La bibliothèque des étudiants en santé

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• Article libreArticleEn anglais

  Community Factors Shaping Early Age at First Sex among Adolescents in Burkina Faso, Ghana, Malawi, and Uganda

  Rob Stephenson, Calleen Simon, Catherine Finneran

  ABSTRACTUsing data from the National Survey of Adolescents (2004), we examine the community-level factors associated with early age at first sex among adolescents 14-19 years old in four African countries. Regression models are fitted separately by sex for each country for an outcome measuring early age at first sex, with a focus on community-level factors as potential influences of age on sexual debut. The community-level factors associated with adolescents’ sexual debut vary widely by both country and gender. Community influences that emerge as risk or protective factors of early sexual debut include community levels of adolescent marriage, wealth, religious group affiliation, sex education, parental monitoring, reproductive health knowledge, media exposure, membership in adolescent social group, and use of alcohol. Results indicate the importance of context-specific understanding of adolescents’ sexual behaviour and suggest how elements of place should be harnessed in the development of effective HIV and sexual health interventions.

  Biostatistiques et épidémiologieImmunologieMaladies 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 work is properly cited.

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  Community health workers' involvement in mother–child care during the 1st year after birth, in Kaya health district, Burkina Faso: A contribution analysis

  Halima Tougri, Rachidatou Compaoré, Adja Mariam Ouédraogo, Blandine Bila, Marleen Temmerman, Séni Kouanda

  IntroductionMaternal and infant morbidity and mortality remain high in sub-Saharan Africa. However, actions to strengthen postpartum care are still weak and mainly limited to health facilities (HFs). In Kaya health district, Burkina Faso, community health workers (CHWs) were involved in mother and child care during the 1st year postpartum through home visits, outreach sessions and accompanying mothers to health facilities. The aim of this study was to assess the contribution of CHWs to postpartum women's attendance at the health facilities.MethodsWe conducted an effect assessment using Mayne and Lemire's contribution analysis framework. Qualitative and quantitative data were collected through project documents review and individual semi-structured interviews with key-informants.ResultsAll the participants interviewed acknowledged that the number of women, who came to postpartum care, had increased since the implementation of the project activities. Postpartum consultation rates within the 1st week postpartum increased from 29% in 2011 to 80% in 2015 and from 19 to 50% within 6 weeks. Others interventions such as Performance based financing, Save The Children nutritional project and the health services component of Missed Opportunities in Mother and Infant Health (MOMI) were the alternative explanations.ConclusionsCHWs involvement in women care contributed to improve their adherence to postpartum consultations in Kaya health district.

  PédiatrieGynécologie-obstétriqueSanté 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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• Article libreArticleEn anglais

  Community perception regarding childhood vaccinations and its implications for effectiveness: a qualitative study in rural Burkina Faso

  M. Kagoné, M. Yé, E. Nébié, A. Sié, O. Müller, C. Beiersmann

  BackgroundVaccination has contributed to major reductions in global morbidity and mortality, but there remain significant coverage gaps. Better knowledge on the interplay between population and health systems regarding provision of vaccination information and regarding health staff organization during the immunization sessions appears to be important for improvements of vaccination effectiveness.MethodsThe study was conducted in the Nouna Health and Demographic Surveillance System (HDSS) area, rural Burkina Faso, from March to April 2014. We employed a combination of in-depth interviews (n = 29) and focus group discussions (n = 4) including children’s mothers, health workers, godmothers, community health workers and traditional healers. A thematic analysis was performed. All material was transcribed, translated and analyzed using the software ATLAS.ti4.2.ResultsThere was better social mobilization in the rural areas as compared to the urban area. Most mothers know the Expanded Program of Immunization (EPI) target diseases, and the importance to immunize their children. However, the great majority of informants reported that mothers don’t know the vaccination schedule. There is awareness that some children are incompletely vaccinated. Mentioned reasons for that were migration, mothers being busy with their work, the practice of not opening vaccine vials unless a critical number of children are present, poor interaction between women and health workers during immunization sessions, potential adverse events associated with vaccination, geographic inaccessibility during rainy season, and lack of information.ConclusionsWell organized vaccination programs are a key factor to improve child health and there is a clear need to consider community perceptions on program performance. In Burkina Faso, a number of factors have been identified which need attention by the EPI managers for further improvement of program effectiveness.

  ImmunologiePédiatrieSanté 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

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• Article libreArticleEn anglais

  Community perceptions of a malaria vaccine in the Kintampo districts of Ghana

  Lawrence G Febir, Kwaku P Asante, Dan-Bright S Dzorgbo, Kojo A Senah, Timothy S Letsa, Seth Owusu-Agyei

  BackgroundMalaria remains the leading cause of morbidity and mortality in sub-Saharan Africa despite tools currently available for its control. Making malaria vaccine available for routine use will be a major hallmark, but its acceptance by community members and health professionals within the health system could pose considerable challenge as has been found with the introduction of polio vaccinations in parts of West Africa. Some of these challenges may not be expected since decisions people make are many a time driven by a complex myriad of perceptions. This paper reports knowledge and perceptions of community members in the Kintampo area of Ghana where malaria vaccine trials have been ongoing as part of the drive for the first-ever licensed malaria vaccine in the near future.MethodsBoth qualitative and quantitative methods were used in the data collection processes. Women and men whose children were or were not involved in the malaria vaccine trial were invited to participate in focus group discussions (FGDs). Respondents, made up of heads of religious groupings in the study area, health care providers, traditional healers and traditional birth attendants, were also invited to participate in in-depth interviews (IDIs). A cross-sectional survey was conducted in communities where the malaria vaccine trial (Mal 047RTS,S) was carried out. In total, 12 FGDs, 15 IDIs and 466 household head interviews were conducted.ResultsKnowledge about vaccines was widespread among participants. Respondents would like their children to be vaccinated against all childhood illnesses including malaria. Knowledge of the long existing routine vaccines was relatively high among respondents compared to hepatitis B and Haemophilus influenza type B vaccines that were introduced more recently in 2002. There was no clear religious belief or sociocultural practice that will serve as a possible barrier to the acceptance of a malaria vaccine.ConclusionWith the assumption that a malaria vaccine wil

  Biostatistiques et épidémiologieParasitologie et mycologieImmunologieLicence : 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

  Community perspectives on family planning service quality among users and non-users: a qualitative study from two cities in Burkina Faso

  Fiacre Bazie, Ilene S. Speizer, Sarah Castle, Kindo Boukary, Amelia Maytan-Joneydi, Lisa M. Calhoun, Yentema Onadja, Georges Guiella

  BackgroundMost studies that focus on quality of family planning (FP) services collect data from facilities. These studies miss the perspectives of quality from women who do not visit a facility and for whom perceived quality may be a barrier to service utilization.MethodsThis qualitative study from two cities in Burkina Faso examines perceived quality of FP services from women who were recruited at the community level to avoid potential biases based on recruiting women at facilities. Twenty focus group discussions were undertaken with varying groups of women of different ages (15–19; 20–24; 25+), marital statuses (unmarried; married), and current modern contraceptive use experiences (current non-users; current users). All focus group discussions were undertaken in the local language and transcribed and translated into French for coding and analysis.ResultsWomen discuss FP service quality in a variety of locations, depending on their age group. Perspectives on service quality for younger women are often informed by others’ experiences whereas for the older women, they are formed by their own and others’ experiences. Two important aspects of service delivery emerge from the discussions including interactions with providers and selected system-level aspects of service provision. Important components of provider interactions relate to (a) the initial reception from the provider, (b) the quality of counseling received, (c) stigma and bias from providers, and d) privacy and confidentiality. At the health system level, discussions revolved around (a) wait time; (b) stockouts of methods; (c) costs of services/methods; (d) the expectation for tests as part of service provision; and (e) difficulties with method removal.ConclusionsTo increase contraceptive use among women, it is crucial to address the components of service quality they identify as related to higher quality services. This means supporting providers to offer services in a more friendly and respectful manner. In

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

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• Article libreArticleEn anglais

  Community satisfaction with the process of curative care administered by community health workers in the Boussé and Boussouma health districts in Burkina Faso

  The development of accessible care for communities is a priority in Burkina Faso. To achieve this, the country has developed integrated community management of childhood illnesses following the global agenda, involving trained and institutionalized community health workers and free community care. This study aims to identify factors likely to influence the quality of the process of this community management. We have undertaken to conduct a mixed cross-sectional study with a descriptive and analytical aim. The data were collected in the health districts of Boussé and Boussouma from February 20 to March 30, 2023 (quantitative data) and from January 12–30, 2024 (qualitative data) using a questionnaire and an interview grid, then the data were analyzed with SPSS IBM 25 and Nvivo 14. At the end of this study, households reported benefiting from curative from community health workers, but don’t use it first in some cases for fear of wasting time and also on the advice of these community health workers. Binary logistic regression analysis identified factors influencing the quality of the process of this community care such as the ease of contacting the community health workers, the level of education of households and courtesy of the community health workers during care. In summary, households trust the integrated community management of childhood illnesses. Their satisfaction with this strategy could be improved by strengthening contacts between communities and community health workers and their technical and communication capacities.

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

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• Article libreArticleEn anglais

  Community structure, seasonal variations and interactions between native and invasive cattle tick species in Benin and Burkina Faso

  Abel Biguezoton, Safiou Adehan, Hassane Adakal, Sébastien Zoungrana, Souaïbou Farougou, Christine Chevillon

  BackgroundThe variation of tick abundance on ruminants had received little attention in West Africa before Rhipicephalus (Boophilus) microplus started to invade this region in the early 2000s. Ten years later, R. microplus was suspected to have replaced the native ticks. In addition to testing this hypothesis, this study investigated the interactions between native and invasive ticks and the relative role of climatic and geographical variables in the variations of tick community composition (beta diversity) on cattle herds.MethodsA one-year-long survey was performed in Benin and Burkina Faso during which adult ticks were collected from 144 steers from 12 localities in four different areas once a month. Morphological features were used to assign the collected ticks to different species (A. variegatum, R. annulatus, R. decoloratus, R. microplus and R. geigyi). Beta diversity analyses and generalized linear models allowed characterizing the geographical variations in species assemblage and the effect of co-infestation patterns on the seasonal variations in the abundance and incidence rates of each taxon.ResultsAbout 68 % (22,491/32,148) of all the adult ticks collected in one year were R. microplus. The most heterogeneously distributed taxa were Hyalomma spp and R. microplus and the lowest specific diversity was found in Central Burkina Faso. Although climatic variables did not provide any additional information on the variation in species assemblages compared with the sampling geography, adult tick abundance tended to peak during the late (Boophilus subgenus) or early (other taxa) rainy season. In most taxon-per-locality analyses, the abundance and incidence rate of a given tick taxon significantly increased when the host was co-infested by other taxa. The comparison with previous estimates (when possible) did not support the hypothesis that R. microplus invasion led to a decrease in native tick species abundance.ConclusionsThe co-infestation patterns among native and

  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

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• Article libreArticleEn anglais

  Community-based delivery of intermittent preventive treatment of malaria in pregnancy in Burkina Faso: a qualitative study

  Danielle Burke, Justin Tiendrebeogo, Courtney Emerson, Susan Youll, Julie Gutman, Ousmane Badolo, Yacouba Savadogo, Kristen Vibbert, Katherine Wolf, William Brieger

  BackgroundBurkina Faso is among ten countries with the highest rates of malaria cases and deaths in the world. Delivery and coverage of intermittent preventive treatment of malaria in pregnancy (IPTp) is insufficient in Burkina Faso; In a 2016 survey, only 22% of eligible women had received their third dose of IPTp. It is also an extremely rural country and one with an established cadre of community healthcare workers (CHWs). To better meet the needs of pregnant women, an enhanced programme was established to facilitate distribution of IPTp at the community level by CHWs.MethodsIn order to assess the perceptions of CHWs and facility healthcare workers (HCWs) involved in this programme rollout, semi-structured interviews were conducted at three high malaria burden health districts in Burkina Faso. Interviews were conducted at baseline with 104 CHWs and 35 HCWs prior to the introduction of community based IPTp (c-IPTp) to assess capacity and any areas of concern. At endline, interviews were conducted with 29 CHWs and 21 HCWs to identify key facilitators and suggestions for further implementation of the c-IPTp programme.ResultsCHWs reported feeling capable of supporting c-IPTp delivery and facilitating linkage to antenatal care (ANC). They noted that the opportunity for enhanced training and close and ongoing connections with facility HCWs and supportive supervision were imperative. Both CHWs and HCWs perceived this approach as acceptable to community members and noted the importance of close community engagement, monthly meetings between CHWs and facility HCWs, and maintaining regular supplies of sulfadoxine–pyrimethamine (SP). Those interviewed noted that it was beneficial to have the involvement of both female and male CHWs.ConclusionsCommunity-based delivery of IPTp was feasible and acceptable to both facility HCWs and CHWs. This approach has the potential to strengthen delivery and uptake of IPTp and ANC both in Burkina Faso and across the region.

  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 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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• Article libreArticleEn anglais

  Community-based dengue control intervention in Ouagadougou: intervention theory and implementation fidelity

  Diane Saré, Dennis Pérez, Paul-André Somé, Yamba Kafando, Ahmed Barro, Valéry Ridde

  BackgroundWhile malaria control is the primary health focus in Burkina Faso, the recent dengue epidemic calls for new interventions. This paper examines the implementation fidelity of an innovative intervention to control dengue in the capital Ouagadougou.MethodsFirst we describe the content of the intervention and its theory. We then assess the fidelity of the implementation. This step is essential as preparation for subsequent evaluation of the intervention’s effectiveness. Observations (n = 62), analysis of documents related to the intervention (n = 8), and semi-structured interviews with stakeholders (n = 18) were conducted. The collected data were organized and analyzed using QDA Miner. The theory of the intervention, grounded in reported good practices of community-based interventions, was developed and discussed with key stakeholders.ResultsThe theory of the intervention included four components: mobilization and organization, operational planning, community action, and monitoring/evaluation. The interactions among these components were intended to improve people’s knowledge about dengue and enhance the community’s capacity for vector control, which in turn would reduce the burden of the disease. The majority of the planned activities were conducted according to the intervention’s original theory. Adaptations pertained to implementation and monitoring of activities.ConclusionsDespite certain difficulties, some of which were foreseeable and others not, this experience showed the feasibility of developing community-based interventions for vector-borne diseases in Africa.

  Parasitologie et mycologieMaladies infectieuses et tropicalesSanté 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

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• Article libreArticleEn anglais

  Community-Based Livestock Breeding: Coordinated Action or Relational Process?

  Maria Wurzinger, Gustavo A. Gutiérrez, Johann Sölkner, Lorenz Probst

  Over the past decade, community-based breeding programs (CBBPs) have been promoted as a viable approach to improving smallholder livelihoods through a systematic livestock breeding. CBBPs aim to initiate systematic breeding at the community level, including an organized animal identification and recording of performance and pedigree data. To ensure the breeding programs' continuity, building capacities, and ownership among participants are essential to the approach. This study's purpose was to understand how CBBPs have evolved in specific institutional settings and which dynamics occur in the course of implementation. We addressed these questions in reflective conversations with six coordinators of a diverse sample of CBBPs: goats (Malawi, Uganda, and Mexico), sheep (Ethiopia), alpaca (Peru), and cattle (Burkina Faso). The interviews and analysis were guided by categories of the multi-level perspective. The respondents considered lack of funding and weak institutionalization as the main constraints on the CBBPs. While the idea of participation and localized ownership was at the center of the programs, linear paradigms of knowledge transfer prevailed. In all cases, the impulse to start a CBBP came from individual researchers, who relied on intermediaries, such as extension agents, for implementation. Personal relations and trust were seen as both a factor in the success and a positive outcome of CBBPs. We conclude that these findings have different implications depending on how rural development is conceptualized: proponents of the innovation systems perspective would call for stakeholders to further align their interests and coordinate their actions. Proponents of process-relational concepts, in contrast, would not consider the CBBP a product but a starting-point for initiators and participants to continuously discover new ways of collaboration and engagement.

  Santé 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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• Article libreArticleEn anglais

  Community-based Malaria Screening and Treatment for Pregnant Women Receiving Standard Intermittent Preventive Treatment With Sulfadoxine-Pyrimethamine: A Multicenter (The Gambia, Burkina Faso, and Benin) Cluster-randomized Controlled Trial

  Adding community-based scheduled malaria screening and treatment to existing intermittent preventive treatment with sulfadoxine-pyrimethamine (IPTp-SP) strategies did not reduce malaria in pregnancy. Increasing the number of IPTp-SP doses given during pregnancy continues to be a priority. AbstractBackgroundWe investigated whether adding community scheduled malaria screening and treatment (CSST) with artemether-lumefantrine by community health workers (CHWs) to standard intermittent preventive treatment in pregnancy with sulfadoxine-pyrimethamine (IPTp-SP) would improve maternal and infant health.MethodsIn this 2-arm cluster-randomized, controlled trial, villages in Burkina Faso, The Gambia, and Benin were randomized to receive CSST plus IPTp-SP or IPTp-SP alone. CHWs in the intervention arm performed monthly CSST during pregnancy. At each contact, filter paper and blood slides were collected, and at delivery, a placental biopsy was collected. Primary and secondary endpoints were the prevalence of placental malaria, maternal anemia, maternal peripheral infection, low birth weight, antenatal clinic (ANC) attendance, and IPTp-SP coverage.ResultsMalaria infection was detected at least once for 3.8% women in The Gambia, 16.9% in Benin, and 31.6% in Burkina Faso. There was no difference between study arms in terms of placenta malaria after adjusting for birth season, parity, and IPTp-SP doses (adjusted odds ratio, 1.06 [95% confidence interval, .78–1.44]; P = .72). No difference between the study arms was found for peripheral maternal infection, anemia, and adverse pregnancy outcomes. ANC attendance was significantly higher in the intervention arm in Burkina Faso but not in The Gambia and Benin. Increasing number of IPTp-SP doses was associated with a significantly lower risk of placenta malaria, anemia at delivery, and low birth weight.ConclusionsAdding CSST to existing IPTp-SP strategies did not reduce malaria in pregnancy. Increasing the number of IPTp-SP doses given d

  Biostatistiques et épidémiologieParasitologie et mycologieHématologieLicence : http://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.

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  Community-based scheduled screening and treatment of malaria in pregnancy for improved maternal and infant health in The Gambia, Burkina Faso and Benin: study protocol for a randomized controlled trial

  Susana Scott, Petra F Mens, Halidou Tinto, Alain Nahum, Esmée Ruizendaal, Franco Pagnoni, Koen Peeters Grietens, Lindsay Kendall, Kalifa Bojang, Henk Schallig, Umberto D’Alessandro

  BackgroundIn sub-Saharan Africa, malaria continues to cause over 10,000 maternal deaths and 75,000 to 200,000 infant deaths. Successful control of malaria in pregnancy could save lives of mothers and babies and is an essential part of antenatal care in endemic areas. The primary objective is to determine the protective efficacy of community-scheduled screening and treatment (CSST) using community health workers (CHW) against the primary outcome of prevalence of placental malaria. The secondary objectives are to determine the protective efficacy of CSST on maternal anaemia, maternal peripheral infection, low birth weight, selection of sulfadoxine-pyrimethamine (SP) resistance markers, and on antenatal clinic (ANC) attendance and coverage of intermittent preventive treatment during pregnancy (IPTp-SP).Methods/designThis is a multi-centre cluster-randomised controlled trial involving three countries with varying malaria endemicity; low (The Gambia) versus high transmission (Burkina Faso and Benin), and varying degrees of SP resistance (high in Benin and moderate in Gambia and Burkina Faso). CHW and their related catchment population who are randomised into the intervention arm will receive specific training on community-based case management of malaria in pregnancy. All women in both study arms will be enrolled at their first ANC visits in their second trimester where they will receive their first dose of IPTp-SP. Thereafter, CHW in the intervention arm will perform scheduled monthly screening and treatment in the womens homes. At time of delivery, a placental biopsy will be collected from all women to determine placental malaria. At each contact point, filter paper and blood slides will be collected for detection of malaria infection and SP resistance markers.DiscussionTo reach successful global malaria control, there is an urgent need to access those at greatest risk of malaria infection. The project is designed to develop a low-cost intervention in pregnant women wh

  Biostatistiques et épidémiologieMicrobiologie (bactériologie, virologie)Parasitologie et mycologieLicence : http://creativecommons.org/licenses/by/4.0 http://creativecommons.org/publicdomain/zero/1.0/ This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (), which permits unrestricted use, distr

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  Comorbidité schizophrénie et tabagisme : enjeux physiopathologiques et état des connaissances du pharmacien d’officine

  Emma Gil

  Par une physiopathologie similaire, centrée en partie sur des déséquilibres dopaminergiques, l’addiction au tabac et la schizophrénie sont étroitement liées. Conséquence de la similarité de ces deux pathologies, la population souffrant de schizophrénie présente un taux de tabagisme supérieur au reste de la population, avec notamment des bouffées plus nombreuses et plus intenses. Comorbidité donc particulièrement fréquente de la schizophrénie, la consommation de tabac impacte grandement leur espérance de vie. Pour autant, la prise en charge de cette addiction est insuffisante, voir même négligée. Le cas notamment en pharmacie d’officine, où il existe un réel manque de connaissances sur la comorbidité schizophrénie – tabac. Le pharmacien, étant un professionnel de santé pourtant accessible facilement, ne peut intervenir et établir une prise en charge complète de ses patients souffrant de schizophrénie. Alors même qu’il pourrait avoir plusieurs rôles dans le dépistage, la sensibilisation et l’accompagnement au sevrage tabagisme de cette population. Renforcer les connaissances et compétences du pharmacien d’officine, ainsi que de l’ensemble du personnel de la pharmacie, constitue une étape nécessaire pour optimiser la prise en charge complète de la patientèle souffrant de schizophrénie.

  PharmacologieToxicologiePharmacie galéniqueLicence : https://creativecommons.org/licenses/by/4.0/

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  Comorbidity of sickle cell trait and albinism: a cross-sectional survey in the Democratic Republic of the Congo

  Paul Kambale-Kombi, Roland Marini Djang'eing'a, Jean-Pierre Alworong'a Opara, Gaylor Inena wa Inena, Daddy Falay Sadiki, François Boemer, Vincent Bours, Charles Kayembe Tshilumba, Salomon Batina-Agasa

  IntroductionSickle Cell Disease (SCD) and albinism are both recessive hereditary diseases in human kind with a high prevalence in sub-Saharan Africa. This study aimed to determinate the prevalence of sickle cell trait in people living with albinism (PLA).Methodsa cross-sectional descriptive survey was conducted in PLA attending the "Hôpital du Cinquantenaire de Kisangani". In total, by non-probabilistic convenience sampling, 82 albinos and 139 non-albinos and without any antecedents of albinism in their family were included, selected from students in the Faculty of Medicine and Pharmacy at the University of Kisangani. Blood samples were collected on "dried blood spot" and analyzed by mass spectrometry at CHU of Liège. Data were entered into an Excel file and analysed on SPSS 20.0 (Chicago, IL).Resultsforty-six of the 82 albinos (56.1%) were female and 43.9% male with a sex ratio of 1.28. Among albinos, 18.3% had hemoglobin AS (HbAS) and 81.7% hemoglobin AA (HbAA) compared to 18% of subjects with hemoglobin AS and 82% hemoglobin AA in the control group. The difference was not statistically significant (Chi-square=0.003, ddl=1, p=0.9544).Conclusionthis study highlighted that the prevalence of the sickle cell trait is high among people living with albinism, but does not differ from that observed in non-albinos in the Democratic Republic of the Congo. It is therefore important to raise awareness among this category of people about sickle cell disease and the importance of its premarital screening.

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

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  Comparability of modern contraceptive use estimates between a face-to-face survey and a cellphone survey among women in Burkina Faso

  IntroductionThe proliferation of cell phone ownership in Sub-Saharan Africa (SSA) presents the opportunity to collect public health indicators at a lower cost compared to face-to-face (FTF) surveys. This analysis assesses the equivalence of modern contraceptive prevalence estimates between a nationally representative FTF survey and a cell phone survey using random digit dialing (RDD) among women of reproductive age in Burkina Faso.MethodsWe analyzed data from two surveys conducted in Burkina Faso between December 2017 and May 2018. The FTF survey conducted by Performance Monitoring and Accountability (PMA2020) comprised a nationally representative sample of 3,556 women of reproductive age (15–49 years). The RDD survey was conducted using computer-assisted telephone interviewing and included 2,379 women of reproductive age.ResultsCompared to FTF respondents, women in the RDD sample were younger, were more likely to have a secondary degree and to speak French. RDD respondents were more likely to report using modern contraceptive use (40%) compared to FTF respondents (26%) and the difference remained unchanged after applying post-stratification weights to the RDD sample (39%). This difference surpassed the equivalence margin of 4%. The RDD sample also produced higher estimates of contraceptive use than the subsample of women who owned a phone in the FTF sample (32%). After adjusting for women’s sociodemographic factors, the odds of contraceptive use were 1.9 times higher (95% CI: 1.6–2.2) in the RDD survey compared to the FTF survey and 1.6 times higher (95% CI: 1.3–1.8) compared to FTF phone owners.ConclusionsModern contraceptive prevalence in Burkina Faso is over-estimated when using a cell phone RDD survey, even after adjusting for a number of sociodemographic factors. Further research should explore causes of differential estimates of modern contraceptive use by survey modes.

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

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  Comparaison d’une méthode de mesure du temps de recoloration cutanée par vidéo avec une méthode visuelle en réanimation : une étude prospective monocentrique au sein du CHU Amiens Picardie

  Pierre Bachmann

  Introduction : l’évaluation du TRC (Temps de recoloration cutanée) au lit du malade est un outil simple qui permet d’évaluer la microcirculation périphérique. Il est peu coûteux, non invasif et rapidement réalisable en pratique clinique. Cependant il reste souvent trop subjectif et donc opérateur dépendant. C’est dans ce contexte que nous voulons déterminer si cette reproductibilité inter observateur du TRC peut être améliorée par une évaluation vidéo du TRC. Matériel et méthode : nous avons réalisé une étude prospective monocentrique sur 69 patients hospitalisés en réanimation au sein du CHU d’Amiens. Nous avions réalisé des TRC par la méthode classique « visuel », ainsi que vidéo assisté. Puis à l’aide du logiciel ImageJ® nous avons réalisé des courbes nous permettant d’obtenir le TRC par méthode vidéo. Résultats : pour la méthode visuelle, le coefficient de corrélation était de 0.79 avec un IC à 95% de [0.68 - 0.86]. Pour la méthode vidéo, le coefficient de corrélation était de 0.92 avec un IC à 95% de [0.86 - 0.95]. Pour la concordance entre la méthode vidéo et la méthode visuelle, le coefficient de corrélation était de 0.63 avec un IC à 95% de [0.44 - 0.76]. Le TRC visuel était un facteur prédictif de reprise opératoire (p=0.040 OR=1.71 IC95 de l’OR [1.08 - 3.06]). Discussion : nous avons retrouvé une bonne concordance inter-observateurs pour les TRC visuels et entre les TRC visuels et vidéo. De plus nous avons une concordance quasi parfaite concernant les TRC vidéo. Ces résultats pourraient nous permettre d’utiliser l’analyse vidéo du TRC pour des futures études nécessitant une évaluation du TRC. Nos résultats sont toutefois rassurants concernant l’évaluation en routine du TRC au lit du patient avec une bonne reproductibilité inter-observateur avec la méthode visuelle. Le TRC visuel est un facteur prédictif de reprise chirurgicale. De nouvelles études doivent être réalisées afin de confirmer cette hypothèse. De plus, nous avons constaté que les aspects de nos

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  Comparaison de deux scores pronostiques dans les hémorragies digestives hautes non variqueuses dans un centre hospitalier d'Antananarivo

  Aurélia Rakotondrainibe, Thierry Pierre Randrianambinina, Harifetra Mamy Richard Randriamizao, Fanjandrainy Rasoaherinomenjanahary, Mialimanana Joël Randriamiarana, Luc Hervé Samison

  Il est actuellement recommandé de stratifier les hémorragies digestives hautes, en fonction de leur risque, par des scores pronostiques. L'objectif de cette étude a été d'appliquer ces scores en vue de les comparer, dans un centre hospitalier malgache. Etude prospective sur 419 patients, sur une période entre janvier et décembre 2011, au Centre Hospitalo-Universitaire d'Antananarivo. Les scores de Rockall initial et de Blatchford ont été calculés pour chaque patient présentant une hémorragie digestive haute non variqueuse dont les dossiers été complets, avec notamment la valeur de l'urémie et de l'hémoglobine. Une comparaison de ces deux scores a été faite pour déterminer le pronostic et l’évolution de cette pathologie. 46,3% des dossiers n'avaient pas de valeur d'urémie ni de l'hémoglobine. Les 185 patients retenus, avaient une moyenne d’âge de 48,2 ± 18,2 ans et une prédominance masculine (72,4%). Le risque clinique était élevé dans 62,7% des cas, dont 59,4% ont bénéficié d'une transfusion. Une mortalité de 9,7% a été observée. Le score de Blatchford était plus prédictif du risque clinique par rapport au score de Rockall initial (AUROC = 0,82 vs 0,64; p < 0,0001), mais aussi de la nécessité d'une transfusion (AUROC = 0,79 vs 0,62; p= 0,00013). L'instauration d'un score clinico-biologique est assez limitée par faute de moyens, alors que le score de Blatchford aiderait en matière de pronostic des hémorragies digestives hautes.

  HématologieLicence : 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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  Comparaison de l'effet d'un remplissage vasculaire per os et intraveineux sur la réponse au remplissage et les débits régionaux : étude pilote, prospective, randomisée. étude WATERNAL

  Guillaume Bayart

  Introduction : le remplissage vasculaire a pour but d'augmenter le retour veineux, la précharge et le débit cardiaque. L'ensemble des solutés peuvent présenter des effets secondaires. L'eau par voie orale peut modifier le débit cardiaque et la pression artérielle par divers effets physiologiques. Cette étude pilote visait à comparer les effets cardiovasculaires du remplissage vasculaire par voie intraveineuse et orale. Méthode : nous avons mené une étude pilote, prospective, randomisée, ouverte et monocentrique portant sur des sujets volontaires sains âgés de 18 à 30 ans au centre hospitalier universitaire d'Amiens, en France, d'avril 2022 à mai 2022. Après autorisations réglementaires, les sujets sains ont été randomisés en deux groupes (groupe "Eau" et "NaCl"). Le critère d'évaluation principal était le nombre de répondeurs au remplissage 30 minutes après remplissage (T3). Les répondeurs étaient définis par une augmentation de 15% du volume d'éjection systolique (VES).Résultats : 60 sujets ont été randomisés entre le groupe "Eau" (n=31) et le groupe "NaCl" (n=29). Les caractéristiques cliniques de base ne différaient pas. Le nombre de sujets présentant une réponse au remplissage ne différait pas entre les deux groupes (n=5(17,2%) vs n=8(25,8%), p=0,53). Au sein des répondeurs, nous avons observé une cinétique du VES identique dans le groupe "Eau" et dans le groupe "NaCl". Conclusion : chez les jeunes volontaires sains, l'administration d'eau par voie orale est associée à une réponse au remplissage. Le nombre de répondeurs ne différait pas entre les deux groupes (groupes "NaCl" et "Eau"). De même, la cinétique du VES après remplissage ne différait pas significativement entre les deux groupes.

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  Comparaison de la gestion de la crise sanitaire liée au SARS-Cov-2 entre la France et la Corée du Sud

  Margot Maniez-Depret

  Au début de la pandémie de SARS-CoV-2, la Corée du Sud et la France furent parmi les premiers pays touchés par le virus. Cependant, une accélération épidémique plus intense en France qu’en Corée du Sud est observée, avec un taux de mortalité plus élevé. Ces différences sont explicables par les différentes stratégies mises en place par les deux pays afin de lutter contre la propagation du virus dans leurs populations respectives. La Corée du Sud a mis en place une stratégie d’isolement et de tests plus efficace que la France au cours de la pandémie. A contrario, la France a su mettre en place une campagne de vaccination plus efficace que la Corée du Sud. En complément, certaines mesures sanitaires sont similaires entre les deux pays. La comparaison des stratégies des deux pays permet d’obtenir un aperçu des raisons pour lesquelles il est possible d’observer des données épidémiologiques différentes entre les deux pays.

  Biostatistiques et épidémiologieImmunologiePharmacologieLicence : https://creativecommons.org/licenses/by/4.0/

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  Comparaison de la rectosigmoïdoscopie à la coloscopie totale pour l’évaluation de la cicatrisation muqueuse au cours de la rectocolite hémorragique

  Capucine Moreau

  Introduction : de nouveaux objectifs thérapeutiques sont récemment apparus dans la prise en charge de la rectocolite hémorragique (RCH). L'objectif de cette étude était de comparer les performances de la rectosigmoïdoscopie (RS) à celle de la coloscopie totale pour évaluer la cicatrisation muqueuse (CM) totale Mayo 0 et la cicatrisation histologique. Matériels et méthodes : les patients ont été inclus de façon prospective entre janvier 2021 et janvier 2023 au moment de leur coloscopie de suivi au cours de laquelle l’activité endoscopique a été mesurée par le score endoscopique MAYO sur chaque segment. Des biopsies ont été réalisées sur chaque segment. La corrélation entre RS ou rectoscopie seule et CT en terme de cicatrisation muqueuse endoscopique et histologique a été évaluée à l'aide du coefficient kappa de Cohen. Résultats : 80 patients ont été inclus. 34 patients étaient cicatrisés MAYO 0 en RS et CT, 44 n’étaient pas cicatrisés en RS et CT. La corrélation entre les deux examens était presque parfaite avec un indice к à 0,949 (p=0) pour le MAYO 0, et к à 0,945 (p=0) pour le MAYO 0-1. La corrélation entre la cicatrisation histologique en RS et CT était presque parfaite (к=0,877, p<0.001). De même, la corrélation entre la rectoscopie et la CT pour l’évaluation de la cicatrisation muqueuse MAYO 0 et histologique était presque parfaite (к=0,826 (p < 0,001) et к=0,8 (p < 0,001), respectivement). Conclusion : la RS est suffisante dans le suivi des patients atteints de rectocolite hémorragique pour rechercher une cicatrisation muqueuse endoscopique (qu’elle soit définie par un score Mayo 0 ou 1) ou une cicatrisation histologique. De même, avec un taux de faux négatif < 10%, une rectoscopie avec biopsies pourrait être suffisante pour évaluer la cicatrisation endoscopique totale et histologique.

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  Comparaison des blocs nerveux serratus versus para-vertébral versus serratus et para-vertébral pour l'analgésie post opératoire après chirurgie par vidéothoracoscopie : un essai randomisé

  Florian Delatre

  Rationnel : la chirurgie par vidéothoracoscopie (VATS) peut causer d'importantes douleurs post opératoires aux conséquences parfois graves. L'anesthésie locorégionale (ALR) dans ce contexte est recommandée mais sans technique favorisée parmi le bloc serratus (BS), le bloc paravertébral (BPV) et la combinaison des 2 (BS+BPV). L'objectif de l'étude était de comparer les trois stratégies sur la prise en charge de la douleur aiguë post opératoire. Méthodes : nous avons mené une étude prospective randomisée contrôlée en double aveugle monocentrique au CHU d'Amiens. Les patients étaient affectés au groupe BS, BPV ou BS+BPV selon la randomisation. La population d'étude était les patients adultes admis pour une chirurgie d'exérèse pulmonaire programmée sous VATS. Le critère de jugement principal était la douleur à la toux à l'admission en salle de réveil évaluée par l'échelle numérique de la douleur (END). Les critères de jugement secondaires étaient la douleur à la toux et au repos au cours de l'hospitalisation, la consommation totale d'opiacés, l'incidence de la pneumopathie et la douleur chronique à 6 mois. Résultats : de janvier 2020 à août 2022, 156 patients ont été randomisés : groupe BS (n=52), groupe BPV (n=52) et groupe BS+BPV (n=52). Le critère de jugement principal ne différait pas entre les 3 groupes (respectivement, END à 3 [0 ; 6], 4 [0 ; 8] et 2 [0 ; 6] pour les groupes BS, BPV et BS+BPV). Concernant les critères de jugement secondaire, aucune différence significative n'a été retrouvée entre les 3 groupes. Conclusion : notre étude ne permet pas de conclure à la supériorité d'une technique par rapport aux autres. Elle a principalement souffert d'un manque de puissance.

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  Comparaison des données de l’échographie par rapport à l’électroneuromyogramme dans le diagnostic de syndrome de canal carpien

  Siham Bouchal, Aouatef El Midaoui, Khadija Berrada, Abourazzak Fatima Zahra, Nassira Aradoini, Taoufik Harzy, Mohamed Faouzi Belahsen

  L’objectif de cette étude est d’évaluer l’utilité de l’échographie dans le diagnostic de syndrome du canal carpien par rapport à l’électroneuromyogramme (ENMG). Il s’agit d’une étude transversale incluant 50 patients sur une période de 6 mois. Tous les patients avaient bénéficié d’une échographie avec mesure de la surface du nerf médian à l’entrée du canal carpien et une étude électroneuromyographique des 2 poignets. La sensibilité et la spécificité de l’échographie ont été comparées à ceux de l’ENMG comme référence. L’âge moyen est de 49,6 ans avec une nette prédominance féminine dans 98%. La majorité des patientes étaient des femmes au foyer. Les paresthésies étaient le motif le plus fréquent de consultation dans 86%. La symptomatologie clinique était bilatérale dans 78% des cas. L’ENMG était pathologique chez 89 poignets (89%). L’échographie était anormale chez 63 poignets (63%) avec une médiane de la surface du nerf médian de 11 mm2. D’après cette étude, la sensibilité d’échographie était de 70%, et la spécificité était de 100% avec une valeur prédictive positive (VPP) de 100% et une valeur prédictive négative (VPN) de 29,7%. On a conclu que l’échographie n’est sensible que pour le syndrome de canal carpien avec une atteinte sévère à l’ENMG.

  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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  COMPARAISON DES ÉLEVAGES EN ÉTANGS ET EN CAGES FLOTTANTES DU TILAPIA DU Nil Oreochromis niloticus (Linné, 1758) NOURRIS AVEC LES ALIMENTS GRANULÉS EXTRUDÉS FLOTTANTS DANS LA RÉGION DU SUD-COMOÉ, CÔTE D'IVOIRE

  Ahou Rachel Koumi, Koffi Simon Kouamé, Boua Célestin Atsé

  La présente étude évalue la productivité des élevages de Oreochromis niloticus en cages flottantes et en étangs afin d’estimer leur contribution potentielle à la production de poisson d’élevage. Une collecte de données a été réalisée sur les pratiques d’élevage, la croissance des poissons, la production de poissons marchands et les paramètres économiques de six fermes piscicoles, dont trois élevages en cages flottantes et trois en étangs. Les résultats montrent que les pisciculteurs enquêtés sont expérimentés, embauchent du personnel technique, pratiquent la monoculture de Oreochromis niloticus et respectent les bonnes pratiques d’élevage. En étangs comme en cages flottantes, ces pisciculteurs utilisent des aliments commerciaux importés, adaptés aux différents stades de croissance des poissons. En cages flottantes, la durée d’élevage de Oreochromis niloticus de 9,00 ± 1,15 g à 600,00 ± 86,60 g est de 6,71 ± 0,62 mois pour un gain de masse quotidien moyen de 2,98 ± 0,09 g/j, tandis qu’en étangs, la durée d’élevage de Oreochromis niloticus de 10 ± 0,00 g à 500,00 ± 0,00 g est de 6,78 ± 1,35 mois pour un gain de masse quotidien moyen de 2,47 ± 0,44 g/j. La capacité annuelle de production de poissons marchands est beaucoup plus liée à la capacité des installations et au niveau de financement du promoteur. Cependant, pour des productions similaires, les marges bénéficiaires sont supérieures dans les élevages en étang qu’en cage flottante.

  BiochimieBiologie cellulaire et moléculaireLicence : https://creativecommons.org/licenses/by/4.0/

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  Comparaison des mesures par questionnaire et par accélérométrie des composantes du sommeil chez les adolescents calédoniens

  Guillaume Wattelez, Krestina Amon, Rowena Forsyth, Stéphane Frayon, Akila Nedjar-Guerre, Corinne Caillaud, Olivier Galy

  Infographie résumant l'article scientifique suivant : Wattelez G., Amon K. L., Forsyth R., Frayon S., Nedjar-Guerre A., Caillaud C., Galy O. Self-reported and accelerometry measures of sleep components in adolescents living in Pacific Island countries and territories: Exploring the role of sociocultural background. Child: Care, Health and Development. 2024; 50(3), e13272. doi: 10.1111/cch.13272

  Biostatistiques et épidémiologiePédiatrieSanté publiqueLicence : https://creativecommons.org/licenses/by/4.0/

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