traitement. Les barotraumatismes du sinus frontal sont des accidents liés aux variations de la pression ambiante. L'épistaxis est un signe de gravité. Le scanner a un intérêt dans la recherche des facteurs favorisants et la surveillance. Le traitement vise à supprimer la symptomatologie et la cause favorisante. Les barotraumatismes sinusiens constituent un accident rare, les complications orbitaires et encéphaliques sont exceptionnelles. Leur traitement curatif se confond avec celui de la pathologie causale.

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

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• Article libreArticleEn anglais

  Barriers and Facilitators of Availability of Hydroxyurea for Sickle Cell Disease in Tanzania; A Qualitative Study of Pharmaceutical Manufacturers, Importers, and Regulators

  Despite three decades of proven safety and effectiveness of hydroxyurea in modifying sickle cell disease (SCD), its accessibility is limited in Sub-Saharan Africa, which shares 75% of the world’s SCD burden. Therefore, it is time to explore the barriers and facilitators for manufacturing and importation of hydroxyurea for SCD in Tanzania. This was qualitative research that employed a case study approach. Purposive sampling followed by an in-depth interview (IDI) using a semi-structured questionnaire aspired by data saturation enabled us to gather data from 10 participants. The study participants were people with more than three years of experience in pharmaceuticals importation, manufacturing, and regulation. The audio-recorded data were verbatim transcribed and analyzed using thematic analysis. Two themes were generated. The first comprised barriers for importation and manufacturing of hydroxyurea with sub-themes such as inadequate awareness of SCD and hydroxyurea, limited market, and investment viability. The second comprised opportunities for importation and manufacturing of hydroxyurea with sub-themes such as awareness of activities performed by medicines regulatory authority and basic knowledge on SCD and hydroxyurea. Inadequate understanding of SCD, hydroxyurea, and orphan drug regulation are major issues that aggravate the concern for limited market and investment viability. Existing opportunities are a starting point towards increasing the availability of hydroxyurea.

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

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• Article libreArticleEn anglais

  Barriers and facilitators to community acceptability of integrating point-of-care testing to screen for sickle cell disease in children in primary healthcare settings in rural Upper East Region of Northern Ghana

  IntroductionSickle cell disease (SCD) remains a public health problem especially in sub-Saharan Africa including Ghana. While pilot initiatives in Africa have demonstrated that neonatal screening coupled with early intervention reduces SCD-related morbidity and mortality, only 50–70% of screen-positive babies have been successfully retrieved to benefit from these interventions. Point-of-care testing (POCT) with high specificity and sensitivity for SCD screening can be integrated into existing immunization programs in Africa to improve retrieval rates. This study explored community acceptability of integrating POCT to screen for SCD in children under 5 years of age in primary healthcare facilities in Northern Ghana.MethodThis was an exploratory study using qualitative research approach where 10 focus group discussions and 20 in-depth interviews were conducted with community members and health workers between April and June 2022. The recorded interviews were transcribed verbatim after repeatedly listening to the recordings. Data was coded into themes using QSR Nvivo 12 software before thematic analysis.ResultsMost participants (70.9%) described SCD as serious and potentially life-threatening condition affecting children in the area. Of 148 community members and health workers, 141 (95.2%) said the screening exercise could facilitate diagnosis of SCD in children for early management. However, discrimination, fear of being tested positive, stigmatization, negative health worker attitude linked with issues of maintaining confidentiality were reported by participants as key factors that could affect uptake of the SCD screening exercise. Most participants suggested that intensive health education (78.3%), positive attitude of health workers (69.5%), and screening health workers not being biased (58.8%) could promote community acceptability.ConclusionA large majority of participants viewed screening of SCD in children as very important. However, opinions expressed by most p

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

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• Article libreArticleEn anglais

  Barriers and facilitators to implementing a task-sharing mental health intervention for Sickle Cell Disease populations in low- and middle-income countries: a qualitative analysis using the Consolidated Framework for Implementation Research (CFIR)

  John Patena, Leah Elster, Tania Hameed, Sumedha Kulkarni, Alden Yuanhong Lai, Annika C. Sweetland, Joyce Gyamfi, Temitope Ojo, Angela Odoms-Young, Charmaine Royal, Emmanuel Peprah

  BackgroundPeople living with Sickle Cell Disease (SCD) experience higher rates of common mental disorders (CMD). There is an alarming treatment gap in the provision of adequate mental health services for CMDs in low- and middle-income countries (LMIC). One solution is the implementation of task-sharing interventions such as the Friendship Bench which utilizes concepts of problem-solving therapy (PST). This investigation uses a qualitative study design to evaluate the acceptability and feasibility of implementing a PST-based task-sharing mental health intervention for SCD populations in LMICs using the Consolidated Framework for Implementation Research (CFIR).MethodsPurposive, convenience, and snowball sampling strategies were utilized to identify study participants targeting two key groups: (1) SCD stakeholders and (2) global mental health (GMH) experts. Key informant interviews were conducted between July–September 2024. A framework analysis approach was used by iterative deductive and inductive coding. Results were analyzed and synthesized into key themes and patterns, stratified by participant type to highlight variations across stakeholder perspectives.ResultsA total of 16 participants completed key informant interviews: 10 (62.5%) were SCD stakeholders and 6 (37.5%) were GMH experts. The geographic scope of work spans 12 countries, with 9 (75.0%) located in sub-Saharan Africa. Both SCD stakeholders and GMH experts expressed a shared consensus on the urgent need for mental health care tailored to SCD populations in LMIC settings. Implementing a task-sharing mental health intervention was viewed as acceptable, however, perspectives on its feasibility varied. Identified barriers included the absence of robust health care systems, limited prioritization and funding for mental health, a shortage of trained mental health professionals, and the pervasive stigma surrounding both SCD and mental health conditions. Conversely, facilitators included the potential receptive

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

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  Barriers of West African women scientists in their research and academic careers: A qualitative research

  ObjectiveThis study aims to identify barriers to the professional advancement of women researchers in West Africa.MethodsThis was a descriptive, observational, cross-sectional qualitative study conducted between June and September 2020 in five West African countries (Ghana, Senegal, Burkina Faso, Niger and Mali). Interviews were conducted with 21 female and 9 male health researchers by video call. After transcription, the data was thematically analysed using an inductive process.ResultsFour themes associated with barriers to women’s careers development were identified. First. was family- and environmental-related barriers. Gender norms that assign domestic tasks and responsibilities to women reduced the time they were able to dedicate to research. Second was gender insensitive organisational culture and institutional policies that deepened gender disparities and made it more difficult for women to attain leadership positions. Third was the need for women in research to undergo emancipation programs to strengthen their resilience and ability to make critical decisions as strategic approaches to address the challenges faced by women in the academia were a lot more focused on addressing their relationship with their spouse. Forth, was the individual intermediate perception of professional and personal success which for many women, they perceive themselves as competent as their male counterparts and should not be subject to the gender discrimination they experience.ConclusionThe web created between work-life and home-life for West African women researchers mainly as a result of the gender inequalities in the social structure will require more medium- and long-term strategic planning by institutional authorities to reduce gender disparities in research and academia. This work has highlighted the influence of family and social life on the professional lives of West African women researchers. The study could help contribute to the development of gender equality interventio

  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.

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• Article libreArticleEn anglais

  Barriers to antenatal syphilis screening in Burkina Faso

  Fadima Yaya Bocoum, Seni Kouanda, Christina Zarowsky

  IntroductionDespite advances in treatment and management, syphilis remains a major public health problem in Burkina Faso. Syphilis in pregnancy poses major health risks for the mother and the fetus and also increases the risk for HIV transmission. Despite its potential benefits, antenatal syphilis screening is often poorly implemented in many sub-Saharan African countries. The purpose of the study is to identify and understand barriers affecting health system performance for syphilis screening among pregnant women in Burkina Faso.MethodsWe conducted in-depth interviews and observations in the Kaya health district, Burkina Faso. Participants were purposively selected to capture a range of perspectives across different actors with different roles and responsibilities. Seventy-five interviews were conducted with health providers, district managers, facility managers, traditional healers, pregnant women, community health workers, and Non-Governmental Organizations (NGO) managers. Interviews were transcribed and organized into codes and categories using NVivo software.ResultsParticipants identified multiple barriers at health providers and community levels. Key barriers at provider level included fragmentation of services, poor communication, low motivation for prescription, and low awareness of syphilis burden. Cost of testing, distance to laboratory and lack of knowledge about syphilis were identified as barriers at community level.ConclusionThe study highlights barriers such as distance, cost of testing, and knowledge about syphilis. The introduction of point of care testing for syphilis could be an entry point for improving coverage of antenatal syphilis screening.

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

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  Barriers to post-abortion care service provision: A cross-sectional analysis in Burkina Faso, Kenya and Nigeria

  Despite several political commitments to ensure the availability of and access to post-abortion care services, women in sub-Saharan Africa still struggle to access quality post-abortion care, and with devastating social and economic consequences. Expanding access to post-abortion care while eliminating barriers to utilization could significantly reduce abortions-related morbidity and mortality. We describe the barriers to providing and utilizing post-abortion care across health facilities in Burkina Faso, Kenya, and Nigeria. This paper draws on three data sources: health facility assessment data, patient-exit interview data, and qualitative interviews conducted with healthcare providers and policymakers. All data were based on a cross-sectional survey of a nationally representative sample of health facilities conducted between November 2018 and February 2019. Data on post-abortion care service indicators were collected, including staffing levels and staff training, availability of post-abortion care supplies, equipment and commodities. Patient-exit interviews focused on patients treated for post-abortion complications. In-depth interviews were conducted with healthcare providers within a sample of the study health facilities and national or local decision-makers in sexual and reproductive health. Few primary-level facilities in Burkina Faso (15%), Kenya (46%), and Nigeria (20%) had staff trained on post-abortion care. Only 16.6% of facilities in Kenya had functional operating theaters or MVA rooms, Burkina Faso (20.3%) and Nigeria (50.7%). Primary facilities refer post-abortion care cases to higher-level facilities despite needing to be more adequately equipped to facilitate these referrals. Several challenges that impede the provision of quality and comprehensive post-abortion care across the three countries. The absence of post-abortion care training, equipment, and inadequate referral capacity was among the critical reasons for the lack of services. There is a ne

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

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  Barriers to the quality delivery of seasonal malaria chemoprevention in Chad and Burkina Faso: a qualitative exploration of caregivers and community distributors’ perspectives

  Kévin Lasmi, Kelly Elimian, Laura Donovan, Narcisse Tounaikok, Adama Traoré, Tinne Gils, Christian Rassi, Madeleine Marasciulo, Sol Richardson, Gauthier Tougri, Mahamat Saleh Issakha Diar, Kevin Baker

  BackgroundRecommended since 2012 by the World Health Organization (WHO), seasonal malaria chemoprevention (SMC) is a community-based intervention to prevent malaria in children in African regions where malaria transmission follows a seasonal pattern. Following the publication of consolidated WHO guidelines for malaria, SMC is expected to reach more children in new geographies in future years. Though SMC has been shown to reduce malaria-related morbidity and mortality, there is potential for quality improvement of the intervention implementation. Assisted by ten quality standards from a framework developed by Malaria Consortium, this paper aims to better understand the quality of SMC implementation and identify potential barriers to quality delivery of SMC.MethodsA qualitative thematic analysis on data collected after the annual SMC rounds implemented in Burkina Faso and Chad in 2019 was conducted. Sixteen focus group discussions conducted with caregivers and community distributors were analysed. Three selected quality standards for SMC delivery; planning and enumeration; community engagement; and administration of SMC medicines provided overarching quality themes under which subthemes were identified.ResultsEight subthemes relating to the three quality standards were identified. Although SMC was well accepted by communities in both settings, common barriers to the quality delivery of SMC were identified including difficulty ensuring adherence to the SMC administration protocol; difficulties reaching mobile populations; concerns around adverse drug reactions; rumours, and concerns about SMC safety; and community distributors’ working conditions. Context-specific barriers included: the suboptimal timeliness of the SMC round in Burkina Faso, and the lack of involvement of female caregivers in mobilization activities in Chad.ConclusionIn the context of increased adoption of SMC, this paper provides relevant insights and recommendations for the improved implementation of

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

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  Barriers to Therapeutic Use of Hydroxyurea for Sickle Cell Disease in Nigeria: A Cross-Sectional Survey

  Emmanuel Chide Okocha, Joyce Gyamfi, Nessa Ryan, Oluwatoyin Babalola, Eno-Abasi Etuk, Reuben Chianumba, Maxwell Nwegbu, Hezekiah Isa, Anazoeze Jude Madu, Samuel Adegoke, Uche Nnebe-Agumandu, Biobele Brown, Emmanuel Peprah, Obiageli E. Nnodu

  Background: Sickle cell disease, the inherited blood disorder characterized by anemia, severe pain and other vaso-occlusive complications, acute chest syndrome, disproportionate hospitalization, and early mortality, has significant financial, social, and psychosocial impacts and drains individuals, families, and health systems globally. Hydroxyurea could improve the health of the 300,000 individuals born each year with sickle cell disease in sub-Saharan Africa; however, challenges to adoption and adherence persist. This study assessed the barriers to therapeutic use of hydroxyurea for sickle cell disease within the Nigerian healthcare system, specifically from the level of the patient, provider, and health system. Methods: We used purposive sampling to recruit participants from 13 regions in Nigeria. A cross-sectional survey was administered to physicians (n = 70), nurses or counselors (n = 17), and patients or their caregivers (n = 33) at 13 health centers. Findings were mapped onto the appropriate Consolidated Framework for Implementation Research (CFIR) domains. Results: This study was able to identify factors that mapped onto the inner setting, outer setting, and characteristics of individuals domains of CFIR. The majority of physicians (74.3%) prescribe hydroxyurea, and half stated hydroxyurea is the standard of care. Among clinicians, barriers included limited knowledge of the drug, as well as low self-efficacy to prescribe among physicians and to counsel among nurses; perceived side effects; perceived patient preference for traditional medicine; cost for patient and expense of accompanying laboratory monitoring; and limited availability of the drug and equipment for laboratory monitoring. Among patients and caregivers, barriers included lack of knowledge; perceived side effects; cost; religious beliefs of disease causation; and lack of pediatric formulation. Conclusions: Findings suggest that patient, provider, and health systems-level interventions are neede

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

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  Base de données publique des médicaments (France)

  ANSM / HAS / Assurance Maladie

  Résumés des caractéristiques du produit (RCP) et notices officielles des médicaments commercialisés en France.

  PharmacologiePharmacie galéniqueLicence : lecture-libre

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  Baseline Characteristics of a Cluster Randomized Controlled Trial Targeting Hand Hygiene in Primary Healthcare in Burkina Faso and Mali

  Anaïs Galli, Mirko S. Winkler, Jan Hattendorf, Max N. D. Friedrich, Issa Bagayogo, Aboubacar Ballo, Carola Bänziger, Hassane Dembélé, Mamadou Sory Keita, Maryna Peter, Alimata Ousséni Tall, Jürg Utzinger, Branwen Nia Owen

  ObjectivesThis study presents baseline characteristics of a cluster randomized controlled trial (cRCT) on hand hygiene in primary healthcare in Burkina Faso and Mali, addressing data gaps on hand hygiene practices in these settings.MethodsWe implemented a two-arm cRCT in 48 primary healthcare facilities. Baseline data were collected (January–June 2023), followed by covariate-constrained randomization. We conducted covert hand hygiene observations, hand-rinse sampling for Escherichia coli detection, and a survey on behavioral factors among healthcare workers. The primary outcome is observed handwashing rate.ResultsBaseline data included 309 healthcare workers. Trial arms were balanced in hand hygiene adherence, behavioral factors, and E. coli contamination. Hand hygiene adherence was low (12%). E. coli contamination was very high in Burkina Faso (76%) and considerable in Mali (23%). Participants had a high intention to wash their hands (93%) but only a quarter could name all moments for hand hygiene.ConclusionPoor hand hygiene and E. coli contamination in our setting may heighten nosocomial infection risks. Interventions should address knowledge and build on high intentions to perform hand hygiene.

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

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  Baseline entomologic data on malaria transmission in prelude to an indoor residual spraying intervention in the regions of Alibori and Donga, Northern Benin, West Africa

  Albert S. Salako, Idelphonse Ahogni, Casimir Kpanou, Arthur Sovi, Roseric Azondekon, André A. Sominahouin, Filémon Tokponnon, Virgile Gnanguenon, Fortuné Dagnon, Laurent Iyikirenga, Martin C. Akogbeto

  BackgroundDespite the success of indoor residual insecticide spraying (IRS) in Africa, particularly in Benin, some gaps of information need to be filled to optimize the effectiveness of this intervention in the perspective of the country’s effort to eliminate malaria. In anticipation to the 2018 IRS campaign in two targeted regions of northern Benin, this study aimed, to collect baseline information on vector composition, spatio-temporal variation and peak malaria transmission in the Alibori and Donga, two targeted regions of northern Benin. Information collected will help to better plan the implementation and later on the impact assessment of this IRS campaign.MethodsThe study was carried out in four districts of the two IRS targeted regions of northern Benin. Human landing catches and pyrethrum spray catches protocols were used to assess the biting rate (HBR) and, biting/resting behaviour of malaria vector populations. After morphological identification of collected Anopheles, the heads and thoraxes of Anopheles gambiae sensu lato (s.l.) were analysed by the ELISA CSP tests to estimate the sporozoite index (SI). The entomological inoculation rate was calculated as the product of mosquito biting rate (HBR) and the SI.ResultsThe biting rates of An. gambiae s.l., the major vector in this study sites, varied significantly from region to region. It was higher: in rural than in urban areas, in rainy season than in dry season, indoors than outdoors. Overall, SI was comparable between sites. The highest EIRs were observed in the Donga region (16.84 infectious bites/man/month in Djougou district and 17.64 infectious bites/man/month in Copargo district) and the lowest in the Alibori region (10.74 infectious bites/man/month at Kandi district and 11.04 infectious bites/man/month at Gogounou district).ConclusionThis study showed the heterogeneous and various nature of malaria epidemiology in Northern Benin. Indeed, the epidemiological profile of malaria transmission in the Ali

  Biostatistiques et épidémiologieParasitologie et mycologieMaladies infectieuses et tropicalesLicence : 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

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  Baseline malarial and nutritional profile of children under seasonal malaria chemoprevention coverage in the health district of Nanoro, Burkina Faso

  Seasonal Malaria chemoprevention (SMC) is one of the large-scale life-saving malaria interventions initially recommended for the Sahel subregion, including Burkina Faso and recently extended to other parts of Africa. Initially, SMC was restricted to children 3 to 59 months old, but an extension to older children in some locations was recently recommended. Further characterization of SMC population profile beyond age criterion is necessary for understanding factors that could negatively impact the effectiveness of the intervention and to define complementary measures that could enhance its impact. Children were assessed through a cross-sectional survey during the first month of the 2020 SMC campaign (July-August 2020) as part of the SMC-NUT project in the health district of Nanoro. Parameters such as body temperature, weight, height, mid-upper arm circumference (MUAC) were assessed. In addition, blood sample was collected for malaria diagnosis by rapid diagnostic tests (RDT) and microscopy, and for haemoglobin measurement. A total of 1059 children were enrolled. RDT positivity rate (RPR) was 22.2%, while microscopy positivity rate (MPR) was 10.4%, with parasitaemia levels ranging from 40 to 70480/μL. RPR and MPR increased as patient age increased. Wasting was observed in 7.25% of children under SMC coverage while the prevalence of stunting and underweight was 48.79% and 23.38%, respectively. As the age of the children increased, an improvement in their nutritional status was observed. Finally, undernourished children had higher parasite densities than children with adequate nutritional status. In the health district of Nanoro, children who received Seasonal Malaria Chemoprevention (SMC) were mostly undernourished during the period of SMC delivery, suggesting the need for combining the SMC with synergistic interventions against malnutrition to achieve best impact.

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

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