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• Article libreArticleEn anglais

  Disparities in caesarean section prevalence and determinants across sub-Saharan Africa countries

  Sanni Yaya, Olalekan A. Uthman, Agbessi Amouzou, Ghose Bishwajit

  BackgroundAccess to safe Cesarean section (C-section) in resource-constrained settings such as sub-Sahara Africa (SSA) region is a foremost approach to reduce maternal mortality. C-section is an obstetric operative procedure used appropriately to improve delivery outcomes. However, errors in the procedure have enormous potential harm that may outweigh the benefits. This study assessed the prevalence and determinants of C-section in several SSA countries. This study examined the prevalence and determinants associated with cesarean delivery in SSA countries.MethodsSecondary data of women of reproductive age (15-49 years) from the current Demographic and Health Survey (DHS) in 34 SSA countries was utilized in this study. The mode of delivery among women was the primary outcome variable. Percentage and descriptive statistics were used to conduct univariate analyses. Furthermore, multivariable multilevel logistic regression was used to investigate correlates of C-section among SSA women.ResultsResults showed disparities in the percentage of C-section among women from 34 SSA countries. C-section at public healthcare settings ranged from 3% in Burkina Faso to 15.6% in Ghana. However, in private healthcare settings, C-section ranged from 0% in Sao Tome and Principe to 64.2% in Rwanda. Overall, C-section was 7.9% from public healthcare and 12.3% from private healthcare facilities respectively. In the adjusted regression model; women aged 35–49 had increase in the odds of C-section, while a unit increase in the number of children ever born had 17 and 20% significant reduction in the odds of C-section in public and private healthcare respectively. Assessing public healthcare settings; women from richer/richest households, male and large size children at birth had increase in the odds of C-section, while those from rich neighbourhood had reduction in the odds of C-section. In private healthcare settings, women with high decision making power and multiple births had increase in

  Biostatistiques et épidémiologiePharmacologiePédiatrieLicence : 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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  Disparities in dolutegravir utilisation in children, adolescents and young adults (0–24 years) living with HIV

  Sophie Desmonde, Joycelyn Dame, Karen Malateste, Agatha David, Madeleine Amorissani-Folquet, Sylvie N’Gbeche, Mariam Sylla, Elom Takassi, François Tanoh Eboua, Kouadio Kouakou, Lehila Bagnan Tossa, Caroline Yonaba, Valériane Leroy

  Introduction:We describe the 24-month incidence of Dolutegravir (DTG)-containing antiretroviral treatment (ART) initiation since its introduction in 2019 in West Africa.Methods:We included all patients aged 0–24 years on ART from nine clinics in Côte d’Ivoire (n=4), Ghana, Nigeria, Mali, Benin, and Burkina Faso. Baseline varied by clinic and was defined as date of first DTG prescription; patients were followed up until database closure/death/loss to follow-up (LTFU, no visit ≥ 7 months), whichever came first. We computed the cumulative incidence function for DTG initiation; associated factors were explored in a shared frailty model, accounting for clinic heterogeneity.Results:Since 2019, 3,350 patients were included; 47.2% were female; 78.9% had been on ART ≥ 12 months. Median baseline age was 12.5 years (Interquartile range[IQR]: 8.4–15.8). Median follow-up was 14 months (IQR: 7–22). The overall cumulative incidence of DTG initiation reached 22.7% (95% Confidence Interval (CI): 21.3–24.2) and 56.4% (95% CI: 54.4–58.4) at 12 and 24 months, respectively. In univariate analyses, those aged <5 years and females were overall less likely to switch. Adjusted on ART line and available viral load (VL) at baseline, females >10 years were less likely to initiate DTG compared to males of the same age (adjusted Hazard Ratio [HR] among 10–14 years: 0.62, 95% CI: 0.54–0.72; among ≥15 years: 0.43, 95% CI: 0.36–0.50), as were those with detectable VL (> 50 copies/mL) compared to those in viral suppression (aHR: 0.86, 95% CI: 0.77–0.97) and those on protease inhibitors compared to those on non-nucleoside reverse-transcriptase inhibitors (aHR after 12 months of roll-out: 0.75, 95% CI: 0.65–0.86).Conclusion:Paediatric DTG uptake was incomplete and unequitable in West African settings: DTG use was least likely in children <5years, females ≥ 10 years and those with detectable viral load. Maintained monitoring and support of treatment practices is required to better ensure universal and

  ImmunologieMaladies infectieuses et tropicalesPédiatrieLicence : Creative Commons Attribution 4.0 International License This work is licensed under a, which allows reusers to distribute, remix, adapt, and build upon the material in any medium or format, so long as attribution is given to the creator. The license allows for commercial use.

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• Article libreArticleEn anglais

  Disparities in positive mental health of sexual and gender minority adults in Canada

  Sonia Hajo, Colin A. Capaldi, Li Liu

  AbstractIntroduction:The goal of this study was to examine potential disparities in positive mental health (PMH) among adults in Canada by sexual orientation and gender modality.Methods:Using 2019 Canadian Community Health Survey (CCHS) Annual Component data (N=57034), we compared mean life satisfaction and the prevalence of high self-rated mental health (SRMH), happiness and community belonging between heterosexual and sexual minority adults, and between cisgender and gender minority adults. We used 2019 CCHS Rapid Response on PMH data (N = 11486) to compare the prevalence of high psychological well-being between heterosexual and sexual minority adults. Linear and logistic regression analyses examined the between-group differences in mean life satisfaction and the other PMH outcomes, respectively.Results:Sexual minority (vs. heterosexual) adults reported lower mean life satisfaction (B=−0.7, 95% CI: −0.8, −0.5) and were less likely to report high SRMH (OR = 0.4, 95%CI:0.3,0.5), happiness (OR = 0.4, 95% CI: 0.3, 0.5), community belonging (OR= 0.6, 95% CI:0.5, 0.7) and psychological well-being (OR = 0.4, 95% CI: 0.3, 0.6). Differences were not always significant for specific sexual minority groups in sex-stratified analyses. Gender minority adults reported lower mean life satisfaction and were less likely to report high SRMH and happiness than cisgender adults.Conclusion:Future research could investigate how these PMH disparities arise, risk and protective factors in these populations, how other sociodemographic factors interact with sexual orientation and gender identity to influence PMH and changes in disparities over time.

  Biostatistiques et épidémiologieSanté publiqueLicence : This work is licensed under a Creative Commons Attribution 4.0 International License

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• Article libreArticleEn anglais

  Disputed paternity presumption in Burkina Faso: determination of the biological fathers of children using ABO-rhesus/hemoglobin electrophoresis and STR assays

  Missa Millogo, Serge Theophile Soubeiga, Bapio Valerie Jean Telesphore Bazie, Theodora Mahoukede Zohoncon, Abdoul Karim Ouattara, Albert Theophane Yonli, Jacques Simpore

  BackgroundIn resource-limited countries, ABO, HLA, MNS, Kells, and hemoglobin electrophoresis are classic tests for the resolution of paternity disputes due to their affordable cost. The limitations of these tests in cases of disputed paternity require the use of Short Tandem Repeats (STR) for their certification. This study aimed to determine the biological fathers of children using ABO-rhesus/hemoglobin electrophoresis and STR assays in Burkina Faso, West Africa.ResultsOf the fourteen trios studied, the ABO-rhesus/hemoglobin electrophoresis analysis revealed ten probable inclusion cases, three exclusion cases, and one undetermined paternity. DNA STR analysis found five inclusions of paternity out of the ten probable inclusions with ABO-rhesus/hemoglobin electrophoresis assay versus nine exclusions of paternity.ConclusionThis study showed that the implementation of the analysis of short tandem repeat is required to resolve increasing disputed filiation cases in Burkina Faso.

  HématologiePédiatrieSanté publiqueLicence : Open Access http://creativecommons.org/licenses/by/4.0/ This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original autho

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• Article libreArticleEn anglais

  Dissecting the dynamics of virus-derived DNA of dengue virus 2 (DENV-2) in Aedes mosquitoes

  Dengue is one of the neglected tropical diseases (NTDs) transmitted by Aedes mosquitoes and continues to spread globally. When mosquitoes are infected with dengue virus (DENV), virus-derived DNA (vDNA) is generated in mosquitoes, which subsequently contributes to their immune response. We traced the generation and presence of dengue virus type 2 (DENV-2) vDNA in experimentally infected cultured mosquito cells and Aedes mosquitoes, and notably, in wild mosquitoes collected in Burkina Faso. Detection of vDNA was achieved using a method incorporating loop-mediated isothermal amplification (LAMP), specifically, a LAMP-based vDNA detection method (vDNA-LAMP). The LAMP reaction, using primers targeting a segment of the NS5 region of DENV-2, detected vDNA from crude DNA extracted from experimentally infected cultured cells and Aedes mosquitoes. Detection revealed that the amount of DENV-2 vDNA generated in infected cells was relatively low; nevertheless, vDNA-LAMP enabled successful detection. The timing and quantity of vDNA generation in cultured cells were associated with the initial number of viral particles introduced during infection. Furthermore, vDNA-LAMP was applied to detect dengue virus vDNA in wild mosquitoes in dengue-endemic regions. This resulted in the successful detection of DENV-2 vDNA in field-collected mosquitoes, indicating that a proportion of wild mosquitoes in Burkina Faso harbored DENV-2 vDNA. Mapping these vDNA-positive mosquitoes allowed the identification of areas where infected mosquitoes and/or their progeny were likely present. These findings provide insights into the dynamics of DENV-2 vDNA in natural environments and underscore the potential of vDNA-LAMP as a tool for tracing vDNA in wild mosquitoes, which are responsible for transmitting viral infections.

  ImmunologieSanté 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

  Dissecting the mechanisms responsible for the multiple insecticide resistance phenotype in Anopheles gambiae s.s., M form, from Vallée du Kou, Burkina Faso

  Rachel M. Kwiatkowska, Naomi Platt, Rodolphe Poupardin, Helen Irving, Roch K. Dabire, Sara Mitchell, Christopher M. Jones, Abdoulaye Diabaté, Hilary Ranson, Charles S. Wondji

  With the exception of target site mutations, insecticide resistance mechanisms in the principle malaria vector Anopheles gambiae, remains largely uncharacterized in Burkina Faso.Here we detected high prevalence of resistance in Vallée du Kou (VK) to pyrethroids, DDT and dieldrin, moderate level for carbamates and full susceptibility to organophosphates. High frequencies of L1014F kdr (75%) and Rdl (87%) mutations were observed showing strong correlation with pyrethroids/DDT and dieldrin resistance. The frequency of ace1R mutation was low even in carbamate resistant mosquitoes. Microarray analysis identified genes significantly over-transcribed in VK. These include the cytochrome P450 genes, CYP6P3 and CYP6Z2, previously associated with pyrethroid resistance. Gene Ontology (GO) enrichment analysis suggested that elevated neurotransmitter activity is associated with resistance, with the over-transcription of target site resistance genes such as acetylcholinesterase and the GABA receptor. A rhodopsin receptor gene previously associated with pyrethroid resistance in Culex pipiens pallens was also over-transcribed in VK.This study highlights the complex network of mechanisms conferring multiple resistance in malaria vectors and such information should be taken into account when designing and implementing resistance control strategies. Highlights► High pyrethroids, DDT and dieldrin resistance in VK, moderate for carbamate ► High frequencies kdr and Rdl mutations in VK with strong correlation with resistance ► Detection using microarray of genes upregulated in VK notably CYP6P3 and CYP6Z2 P450s ► Neurotransmitter activity GO terms enriched in VK; Ace-1/GABA receptor upregulated ► A rhodopsin gene associated with resistance in Culex p. pallens upregulated in VK

  Biologie cellulaire et moléculaireGénétiqueBiostatistiques et épidémiologieLicence : CC BY 3.0 Open Access underlicense

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  Dissection aortique anevrismale chez un adulte infecte par le VIH-1 dans le cadre d'un syndrome de reconstitution immune avec tuberculose

  D. R. Moh, Anani Dodzi Badje, N. F. Ello, J. B. N'Takpe, J. B. Anzouan-Kacou, G. M. Kouame, S. Ackoundze, F. Boccara, O. Ba-Gomis, Serge Paul Eholie, Xavier Anglaret, Christine Danel

  Un homme de 35 ans, VIH-1, sans antécédents médicaux et chirurgicaux particuliers, a été hospitalisé à Abidjan, Côte d'Ivoire, dans un contexte fébrile, toux, dyspnée, douleurs thoraciques et à la radiographie pulmonaire, un déroulement de la crosse de l'aorte une semaine après avoir débuté les antirétroviraux (ARV). Les scanners angiothoraciques réalisés ont mis en évidence une ectasie aortique globale étendue avec thrombus mural. Une échocardiographie transoesophagienne conclut à une dissection aortique, type A de Stanford. Le diagnostic de tuberculose a été confirmé par l'isolation en culture de Mycobacterium Tuberculosis. Huit ans après, le patient est encore vivant, sans intervention chirurgicale et se plaint de douleurs thoraciques intermittentes. Sa pression artérielle est stable et a une insuffisance rénale modérée. Nous rapportons un cas rare de dissection aortique anévrismale chez un adulte infecté par le VIH-1 dans le cadre d'un syndrome de reconstitution immune avec tuberculose pulmonaire.

  Microbiologie (bactériologie, virologie)ImmunologieSémiologieLicence : https://creativecommons.org/licenses/by/4.0/

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  Dissection aortique anévrismale chez un adulte infecté par le VIH-1 dans le cadre d'un syndrome de reconstitution immune avec tuberculose

  Desmorys Raoul Moh, Anani Badjé, Nogbou Frederic Ello, Jean-Baptiste N'takpé, Jean-Baptiste Anzouan-Kacou, Gérard Menan Kouamé, Simplice Ackoundzé, Franck Boccara, Olivier Ba-Gomis, Serge-Paul Eholié, Xavier Anglaret, Christine Danel

  Un homme de 35 ans, VIH-1, sans antécédents médicaux et chirurgicaux particuliers, a été hospitalisé à Abidjan, Côte d'Ivoire, dans un contexte fébrile, toux, dyspnée, douleurs thoraciques et à la radiographie pulmonaire, un déroulement de la crosse de l'aorte une semaine après avoir débuté les antirétroviraux (ARV). Les scanners angiothoraciques réalisés ont mis en évidence une ectasie aortique globale étendue avec thrombus mural. Une échocardiographie transoesophagienne conclut à une dissection aortique, type A de Stanford. Le diagnostic de tuberculose a été confirmé par l'isolation en culture de Mycobacterium Tuberculosis. Huit ans après, le patient est encore vivant, sans intervention chirurgicale et se plaint de douleurs thoraciques intermittentes. Sa pression artérielle est stable et a une insuffisance rénale modérée. Nous rapportons un cas rare de dissection aortique anévrismale chez un adulte infecté par le VIH-1 dans le cadre d'un syndrome de reconstitution immune avec tuberculose pulmonaire.

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

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  Dissection de l'aorte thoracique descendante et de l'aorte abdominale dans la maladie de Takayasu: à propos d'un cas

  Abdelaziz Zaghdoudi, Monika Bukta, Mohamed Ali Mongalgi, Kais Malouche, Sonia Malouche

  La dissection aortique est une complication très rare de la maladie de Takayasu. Dans la littérature récente seulement 14 cas ont été publiés. Nous rapportons le cas d'un maghrébin âgé de 67 ans, présentant une dissection aigue de l'aorte thoracique descendante et de l'aorte abdominale avec un syndrome inflammatoire, révélateur d'une maladie de Takayasu. Le type de l'atteinte aortique (type III b, selon la classification de De Bakey et Standford) confirmé par angioscanner chez notre patient, n'a pas été rapporté. Il nous parait que l'artérite de Takayasu est sous-estimée chez les malades dépassant l’âge de la 4ème décennie. La forme tardive de cette pathologie pose un problème de diagnostic différentiel avec la maladie de Horton, selon les critères d’âge et d'ethnie. Actuellement la majorité des auteurs donnent la priorité à l'imagerie médicale, avec ou sans syndrome inflammatoire pour la confirmation du diagnostic de la maladie de Takayasu.

  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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  Dissection de l´aorte abdominale révélatrice de la maladie de Takayasu: à propos d´un cas en Guinée

  Barry Ibrahima Sory, Balde El Hadj Yaya, Camara Abdoulaye, Samoura Aly, Koivogui Diarra, Koivogui Kokoulo, Soumaoro Morlaye, Sylla Djibril, Bah Mamadou Bassirou, Beavogui Mariame, Balde Mamadou Dadhi, Conde Mamady

  La maladie de Takayasu (MT) est une artériopathie inflammatoire chronique touchant l´aorte, ses principales branches et les artères pulmonaires. Son appellation tient de l´ophtalmologiste japonais Mikito Takayasu qui publia en 1908 la première description de la maladie. Il s´agissait d´un patient de 78ans admis pour douleur abdominale, douleur du membre inférieur droit à la marche, insomnie. Evoluant depuis 1an sans antécédent de maladie cardio-vasculaire connu. A l´examen physique: le rythme cardiaque régulier à 87 battements par minute sans bruits pathologiques surajoutés avec une absence de pouls pédieux droit, tension artérielle à 120/78 mmhg, poumons libres, abdomen souple avec une masse battante dans la fosse iliaque droite dont l´auscultation met en évidence un souffle continu. Le reste de l´examen est sans particularité. L´angioscanner abdominal confirmait un aspect de dissection aortique étendue sur l´ensemble de l´aorte abdominale avec opacification synchrone des deux chenaux, un anévrisme thrombosé des artères iliaques primitives mesurant 48mm x100mm à droite et 38mm x 90mm à gauche, absence de fissuration visible. Nous rapportons le cas d´une dissection de l´aorte abdominale associée à un anévrisme thrombosé des artères iliaques primitives révélant une maladie de Takayashu au service de cardiologie de l´hôpital national Ignace Deen. La fréquence de la dissection de l´aorte abdominale au cours de la maladie de Takayasu est rare. Elle est plus souvent diagnostiquée dans sa phase occlusive. Le pronostic dépend des complications évolutives.

  Médecine interne (cardiologie, endocrinologie, néphrologie…)Licence : https://creativecommons.org/licenses/by/4.0/ The Pan African Medical Journal (ISSN: 1937-8688). This is an Open Access article distributed under the terms of the Creative Commons Attribution International 4.0 License (), which permits unrestricted use, distribution, and reproduction in any medium, p

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  Dissection spontanée et isolée du tronc cœliaque

  Melek Ben Mrad, Nizar Elleuch

  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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  Dissection vertébrale post-traumatique: résultats IRM

  Youssef Alaoui Lamrani, Mustapha Maaroufi

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

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• Article libreArticleEn anglais

  Distance sampling for epidemiology: an interactive tool for estimating under-reporting of cases from clinic data

  Luca Nelli, Moussa Guelbeogo, Heather M. Ferguson, Daouda Ouattara, Alfred Tiono, Sagnon N’Fale, Jason Matthiopoulos

  BackgroundDistance sampling methods are widely used in ecology to estimate and map the abundance of animal and plant populations from spatial survey data. The key underlying concept in distance sampling is the detection function, the probability of detecting the occurrence of an event as a function of its distance from the observer, as well as other covariates that may influence detection. In epidemiology, the burden and distribution of infectious disease is often inferred from cases that are reported at clinics and hospitals. In areas with few public health facilities and low accessibility, the probability of detecting a case is also a function of the distance between an infected person and the “observer” (e.g. a health centre). While the problem of distance-related under-reporting is acknowledged in public health; there are few quantitative methods for assessing and correcting for this bias when mapping disease incidence. Here, we develop a modified version of distance sampling for prediction of infectious disease incidence by relaxing some of the framework’s fundamental assumptions. We illustrate the utility of this approach using as our example malaria distribution in rural Burkina Faso, where there is a large population at risk but relatively low accessibility of health facilities.ResultsThe modified distance-sampling framework was used to predict the probability of reporting malaria infection at 8 rural clinics, based on road-travel distances from villages. The rate at which reporting probability dropped with distance varied between clinics, depending on road and clinic positions. The probability of case detection was estimated as 0.3–1 in the immediate vicinity of the clinic, dropping to 0.1–0.6 at a travel distance of 10 km, and effectively zero at distances > 30–40 km.ConclusionsTo enhance the method’s strategic impact, we provide an interactive mapping tool (as a self-contained R Shiny app) that can be used by non-specialists to interrogate model outputs a

  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

  Distance to care, care seeking and child mortality in rural Burkina Faso: findings from a population‐based cross‐sectional survey

  S. Sarrassat, N. Meda, H. Badolo, M. Ouedraogo, H. Somé, S. Cousens

  AbstractObjectiveAlthough distance has been identified as an important barrier to care, evidence for an effect of distance to care on child mortality is inconsistent. We investigated the association of distance to care with self‐reported care seeking behaviours, neonatal and post‐neonatal under‐five child mortality in rural areas of Burkina Faso.MethodsWe performed a cross‐sectional survey in 14 rural areas from November 2014 to March 2015. About 100 000 women were interviewed on their pregnancy history and about 5000 mothers were interviewed on their care seeking behaviours. Euclidean distances to the closest facility were calculated. Mixed‐effects logistic and Poisson regressions were used respectively to compute odds ratios for care seeking behaviours and rate ratios for child mortality during the 5 years prior to the survey.ResultsThirty per cent of the children lived more than 7 km from a facility. After controlling for confounding factors, there was a strong evidence of a decreasing trend in care seeking with increasing distance to care (P ≤ 0.005). There was evidence for an increasing trend in early neonatal mortality with increasing distance to care (P = 0.028), but not for late neonatal mortality (P = 0.479) and post‐neonatal under‐five child mortality (P = 0.488). In their first week of life, neonates living 7 km or more from a facility had an 18% higher mortality rate than neonates living within 2 km of a facility (RR = 1.18; 95%CI 1.00, 1.39; P = 0.056). In the late neonatal period, despite the lack of evidence for an association of mortality with distance, it is noteworthy that rate ratios were consistent with a trend and similar to or larger than estimates in early neonatal mortality. In this period, neonates living 7 km or more from a facility had an 18% higher mortality rate than neonates living within 2 km of a facility (RR = 1.18; 95%CI 0.92, 1.52; P = 0.202). Thus, the lack of evidence may reflect lower power due to fewer deaths rather than a weak

  Biostatistiques et épidémiologiePédiatrieGynécologie-obstétriqueLicence : http://creativecommons.org/licenses/by/4.0/ This is an open access article under the terms of theLicense, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

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  Distance to primary care facilities and healthcare utilization for preschool children in rural northwestern Burkina Faso: results from a surveillance cohort

  Catherine E. Oldenburg, Ali Sié, Mamadou Ouattara, Mamadou Bountogo, Valentin Boudo, Idrissa Kouanda, Elodie Lebas, Jessica M. Brogdon, Ying Lin, Fanice Nyatigo, Benjamin F. Arnold, Thomas M. Lietman

  BackgroundDelays in care-seeking for childhood illness may lead to more severe outcomes. We evaluated whether community distance from a primary healthcare facility was associated with decreased healthcare utilization in a rural district of northwestern Burkina Faso.MethodsWe conducted passive surveillance of all government-run primary healthcare facilities in Nouna District, Burkina Faso from March 1 through May 31, 2020. All healthcare visits for children under 5 years of age were recorded on a standardized form for sick children. We recorded the age, sex, and community of residence of the child as well as any diagnoses and treatments administered. We calculated healthcare utilization per 100 child-months by linking the aggregate number of visits at the community level to the community’s population of children under 5 months per a census that was conducted from August 2019 through February 2020. We calculated the distance between each community and its corresponding healthcare facility and assessed the relationship between distance and the rate of healthcare utilization.ResultsIn 226 study communities, 12,676 primary healthcare visits were recorded over the three-month period. The median distance between the community and primary healthcare facility was 5.0 km (IQR 2.6 to 6.9 km), and median number of healthcare visits per 100 child-months at the community level was 6.7 (IQR 3.7 to 12.3). The rate of primary healthcare visits declined with increasing distance from clinic (Spearman’s rho − 0.42, 95% CI − 0.54 to − 0.31, P < 0.0001). This relationship was similar for cause-specific clinic visits (including pneumonia, malaria, and diarrhea) and for antibiotic prescriptions.ConclusionsWe documented a distance decay effect between community distance from a primary healthcare facility and the rate of healthcare visits for children under 5. Decreasing distance-related barriers, for example by increasing the number of facilities or targeting outreach to more distant commun

  Biostatistiques et épidémiologieMicrobiologie (bactériologie, virologie)Parasitologie et mycologieLicence : 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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  Distinct and shared risk factors for mood, anxiety and comorbid disorders among Canadians: evidence from the 2019–2020 Canadian Community Health Survey

  Fahima Hassan, Cindy Feng

  AbstractIntroduction:Mood and anxiety disorders frequently co-occur, but few studies have differentiated their unique and shared risk factors. This study examines factors associated with mood disorders alone, anxiety disorders alone and comorbid mood and anxiety disorders among Canadians using 2019–2020 Canadian Community Health Survey data.Methods:The analytic sample included 107859 respondents, weighted to represent the Canadian population. Multinomial logistic regression with survey and bootstrap weights estimated adjusted relative risk ratios (aRRRs) for sociodemographic, socioeconomic, health-related and psychosocial factors.Results:Prevalence was 4.17% for mood disorders alone, 4.99% for anxiety disorders alone and 4.85% for comorbid mood and anxiety disorders. Females had significantly higher risks across all categories (comorbidity aRRR = 2.284; 95% confidence interval [CI]: 1.951–2.673). Younger adults (18–34 years) had greater risks for anxiety disorders alone (aRRR = 3.036; 95% CI: 2.441–3.776) and comorbid disorders (9.311; 7.134–12.153) compared with those aged 65 years and older. Lower household income and poor perceived health were consistently associated with increased risks, with comorbid disorders showing the strongest associations (poor perceived health aRRR = 14.688; 95% CI: 9.908–21.775). Psychosocial factors, including low life satisfaction and a weak sense of community belonging, were also linked to higher risks, particularly for comorbid disorders.Conclusion:Distinct and overlapping factors contribute to mood and/or anxiety disorders. Targeted prevention and intervention efforts addressing health status, socioeconomic disadvantage and psychosocial stressors—especially among younger people and females—are critical to reducing the burden of these mental health conditions in Canada.

  Biostatistiques et épidémiologieSanté publiqueLicence : This work is licensed under a Creative Commons Attribution 4.0 International License

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  Distinct mechanisms mediate X chromosome dosage compensation in Anopheles and Drosophila

  Claudia Isabelle Keller Valsecchi, Eric Marois, M Felicia Basilicata, Plamen Georgiev, Asifa Akhtar

  Sex chromosomes induce potentially deleterious gene expression imbalances that are frequently corrected by dosage compensation (DC). Three distinct molecular strategies to achieve DC have been previously described in nematodes, fruit flies, and mammals. Is this a consequence of distinct genomes, functional or ecological constraints, or random initial commitment to an evolutionary trajectory? Here, we study DC in the malaria mosquito Anopheles gambiae. The Anopheles and Drosophila X chromosomes evolved independently but share a high degree of homology. We find that Anopheles achieves DC by a mechanism distinct from the Drosophila MSL complex–histone H4 lysine 16 acetylation pathway. CRISPR knockout of Anopheles msl-2 leads to embryonic lethality in both sexes. Transcriptome analyses indicate that this phenotype is not a consequence of defective X chromosome DC. By immunofluorescence and ChIP, H4K16ac does not preferentially enrich on the male X. Instead, the mosquito MSL pathway regulates conserved developmental genes. We conclude that a novel mechanism confers X chromosome up-regulation in Anopheles. Our findings highlight the pluralism of gene-dosage buffering mechanisms even under similar genomic and functional constraints.

  Biologie cellulaire et moléculaireGénétiqueParasitologie et mycologieLicence : https://creativecommons.org/licenses/by/4.0/

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  Distribution and Frequency of kdr Mutations within Anopheles gambiae s.l. Populations and First Report of the Ace.1G119S Mutation in Anopheles arabiensis from Burkina Faso (West Africa)

  An entomological survey was carried out at 15 sites dispersed throughout the three eco-climatic regions of Burkina Faso (West Africa) in order to assess the current distribution and frequency of mutations that confer resistance to insecticides in An. gambiae s.l. populations in the country. Both knockdown (kdr) resistance mutation variants (L1014F and L1014S), that confer resistance to pyrethroid insecticides, were identified concomitant with the ace-1 G119S mutation confirming the presence of multiple resistance mechanisms in the An. gambiae complex in Burkina Faso. Compared to the last survey, the frequency of the L1014F kdr mutation appears to have remained largely stable and relatively high in all species. In contrast, the distribution and frequency of the L1014S mutation has increased significantly in An. gambiae s.l. across much of the country. Furthermore we report, for the first time, the identification of the ace.1 G116S mutation in An. arabiensis populations collected at 8 sites. This mutation, which confers resistance to organophosphate and carbamate insecticides, has been reported previously only in the An. gambiae S and M molecular forms. This finding is significant as organophosphates and carbamates are used in indoor residual sprays (IRS) to control malaria vectors as complementary strategies to the use of pyrethroid impregnated bednets. The occurrence of the three target-site resistance mutations in both An. gambiae molecular forms and now An. arabiensis has significant implications for the control of malaria vector populations in Burkina Faso and for resistance management strategies based on the rotation of insecticides with different modes of action.

  Biostatistiques et épidémiologieMicrobiologie (bactériologie, virologie)Parasitologie et mycologieLicence : This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are properly credited.

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  Distribution des dermatoses rencontrées chez les enfants vus en consultation dermatologique à Lomé (Togo)

  Julienne Noude TÉCLESSOU, Kokoè Afiwa DOVI-TEVI, Koussake KOMBATÉ, Bayaki SAKA, Abla Séfako AKAKPO, Palokinam PITCHÉ

  RésuméObjectifLe but de cette étude était d’établir le panorama des dermatoses chez les enfants vus en consultation dermatologique à Lomé et de décrire les tendances de ces dermatoses entre 1992 et 2020.MéthodeIl s'agit d'une étude rétrospective descriptive portant sur les dossiers des patients de 0 à 15 ans vus en consultation dans les services publics de dermatologie de Lomé du 1er janvier 2010 au 31 décembre 2019. Une comparaison des différentes dermatoses a été faite avec celles recensées lors d'une précédente étude similaire en 1992.RésultatsAu cours de la période d’étude, 3 767 enfants ont consulté pour une affection dermatologique (14,2 % de consultations pédiatriques parmi les consultations dermatologiques). L’âge moyen des patients était de 7,4 ans et le sexe ratio M/F était de 0,7. Les mois de juillet, août et septembre étaient ceux qui enregistraient le plus de consultations. Les trois premiers motifs de consultation étaient l'eczéma (26,6%), le prurigo strophulus (15,3%) et la dermatite atopique (4,9%). Aussi, 51,3 % des pathologies cutanées chez les enfants étaient représentées par les dermatoses immunoallergiques, suivies des dermatoses infectieuses (23,6%). Les dermatoses infectieuses prédominantes étaient mycosiques (34,4%) et bactériennes (30,3%). On note entre 1992 et 2019 une augmentation de la prévalence des dermatoses immunoallergiques et une réduction des dermatoses infectieuses.ConclusionLes résultats de cette étude montrent que les dermatoses immunoallergiques sont prédominantes et en nette augmentation chez les enfants vus en consultation dermatologique à Lomé. Nous l'attribuons à l'urbanisation et aux changements climatiques.

  Biostatistiques et épidémiologieImmunologiePédiatrieLicence : 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 ().

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  Distribution épidémiologique de l'infection à VIH chez les femmes enceintes dans les dix régions du Cameroun et implications stratégiques pour les programmes de prévention

  Serge-Clotaire Billong, Joseph Fokam, Edson-Joan Billong, Georges Nguefack-Tsague, Marie-Josée Essi, Raoul Fodjo, Samuel-Martin Sosso, Armelle Gomba, Joseph Mosoko-Jembia, Gabriel Loni-Ekali, Vittorio Colizzi, Anne-Cécile Zoung-Kani Bissek, Francisca Monebenimp, Jean-Bosco Elat Nfetam

  IntroductionLe Cameroun se situe dans un contexte d’épidémie généralisée du VIH. La sous-population des femmes enceintes, facilement accessible au sein de la population générale, représente une cible probante pour mener la surveillance du VIH et estimer l’évolution épidémiologique. L'objectif de notre étude était d’évaluer la distribution épidémiologique du VIH chez les femmes enceintes.MéthodesÉtude transversale menée en 2012 chez 6521 femmes enceintes (49,3% âgées de 15-24 ans) en première consultation prénatale (CPN1) dans 60 sites des 10 régions Camerounaises. L'algorithme en série a été utilisé pour le sérodiagnostic du VIH.RésultatsLa prévalence du VIH était de 7,8% (508/6521), avec une différence non significative (p = 0,297) entre milieu rural (7,4%) et milieu urbain (8,1%). En zone rurale, cette prévalence variait de 0,7% à l'Extrême-Nord à 11,8% au Sud. Cependant, en zone urbaine elle variait de 4% à l'Ouest à 11,1% au Sud-Ouest. Suivant l’âge, la prévalence était plus élevée (11,3%) chez les femmes de 35-39 ans. Suivant le niveau de scolarisation, la prévalence du VIH était plus faible (4,4%) chez celles non-scolarisées, et plus élevée (9,3%) chez celles ayant un niveau primaire. Selon la profession, l'infection était plus élevée chez les coiffeuses (15,5%), secrétaires (14,8%), commerçantes (12,9%) et institutrices/enseignantes (10,8%).ConclusionLa prévalence du VIH reste élevée chez les femmes enceintes au Cameroun, sans distinction entre milieux rural et urbain. Les stratégies de prévention devraient s'orienter préférentiellement chez les femmes enceintes âgées, celles du niveau d'instruction primaire, et celles du secteur des petites et moyennes entreprises.

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

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  Distribution et itinéraire thérapeutique des patients reçus pour accident vasculaire cérébral à l'Hôpital Régional de Bafoussam, Cameroun

  Brice-Donald Agokeng Kemnang, Landry Beyala Bita’a, Styve Hermane Simo Yomi, Brice Tajo Djidjou, Romarique Medjou Mboumo, Cyrielle Djouda Douanla, Victorien Wouafack-Kenfack, Franck-Carrel Nguetsa Tsakeng, Olivia Tania Homla Megaptche, Jérôme Ateudjieu

  IntroductionL'incidence des accidents vasculaires cérébraux (AVC) est sans cesse croissante en Afrique. La morbidité et la mortalité liées à cette maladie dépendent de la prise en charge des patients aussi bien en communauté que dans les formations sanitaires (FOSA). L'objectif était de décrire la distribution de l'évolution et l'itinéraire thérapeutique des patients reçus pour AVC à l'hôpital régional de Bafoussam (HRB).MéthodesIl s'agissait d'une étude de cohorte non contrôlée ciblant les patients qui ont été diagnostiqués pour AVC. Les données étaient collectées à l'aide de deux outils dont un questionnaire anonyme adressé au patient ou à son garde sur la prise en charge pré-hospitalière du patient et une grille pour la collecte des données sur les documents de suivi du patient pendant son hospitalisation. Les données ont été analysées en décrivant la distribution des fréquences des sources et types de soins sollicités avant et pendant l'hospitalisation ainsi que celle de l'évolution à la fin de l'hospitalisation y compris l'incidence des complications.RésultatsAu total 46 patients ont été inclus dans cette étude avec un âge moyen de 62 ans. Vingt-sept soit 58,7% étaient des femmes et 37 soit 80,4% étaient référés à d'autres FOSA. Quatre (8,7%) patients avaient pris des produits avant leur hospitalisation dont 2 (4,3%) un produit traditionnel. Trente-six (78,3%) patients avaient des antécédents cardiovasculaires dont 22 cas connus d'hypertension artérielle. A la sortie après 10 jours d'hospitalisation, 32 (69,6%) avaient repris leur autonomie et 5 (10,9%) patients étaient décédés.ConclusionPeu de patients recourent aux soins non médicalisés avant l'arrivée à l'hôpital. La plupart bénéficient des soins dans les délais requis mais les taux de complications et de décès hospitaliers restent élevés. Une étude devrait être faite pour déterminer les facteurs contribuant à un taux élevé de complications et de décès chez les patients hospitalisés pour AVC à l'HRB.

  Biostatistiques et épidémiologieMédecine interne (cardiologie, endocrinologie, néphrologie…)Santé 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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  Distribution of Parasitic Nematodes Associated with Papaya in Major Production Zones of Burkina Faso

  Kouroubi Raïssa Laëtitia Coulibaly, Bouma Thio, Moussa Sondo, Souleymane Yeo, Jacob Sanou, Kadidia Koita, Diana Fernandez

  AbstractPapaya (Carica papaya L.) is an increasingly important fruit crop in Burkina Faso; however, its production is constrained by plant-parasitic nematodes, whose diversity and impact remain poorly documented. A survey of papaya orchards across 9 production regions identified 10 nematode genera, with Rotylenchulus, Helicotylenchus, Meloidogyne, Scutellonema, and Pratylenchus as the most frequent and abundant. Regional patterns indicated that Meloidogyne, Rotylenchulus, Helicotylenchus, and Scutellonema were widespread, and the High-Basins region harbored the richest nematode diversity. Papaya monocultures presented significantly higher nematode densities than intercropped systems, while banana and eggplant associations reduced populations. Meloidogyne and Rotylenchulus populations were influenced by climatic factors, with frequencies positively correlated with temperature and negatively with rainfall and humidity. Molecular characterization confirmed the widespread presence of Meloidogyne javanica and identified Rotylenchulus reniformis 0type A in papaya orchards. This study provided the first comprehensive description of nematode distribution in papaya systems, offering valuable insights for developing targeted nematode management strategies in Burkina Faso.

  Biostatistiques et épidémiologieParasitologie et mycologieSanté publiqueLicence : This work is licensed under the Creative Commons Attribution 4.0 International License.

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  Distribution of Plasmodium spp. infection in asymptomatic carriers in perennial and low seasonal malaria transmission settings in West Africa

  Constant G. N. Gbalégba, Hampâté Ba, Kigbafori D. Silué, Ousmane Ba, Emmanuel Tia, Mouhamadou Chouaibou, Nathan T. Y. Tian-Bi, Grégoire Y. Yapi, Brama Koné, Jürg Utzinger, Benjamin G. Koudou

  BackgroundSince 2000, substantial progress has been made in reducing malaria worldwide. However, some countries in West Africa remain a hotspot for malaria with all age groups at risk. Asymptomatic carriers of Plasmodium spp. are important sources of infections for malaria vectors and thus contribute to the anchoring of the disease in favourable eco-epidemiological settings. The objective of this study was to assess the asymptomatic malaria case rates in Korhogo and Kaedi, two urban areas in northern Côte d’Ivoire and southern Mauritania, respectively.MethodsCross-sectional surveys were carried out during the rainy season in 2014 and the dry season in 2015 in both settings. During each season, 728 households were randomly selected and a household-based questionnaire was implemented to collect demographic and epidemiological data, including of malaria preventive methods used in communities. Finger-prick blood samples were obtained for biological examination using microscopy and rapid diagnostic tests (RDTs).ResultsOverall, 2672 households and 15 858 consenting participants were surveyed. Plasmodium spp. infection was confirmed in 12.4% (n = 832) and 0.3% (n = 22) of the assessed individuals in Korhogo and Kaedi, respectively. In Korhogo, the prevalence of asymptomatic malaria was 10.5% (95% CI: 9.7–11.2) as determined by microscopy and 9.3% (95% CI: 8.6–10.0%) when assessed by RDT. In Kaedi, asymptomatic malaria prevalence was 0.2% (95% CI: 0.1–0.4%) according to microscopy, while all RDTs performed were negative (n = 8372). In Korhogo, asymptomatic malaria infection was significantly associated with age and season, with higher risk within the 5–14 years-old, and during the rainy season. In Kaedi, the risk of asymptomatic malaria infection was associated with season only (higher during the dry season; crude OR (cOR): 6.37, 95% CI: 1.87–21.63). P. falciparum was the predominant species identified in both study sites representing 99.2% (n = 825) in Korhogo and 59.1% (n

  Biostatistiques et épidémiologieParasitologie et mycologieMaladies infectieuses et tropicalesLicence : Open Access http://creativecommons.org/licenses/by/4.0/ http://creativecommons.org/publicdomain/zero/1.0/ This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (), which permits unrestricted use, distribution, and reproduction in any medium, provid

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  Distribution of resistance genes encoding ESBLs in Enterobacteriaceae isolated from biological samples in health centers in Ouagadougou, Burkina Faso

  Dissinviel S. Kpoda, Abraham Ajayi, Marius Somda, Oumar Traore, Nathalie Guessennd, Aboubakar S. Ouattara, Lassana Sangare, Alfred S. Traore, Mireille Dosso

  ObjectiveResistance to antibiotics most especially third generation cephalosporins has assumed a worrisome dimension globally. Genes conferring these resistance which are mediated by enzymes known as extended spectrum beta-lactamases (ESBLs) are now wide spread among several Enterobacteriaceae species. However there is paucity of data regarding the distribution of these genes in Burkina Faso. Hence this prospective study aims to determine the prevalence and distribution of ESBL encoding genes in ESBL producing Enterobacteriaceae strains isolated from clinical samples of patients attending the three major hospitals in Ouagadougou Burkina Faso.ResultsESBL-encoding genes were assayed in 187 ESBL producing Enterobacteriaceae strains. Among these isolates, the prevalence of ESBL-producing strains with blaTEM, blaSHV and blaCTX-M genes were 26.2% (49/187), 5.9% (11/187) and 40.1% (75/187) respectively. The association of ESBL encoding genes with health centers was statistically significant (p = 0.0209). Approximately 39.6% of E. coli harbored CTX-M and Klebsiella spp. 5.9%. This study demonstrates the dissemination of TEM, SHV and CTX-M genes in ESBL producing Enterobacteriaceae strains in Ouagadougou. Continuous spread of these bacteria poses great public health risk, thus increased surveillance and regulation of antibiotics use is imperative in Burkina Faso.

  Biostatistiques et épidémiologieMicrobiologie (bactériologie, virologie)PharmacologieLicence : Open Access http://creativecommons.org/licenses/by/4.0/ http://creativecommons.org/publicdomain/zero/1.0/ This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (), which permits unrestricted use, distribution, and reproduction in any medium, provid

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