Agastopsylla guzmani n. sp. (Ctenophthalmidae) et Delostichus degus n. sp. (Rhopalopsyllidae) sont décrites. Une clé est donnée pour le genre Agastopsylla ; pour le genre Delostichus, une brève comparaison est faite avec D. incisus et D. ojedoi décrites depuis la parution du Catalogue de Smit en 1987.
Licence : http://creativecommons.org/licenses/by/2.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Microbiologie (bactériologie, virologie)Parasitologie et mycologieImmunologieLicence : https://creativecommons.org/licenses/by/4.0/ Cet article en libre accès est distribué selon les termes de la licence Creative Commons CC BY 4.0 ().
Issam Elouakili, Younes Ouchrif, Redouane Ouakrim, Mohammed Kharmaz, Farid Ismael, Mly Omar Lamrani, Abdou Lahlou, Ahmed El Bardouni, Mustapha Mahfoud, Mohamed Saleh Berrada, Mouradh El Yaacoubi
Les auteurs rapportent 17 cas de la deuxième maladie de Köhler. Il s'agit de jeunes femmes (13 cas), qui ont consulté pour des douleurs métatarso-phalangiennes unilatérales de type mécanique. La maladie touche la deuxième tête métatarsienne dans 14 cas. Le diagnostic est posé grâce à la radiologie: le stade III est retrouvé dans 11 cas. Nous avons opté pour l'intervention de Gauthier: Ostéotomie de dorsiflexion de la tête métatarsienne par résection cunéiforme à base dorsale de la zone nécrotique. Les suites opératoires sont bonnes et l’évolution est favorable pour nos patients, avec un recul moyen de 3 ans.
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.
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.
Aurélie Brunie, Rebecca L. Callahan, Amelia Mackenzie, Simon P.S. Kibira, Madeleine Wayack-Pambè
Background: Unmet need remains high in developing regions. New contraceptive technologies may improve uptake and use. This study examines desirable product characteristics. Methods: We added a module to the female questionnaire of the PMA2020 surveys in Burkina Faso and Uganda and conducted 50 focus group discussions (FGDs) with women, 10 FGDs with men, and 37 in-depth interviews (IDIs) with providers across the two countries. FGDs with women and IDIs with providers included a semi-structured ranking exercise on pre-selected product characteristics. Results: Effectiveness, duration, few side effects, cost, and access were the characteristics most commonly reported as important in choosing a method by survey respondents across both countries. Half or more of women surveyed in each country would like a method that lasts at least one year, while 65% in Burkina Faso and 40% in Uganda said they would use a method causing amenorrhea. Qualitative findings show that women want methods with minimal and predictable side effects. Reactions to increased bleeding were negative, especially in Burkina Faso, but perspectives on reduced bleeding were more mixed. Women and providers preferred methods that are discreet and not user-dependent, and associate duration with convenience of use. Some women in Uganda expressed concerns about the invasive nature of long-acting methods, and cost was an important consideration in both countries. In the ranking exercise, discreet use and few side effects often ranked high, while causing amenorrhea and not requiring a pelvic exam often ranked low. Conclusion: Product development should consider user preferences for success in these settings.
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Francois Kiemde, Adelaide Compaore, Fla Koueta, Athanase M. Some, Berenger Kabore, Daniel Valia, Toussaint Rouamba, Fadima Yaya Bocoum, Seydou Sawadogo, Macaire Nana, Diane Y. Some, Nadine A. Kone, Valentin Pagbeleguem, Inoussa Sangare, Antonia W. Bere, Massa dit Achille Bonko, Gautier Tougri, Sylvie Yeri Youl, Henk Schallig, Halidou Tinto
BackgroundIn Sub-Saharan Africa (SSA), febrile illnesses remain a major public health problem in children. However, the persistence of hrp2 antigen and the low sensitivity of pLDH RDT negatively affect antimalarials and antibiotics prescription practices. These limitations lead to poor management of febrile diseases and antimicrobial resistance (AMR). To improve the diagnosis of these febrile diseases and subsequent prescription of antimicrobials, it is hypothesized that the implementation of an algorithm including a two-step malaria RDT PfHRP2/pLDH supported by point-of-care (PoC) tests for bacterial infections could significantly improve the management of febrile diseases and thereby tackling AMR.MethodsTo assess the value of the proposed algorithm, an open-label randomized controlled trial with three arms, enrolling febrile children from 6 to 59 months is proposed.In the control arm, febrile children will be managed according to the Integrated Management of Childhood Illnesses (IMCI), which is part of the standard of care in Burkina Faso. Treatment will be done according to national guidelines.In the RDT decisional algorithm (RDT-DA) arm (intervention), the clinical examination based on IMIC will be supported by a two-step malaria RDT and bacterial infections RDTs. Prescription will be left to the discretion of the healthcare workers based on clinical examination and PoC test results.In the e-algorithm arm (intervention), artificial intelligence integrating multiple layers of clinical information such as clinical examination, signs/symptoms and medical history, and biological information such as biomarkers (CRP and WBC) and pathogen-specific PoC tests, and oximetry will be developed. The e-algorithm will serve to guide the diagnostic and management of febrile infections in children.In the 3 arms, the case report forms will be digitalized. A final follow-up visit (day 7) will be scheduled for all participants. Patients will be asked to come back to the health faci
Microbiologie (bactériologie, virologie)Parasitologie et mycologiePharmacologieLicence : 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
Alpha Oumar Diallo, Tanga Kiemtoré, Brice Wilfried Bicaba, Isaïe Medah, Tiga Félix Tarbangdo, Simon Sanou, Heidi M Soeters, Ryan T Novak, Honoré Flavien Aké
AbstractNationwide case-based meningitis surveillance was established in Burkina Faso following the introduction of meningococcal serogroup A conjugate vaccine in 2010. However, timely tracking and arrival of cerebrospinal fluid specimens for confirmation at national reference laboratories remained suboptimal. To better understand this gap and identify bottlenecks, the Burkina Faso Ministry of Health, along with key partners, developed and implemented a cloud-based System for Tracking Epidemiological Data and Laboratory Specimens (STELAB), allowing for timely nationwide data reporting and specimen tracking using barcodes. STELAB was adapted to Burkina Faso’s infrastructure to ensure suitability, functionality, flexibility, and sustainability. We describe the design, development, and implementation of STELAB. In addition, we discuss strategies used to promote sustainability, lessons learned during the first year of implementation, and future directions. STELAB’s novel design and country-driven approach has the potential to achieve sustainable real-time data reporting and specimen tracking for the first time in sub-Saharan Africa.
Biostatistiques et épidémiologieMicrobiologie (bactériologie, virologie)ImmunologieLicence : 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.
Barry A. Finette, Megan McLaughlin, Samuel V. Scarpino, John Canning, Michelle Grunauer, Enrique Teran, Marisol Bahamonde, Edy Quizhpe, Rashed Shah, Eric Swedberg, Kazi Asadur Rahman, Hosneara Khondker, Ituki Chakma, Denis Muhoza, Awa Seck, Assiatta Kabore, Salvator Nibitanga, Barry Heath
Abstract.Approximately 3 million children younger than 5 years living in low- and middle-income countries (LMICs) die each year from treatable clinical conditions such as pneumonia, dehydration secondary to diarrhea, and malaria. A majority of these deaths could be prevented with early clinical assessments and appropriate therapeutic intervention. In this study, we describe the development and initial validation testing of a mobile health (mHealth) platform, MEDSINC®, designed for frontline health workers (FLWs) to perform clinical risk assessments of children aged 2–60 months. MEDSINC is a web browser–based clinical severity assessment, triage, treatment, and follow-up recommendation platform developed with physician-based Bayesian pattern recognition logic. Initial validation, usability, and acceptability testing were performed on 861 children aged between 2 and 60 months by 49 FLWs in Burkina Faso, Ecuador, and Bangladesh. MEDSINC-based clinical assessments by FLWs were independently and blindly correlated with clinical assessments by 22 local health-care professionals (LHPs). Results demonstrate that clinical assessments by FLWs using MEDSINC had a specificity correlation between 84% and 99% to LHPs, except for two outlier assessments (63% and 75%) at one study site, in which local survey prevalence data indicated that MEDSINC outperformed LHPs. In addition, MEDSINC triage recommendation distributions were highly correlated with those of LHPs, whereas usability and feasibility responses from LHP/FLW were collectively positive for ease of use, learning, and job performance. These results indicate that the MEDSINC platform could significantly increase pediatric health-care capacity in LMICs by improving FLWs’ ability to accurately assess health status and triage of children, facilitating early life-saving therapeutic interventions.
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.
Ashley L. Grosso, Sosthenes C. Ketende, Shauna Stahlman, Odette Ky-Zerbo, Henri Gautier Ouedraogo, Seni Kouanda, Cesaire Samadoulougou, Marcel Lougue, Jules Tchalla, Simplice Anato, Sodji Dometo, Felicity D. Nadedjo, Vincent Pitche, Stefan D. Baral
BackgroundStigma is a multifaceted concept that potentiates Human Immunodeficiency Virus and sexually transmitted infection acquisition and transmission risks among key populations, including men who have sex with men (MSM) and female sex workers (FSW). Despite extensive stigma literature, limited research has characterized the types and sources of stigma reported by key populations in Sub-Saharan Africa.MethodsThis study leveraged data collected from 1356 MSM and 1383 FSW in Togo and Burkina Faso, recruited via respondent-driven sampling. Participants completed a survey instrument including stigma items developed through systematic reviews and synthesis of existing metrics. Using exploratory factor analysis with promax oblique rotation, 16 items were retained in a stigma metric for MSM and 20 in an FSW stigma metric. To assess the measures’ convergent validity, their correlations with expected variables were examined through bivariate logistic regression models.ResultsOne factor, experienced stigma, included actions that were carried out by multiple types of perpetrators and included being arrested, verbally harassed, blackmailed, physically abused, tortured, or forced to have sex. Other factors were differentiated by source of stigma including healthcare workers, family and friends, or police. Specifically, stigma from healthcare workers loaded on two factors: experienced healthcare stigma included being denied care, not treated well, or gossiped about by healthcare workers and anticipated healthcare stigma included fear of or avoiding seeking healthcare. Stigma from family and friends included feeling excluded from family gatherings, gossiped about by family, or rejected by friends. Stigma from police included being refused police protection and items related to police confiscation of condoms. The Cronbach’s alpha ranged from 0.71–0.82. Median stigma scores, created for each participant by summing the number of affirmative responses to each stigma item, among MSM
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Jessica Heckert, Elena M. Martinez, Greg Seymour, Audrey Pereira, Shalini Roy, Sunny S. Kim, Hazel Malapit
AbstractAgricultural development projects increasingly aim to improve health and nutrition outcomes, often by engaging women. Although evidence shows such projects can improve women's and children's health and nutrition and empower women, little is known about their impacts on women's health‐ and nutrition‐related agency and the extent to which impacts emerge through women's empowerment, largely due to a lack of instruments that measure the dimensions of women's agency that are directly relevant to health and nutrition outcomes. We developed an optional, complementary module for the project‐level women's empowerment in agriculture index (pro‐WEAI) to measure health‐ and nutrition‐related agency (pro‐WEAI + HN). Our method for developing related indicators used data collected from six agricultural development programmes implemented across Bangladesh, Burkina Faso and Mali (pooled sample = 12,114) and applied psychometric analysis (exploratory and confirmatory factor analysis) and the Alkire−Foster methodology. Results revealed seven indicators covering women's agency in the areas of her own health and diet; her health and diet during pregnancy; her child's diet; breastfeeding and weaning; purchasing food and health products; and acquiring food and health products. Multigroup confirmatory factor analysis revealed measurement invariance across contexts and samples. Tests of association (Cramer's V) and redundancy suggest that the pro‐WEAI + HN indicators measured aspects of agency that are distinct from the core pro‐WEAI. The uptake of these indicators in studies of nutrition‐sensitive agricultural development projects may strengthen the evidence on how such programming can enhance women's empowerment to improve health and nutrition outcomes for themselves and their children. Key messages We developed a health and nutrition module for the project‐level Women's Empowerment in Agriculture Index (pro‐WEAI + HN) to measure health‐ and nutrition‐related agency.We used data
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West Africa has been described as a hotspot of climate change. The reliance on rain-fed agriculture by over 65% of the population means that vulnerability to climatic hazards such as droughts, rainstorms and floods will continue. Yet, the vulnerability and risk levels faced by different rural social-ecological systems (SES) affected by multiple hazards are poorly understood. To fill this gap, this study quantifies risk and vulnerability of rural communities to drought and floods. Risk is assessed using an indicator-based approach. A stepwise methodology is followed that combines participatory approaches with statistical, remote sensing and Geographic Information System techniques to develop community level vulnerability indices in three watersheds (Dano, Burkina Faso; Dassari, Benin; Vea, Ghana). The results show varying levels of risk profiles across the three watersheds. Statistically significant high levels of mean risk in the Dano area of Burkina Faso are found whilst communities in the Dassari area of Benin show low mean risk. The high risk in the Dano area results from, among other factors, underlying high exposure to droughts and rainstorms, longer dry season duration, low caloric intake per capita, and poor local institutions. The study introduces the concept of community impact score (CIS) to validate the indicator-based risk and vulnerability modelling. The CIS measures the cumulative impact of the occurrence of multiple hazards over five years. 65.3% of the variance in observed impact of hazards/CIS was explained by the risk models and communities with high simulated disaster risk generally follow areas with high observed disaster impacts. Results from this study will help disaster managers to better understand disaster risk and develop appropriate, inclusive and well integrated mitigation and adaptation plans at the local level. It fulfills the increasing need to balance global/regional assessments with community level assessments where major decisions a
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Helena Ngowi, Ivan Ozbolt, Athanase Millogo, Veronique Dermauw, Télesphore Somé, Paul Spicer, Lori L. Jervis, Rasmané Ganaba, Sarah Gabriel, Pierre Dorny, Hélène Carabin
BackgroundTaeniasis and cysticercosis are two diseases caused by Taenia solium, a parasite transmitted between humans and pigs, leading to considerable economic loss and disabilities. Transmission of the parasite is linked to environmental and behavioural factors such as inadequate sanitation and hygiene, poor pig management, and consumption of infected pork. This study used implementation research method to design a health education intervention strategy for reducing T. solium infections in Burkina Faso, a country endemic for the parasite.MethodsEighteen group discussions were conducted with 8–18 participants each in three villages. In addition, structured interviews were conducted among 4 777 participants and 2 244 pig owners, who were selected through cluster random sampling in 60 villages of three provinces of Burkina Faso. Both approaches assessed knowledge and practices related to T. solium. The information obtained was used to develop a community-adapted health education intervention strategy to control taeniasis and cysticercosis in Burkina Faso.ResultsThe group discussions revealed that participants had a poor quality of life due to the diseases as well as inadequate access to latrines, safe water, and healthcare services. In addition, it was found that pig production was an important economic activity, especially for women. Furthermore, financial and knowledge constraints were important limitations to improved pig management and latrine construction. The survey data also showed that open defecation and drinking unboiled water were common behaviours, enhanced by a lack of knowledge regarding the transmission of the parasite, perceived financial barriers to the implementation of control measures, lack of public sensitization, as well as a lack of self-efficacy towards control of the parasite. Nevertheless, the perceived financial benefits of controlling porcine cysticercosis could be emphasized by an education program that discourages open defecation and enc
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Volker Ermert, Andreas H Fink, Anne E Jones, Andrew P Morse
BackgroundIn the first part of this study, an extensive literature survey led to the construction of a new version of the Liverpool Malaria Model (LMM). A new set of parameter settings was provided and a new development of the mathematical formulation of important processes related to the vector population was performed within the LMM. In this part of the study, so far undetermined model parameters are calibrated through the use of data from field studies. The latter are also used to validate the new LMM version, which is furthermore compared against the original LMM version.MethodsFor the calibration and validation of the LMM, numerous entomological and parasitological field observations were gathered for West Africa. Continuous and quality-controlled temperature and precipitation time series were constructed using intermittent raw data from 34 weather stations across West Africa. The meteorological time series served as the LMM data input. The skill of LMM simulations was tested for 830 different sets of parameter settings of the undetermined LMM parameters. The model version with the highest skill score in terms of entomological malaria variables was taken as the final setting of the new LMM version.ResultsValidation of the new LMM version in West Africa revealed that the simulations compare well with entomological field observations. The new version reproduces realistic transmission rates and simulated malaria seasons are comparable to field observations. Overall the new model version performs much better than the original model. The new model version enables the detection of the epidemic malaria potential at fringes of endemic areas and, more importantly, it is now applicable to the vast area of malaria endemicity in the humid African tropics.ConclusionsA review of entomological and parasitological data from West Africa enabled the construction of a new LMM version. This model version represents a significant step forward in the modelling of a weather-driven ma
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BackgroundMany cities in developing countries experience an unplanned and rapid growth. Several studies have shown that the irregular urbanization and equipment of cities produce different health risks and uneven exposure to specific diseases. Consequently, health surveys within cities should be carried out at the micro-local scale and sampling methods should try to capture this urban diversity.MethodsThis article describes the methodology used to develop a multi-stage sampling protocol to select a population for a demographic survey that investigates health disparities in the medium-sized city of Bobo-Dioulasso, Burkina Faso. It is based on the characterization of Bobo-Dioulasso city typology by taking into account the city heterogeneity, as determined by analysis of the built environment and of the distribution of urban infrastructures, such as healthcare structures or even water fountains, by photo-interpretation of aerial photographs and satellite images. Principal component analysis and hierarchical ascendant classification were then used to generate the city typology.ResultsFive groups of spaces with specific profiles were identified according to a set of variables which could be considered as proxy indicators of health status. Within these five groups, four sub-spaces were randomly selected for the study. We were then able to survey 1045 households in all the selected sub-spaces. The pertinence of this approach is discussed regarding to classical sampling as random walk method for example.ConclusionThis urban space typology allowed to select a population living in areas representative of the uneven urbanization process, and to characterize its health status in regards to several indicators (nutritional status, communicable and non-communicable diseases, and anaemia). Although this method should be validated and compared with more established methods, it appears as an alternative in developing countries where geographic and population data are scarce.
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Anopheles gambiae and its sibling species Anopheles coluzzii are the most efficient vectors of the malaria parasite Plasmodium falciparum. When females of these species feed on an infected human host, oogenesis and parasite development proceed concurrently, but interactions between these processes are not fully understood. Using multiple natural P. falciparum isolates from Burkina Faso, we show that in both vectors, impairing steroid hormone signaling to disrupt oogenesis leads to accelerated oocyst growth and in a manner that appears to depend on both parasite and mosquito genotype. Consistently, we find that egg numbers are negatively linked to oocyst size, a metric for the rate of oocyst development. Oocyst growth rates are also strongly accelerated in females that are in a pre-gravid state, i.e. that fail to develop eggs after an initial blood meal. Overall, these findings advance our understanding of mosquito-parasite interactions that influence P. falciparum development in malaria-endemic regions. Author summaryMalaria, an infectious disease caused by Plasmodium parasites, continues to affect millions of people each year. These parasites are transmitted by Anopheles mosquitoes during blood feeding, which is required by females to produce eggs. After they are ingested by the female, parasites start developing in the midgut at the same time as the mosquito initiates oogenesis, the process of egg development. Here, we investigated how the concomitant processes of egg and parasite development interact in field-derived Anopheles and Plasmodium isolates. We found that in these naturally occurring pairs, oogenesis is negatively linked to parasite development, such that mosquitoes producing fewer eggs harbor faster growing oocysts. Furthermore, when we disrupt signaling pathways that drive oogenesis, oocyst growth is accelerated in a manner that appears to depend on both mosquito and parasite genotype. Additionally, when field mosquitoes fail to develop eggs, they are
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Vivian Paintsil, Mwashungi Ally, Hezekiah Isa, Kofi A. Anie, Josephine Mgaya, Malula Nkanyemka, Victoria Nembaware, Yaa Gyamfua Oppong-Mensah, Flora Ndobho, Lulu Chirande, Abel Makubi, Obiageli Nnodu, Ambroise Wonkam, Julie Makani, Kwaku Ohene-Frempong
Introduction: Sickle Cell Disease (SCD) causes significant morbidity and mortality particularly in sub-Saharan Africa (SSA) where it contributes to early childhood deaths. There is need to standardize treatment guidelines to help improve overall SCD patient health outcomes. We set out to review existing guidelines on SCD and to set minimum standards for management of SCD for the different referral levels of healthcare. Methods: A standards of care working group (SoC-WG) was established to develop the SoC recommendations. About 15 available SCD management guidelines and protocols were reviewed and themes extracted from them. The first draft was on chosen themes with 64 major headings and subtopics. Using a summarised WHO levels of referral document, we were able to get six different referral levels of healthcare. The highest referral level was the tertiary facilities whilst the lowest level was the home setting. Recommendations for SCD management for the regional, district, sub-districts, health posts and CHPs compounds were also drafted. Results: The results from this review yielded a guidelines document which had recommendations for management of SCD on 64 topics and subtopic for all the six (6) different referral levels. Discussions: Every child with SCD need to receive comprehensive care that is coordinated at each level. This recommendation is unique in terms of the availability of recommendations for different levels of care as compared to the traditional guidelines which is more focused at the tertiary levels. Patients can access care at any of the other lower referral hospitals and be managed with recommendations that are in keeping with institutional resources at that level. When such patients need care that requires expertise that is not available at that level, the recommendations will be to refer to the appropriate referral level where those expertise are available. This encourages patients to have good clinical care nearer their homes but also having acc
HématologiePédiatrieLicence : 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
The major arboviruses mainly belong to the Bunyaviridae, Togaviridae, and Flaviviridae families, among which the chikungunya virus and dengue virus have emerged as global public health problems. The main objective of this study was to develop specific, sensitive, and cost-effective molecular multiplex RT-PCR and RT-qPCR assays for the rapid and simultaneous detection of CHIKV and the four serotypes of DENV for arbovirus surveillance. Specific primers for all viruses were designed, and one-step multiplex RT-PCR (mRT-PCR) and RT-qPCR (mRT-qPCR) were developed using reference strains of the CHIKV and DENV serotypes. The specificity of the test for all the viruses was confirmed through sequencing. The standard curves showed a high correlation coefficient, R2 = 0.99, for DENV-2 and DENV-3; R2 = 0.98, for DENV-4; and CHIKV; R2 = 0.93, for DENV-1. The limits of detection were calculated to be 4.1 × 10−1 copies/reaction for DENV-1, DENV-3, and CHIKV and 4.1 × 101 for DENV-2 and DENV-4. The specificity and sensitivity of the newly developed mRT-PCR and mRT-qPCR were validated using positive serum samples collected from India and Burkina Faso. The sensitivity of mRT-PCR and mRT-qPCR are 91%, and 100%, respectively. The specificity of both assays was 100%. mRT-PCR and mRT-qPCR assays are low-cost, and a combination of both will be a useful tool for arbovirus surveillance.
Biologie cellulaire et moléculaireGénétiqueSanté publiqueLicence : 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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Daniel Kandonga, Raphael Zozimus Sangeda, Upendo Masamu, Eliah Kazumali, Agnes Jonathan, Michael Msangawale, Winfrida Kaihula, Julieth Rwegalulila, Jesca Ondego, Hilda J. Tutuba, Joyce Ndunguru, Emmanuela E. Ambrose, Benson R. Kidenya, Mbonea Yonazi, Irene Kyomugisha, Wilson Mupfururirwa, Mario Jonas, Victoria Nembaware, Gaston Kuzamunu Mazandu, Andre Pascal Kengne, Ambroise Wonkam, Julie Makani, Emmanuel Balandya
Background:Sickle cell disease (SCD) is a severe hereditary form of anemia that contributes between 50% and 80% of under-five mortality in Africa. Eleven thousand babies are born with SCD annually in Tanzania, ranking 4th after Nigeria, the Democratic Republic of Congo and India. The absence of well-described SCD cohorts is a major barrier to health research in SCD in Africa.Objective:This paper describes the Sickle Pan African Consortium (SPARCO) database in Tanzania, from the development, design of the study instruments, data collection, analysis of data and management of data quality issues.Methods:The SPARCO registry used existing Muhimbili Sickle Cell Cohort (MSC) study case report forms (CRF) and later harmonized data elements from the SickleInAfrica consortium to develop Research Electronic Data Capture (REDCap) instruments. Patients were enrolled through various strategies, including mass screening following media sensitization and health education events during World Sickle Cell Day each June and the SCD awareness month in September. Additional patients were identified through active surveillance of previously participating patients in the MSC.Results:Three thousand eight hundred patients were enrolled between October 2017 and May 2021. Of these, 1,946 (51.21%) were males and 1,864 (48.79%) were females. The hemoglobin phenotype distribution was 3,762 (99%) HbSS, 3 (0.08%) HbSC and 35 (0.92%) HbSb +thalassemia. Hemoglobin levels, admission history, blood transfusion and painful events were recorded from December 2017 to May 2021.Conclusion:The Tanzania SPARCO registry will improve healthcare for SCD in Africa through the facilitation of collaborative data-driven research for SCD.
Biostatistiques et épidémiologieHématologieSanté publiqueLicence : Creative Commons Attribution License (CC BY) This is an open-access article distributed under the terms of the. 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
Maria Barreix, Theresa A. Lawrie, Nancy Kidula, Fatim Tall, Maurice Bucagu, Ram Chahar, Özge Tunçalp
BackgroundIncreasingly, WHO recommendations are defined by context-specific factors and WHO is developing strategies to ensure that recommendations are successfully adapted and implemented at country level. This manuscript describes the development of a toolkit to support governments to adapt the WHO recommendations on antenatal care (ANC) for a positive pregnancy experience for their context in a systematic manner.MethodsThe toolkit was developed in three steps. It was created with input from methodologists and regional implementation experts (Step 1) followed by a user-testing phase (Step 2), implemented during country stakeholder meetings. User testing consisted of stakeholder interviews that were transcribed, and data was categorised according to the content analysis method. Suggestions for toolkit improvement and issues identified during the interviews were assessed as serious, moderately serious or minor/cosmetic.ResultsA total of 22 stakeholders – comprising five Ministry of Health (MoH) consultants, four MoH policy-makers, and 13 advisors/implementers – from Burkina Faso, India, Rwanda and Zambia participated in user-testing interviews during stakeholder meetings held in each country between August 2018 and February 2019. Most stakeholders had a medical or nursing background and half were women. Overall, responses to the toolkit were positive, with all stakeholders finding it useful and desirable. User testing interviews highlighted four serious, four moderately serious and five minor/cosmetic issues to be managed. These were addressed in the final step (Step 3), an updated version of the WHO ANC Recommendations Adaptation Toolkit, comprised of two main components – a baseline assessment tool with spreadsheets for data entry and a Slidedoc®, a dual-purpose document for reading and presentation, outlining the qualitative data that shaped the women-centred perspective of the guidelines, accompanied by an instruction manual detailing the components’ use.Conclus
Gynécologie-obstétriqueSanté publiqueLicence : https://creativecommons.org/licenses/by/3.0/igo/legalcode This is an open access article distributed under the terms of the Creative Commons Attribution IGO License (), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. In any
Tamara L. Morgan, Michelle S. Fortier, Rahul Jain, Kirstin N. Lane, Kaleigh Maclaren, Taylor McFadden, Jeanette Prorok, Jill Robison, Zachary J. Weston, Jennifer R. Tomasone
AbstractIntroduction:Strategic knowledge mobilization efforts are needed to enhance uptake and use of the Canadian 24-Hour Movement Guidelines (24HMG), which describe optimal amounts of physical activity, sedentary behaviour and sleep each day for overall health. The Whole Day Matters Toolkit for Primary Care is an evidence-informed resource to help primary care providers (PCPs) disseminate the 24HMGs. The purpose of this study was to describe gaining consensus on toolkit components through iterative revisions to improve its utility in preparation for the September 2022 launch, and to summarize early dissemination efforts.Methods:A multidisciplinary expert working group planned three modified Delphi surveys to assess PCPs’ level of agreement with toolkit components on 7-point Likert scales with follow-up prompts for ratings of 4 or less. Consensus was defined a priori as a mean of 6 or higher out of 7 and 60% or more of PCPs selecting at least “somewhat agree.” Items on which consensus was reached were removed from subsequent surveys unless they were revised.Results:Twenty PCPs completed surveys 1 and 2; 15 completed survey 3. Consensus was reached on 5% (4/83), 17% (14/83) and 55% (38/69) of the items in surveys 1, 2 and 3, respectively. The number of qualitative comments decreased from 26 to 19 to 12, further indicating increasing consensus. Conclusion:Items on which consensus was not gained may reflect differences in provider characteristics or settings. A coproduced dissemination strategy was enacted. Toolkit reach was evaluated at launch and 4 months later.
Biostatistiques et épidémiologieSanté publiqueLicence : This work is licensed under a Creative Commons Attribution 4.0 International License
Contexte. La raréfaction des os temporaux cadavériques humains impose la recherche de modèles alternatifs pour la formation en chirurgie otologique. Le porc domestique, dont l'oreille moyenne présente des similitudes anatomiques reconnues avec l'Homme, constitue un candidat disponible et peu couteux. Objectif : décrire l'anatomie de l'oreille moyenne porcine et évaluer sa pertinence comme modèle de simulation chirurgicale ex vivo pour l'apprentissage de la chirurgie otologique. Matériels et méthodes Huit têtes de porcs domestiques soit seize os temporaux ont été disséqués. Un protocole de dissection standardise a été élaboré. Une étude anatomique descriptive et comparative avec l'Homme a été réalisée. En parallèle, deux têtes ont été analysées par tomodensitométrie (TDM) pour compléter l’étude anatomique. Résultats La morphologie externe de l'os temporal porcin différait considérablement de celle de l'Homme. L'oreille moyenne présentait en revanche une proximité anatomique marquée, notamment au niveau de la cavité tympanique. Les particularités anatomiques du CAE porcin ont nécessité l'élaboration d'un abord chirurgical adapte a ses contraintes et reproductible. Conclusion Le porc domestique constitue un modèle anatomiquement pertinent pour la chirurgie de l'oreille moyenne, après adaptation de l’abord chirurgical. Ces résultats posent les bases d'une future validation pédagogique du modèle.
SémiologieMaladies infectieuses et tropicalesMédecine interne (cardiologie, endocrinologie, néphrologie…)Licence : https://creativecommons.org/licenses/by/4.0/
IntroductionL'adrénoleucodystrophie liée à l'X (X-ALD) est une maladie neurodégénérative sévère, due à des mutations du gène ABCD1. Elle se manifeste par une atteinte du système nerveux central et périphérique, une insuffisance surrénalienne et une atteinte des testicules chez le garçon. Son diagnostic repose sur le dosage des Acides Gras à Très Longue Chaine. Le diagnostic précoce est d'une grande importance puisque il définit l'accessibilité aux traitements selon le stage de la maladie.MéthodesNous avons mis en place un programme de diagnostic de l'X-ALD au Maroc au niveau de l'Hôpital d'enfants et du Laboratoire centrale des maladies héréditaires et du métabolisme de Rabat. Le programme s'articule sur trois axes à savoir : le recrutement des patients, le diagnostic et la sensibilisation. Le diagnostic s'effectue selon trois protocoles : un protocole pour les cas symptomatiques, un deuxième pour les cas asymptomatiques et un troisième pour les femmes hétérozygotes.RésultatsDurant trois ans après la mise en place de notre programme de diagnostic de l'Adrénoleucodystrophie liée à l'X, nous avons diagnostiqué la maladie chez sept familles, avec neuf garçons et trois femmes hétérozygotes. Tous les enfants diagnostiqués présentaient la forme cérébrale démyélinisante. Toutes les femmes hétérozygotes étaient asymptomatiques. Une prise en charge thérapeutique a été mise place selon la symptomatologie de chaque cas.Conclusionl'X-ALD est une maladie rare. Notre programme de diagnostique a permis de diagnostiquer un nombre important de cas, ce qui montre son importance. Les compagnes de sensibilisation auprès des professionnels permettront de mieux comprendre la maladie et mieux la diagnostiquer et ainsi donner accès à un nombre plus élevé de patients.
PédiatrieLicence : The Pan African Medical Journal - ISSN 1937-8688. This is an Open Access article distributed under the terms of the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Olivier Mukuku, Augustin Mulangu Mutombo, Lewis Kipili Kamona, Toni Kasole Lubala, Paul Makan Mawaw, Michel Ntani Aloni, Stanislas Okitotsho Wembonyama, Oscar Numbi Luboya
RésuméIntroductionL’objectif de cette étude est de développer un score prédictif de la malnutrition aiguë sévère (MAS) chez les enfants de 6 à 59 mois.MéthodesEtude cas-témoins: les cas (n = 263) étaient les enfants de 6 à 59 mois admis à l’hôpital Sendwe de Lubumbashi pour une MAS; les témoins (n = 263) étaient les enfants de même âge admis dans le même hôpital pour une pathologie autre que la MAS. Nous avons procédé par une analyse univariée puis multivariée. La discrimination du score était évaluée à l’aide de la courbe ROC et du C-index.RésultatsAprès modélisation logistique, neuf critères ressortent comme facteurs prédictifs de MAS: le faible poids à la naissance, la diarrhée à répétition/chronique, le nombre de repas journaliers < 3, l’âge d’arrêt d’allaitement maternel < 6 mois, l’âge d’introduction d’alimentation de complément < 6 mois, l’âge maternel < 25 ans, la parité < 5, l’antécédent familial de malnutrition et le nombre d’enfants âgés de moins de 5 ans dans la fratrie ≥ 3. L’aire sous la courbe ROC est de 0,9685, la sensibilité de 93,54%, la spécificité de 93,16%, la valeur prédictive positive de 93,18% et le rapport de vraisemblance positif de 6,84%.ConclusionNous proposons un score prédictif du risque de survenue de MAS dans une population de moins de 5 ans. Ce score prédictif de MAS serait un outil clinique utile et simple pour cibler la population à risque, limiter les taux élevés de malnutrition et réduire la morbidité et la mortalité infanto-juvénile enregistrés dans les pays en développement.
PédiatrieGynécologie-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.