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• Article libreArticleEn anglais

  Distribution Systems of Insecticide-Treated Bed Nets for Malaria Control in Rural Burkina Faso: Cluster-Randomized Controlled Trial

  BackgroundInsecticide-impregnated bed nets (ITNs) have been shown to be a highly effective tool against malaria in the endemic regions of sub-Saharan Africa (SSA). There are however different opinions about the role of ITN social marketing and ITN free distribution in the roll-out of ITN programmes. The objective of this study was to evaluate the effects of free ITN distribution through antenatal care services in addition to an ITN social marketing programme in an area typical for rural SSA.MethodsA cluster-randomised controlled ITN trial took place in the whole Kossi Province in north-western Burkina Faso, an area highly endemic for malaria. Twelve clusters were assigned to long-term ITN (Serena brand) social marketing plus free ITN (Serena brand) distribution to all pregnant women attending governmental antenatal care services (group A), and 13 clusters to ITN social marketing only (group B). The intervention took place during the rainy season of 2006 and thereafter. The trial was evaluated through a representative household survey at baseline and after one year. Serena ITN household ownership was the primary outcome measure.FindingsA total of 1052 households were visited at baseline in February 2006 and 1050 at follow-up in February 2007. Overall Serena ITN household ownership increased from 16% to 28% over the study period, with a significantly higher increase in group A (13% to 35%) than in group B (18% to 23%) (p<0.001).InterpretationThe free distribution of ITNs to pregnant women through governmental antenatal care services in addition to ITN social marketing substantially improved ITN household ownership in rural Burkina Faso.Trial registrationControlled-Trials.com ISRCTN07985309

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

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  Diversité des mouches synanthropes et leur potentiel de transmission des maladies diarrhéïques à Maroua (Extrême-Nord, Cameroun)

  Daniel Amani Dawaye, Moussa Djaouda, Eric Moïse Bakwo Fils

  Introductionles voies de transmission des maladies diarrhéiques font parfois intervenir les mouches synanthropes, comme vecteurs mécaniques des germes pathogènes. Ce travail avait pour objectif d´évaluer la diversité des mouches synanthropes et de déterminer leur implication potentielle dans la transmission des maladies diarrhéiques dans la ville de Maroua.Méthodesdes séances de captures des mouches ont été effectuées par saison dans 12 quartiers, en cinq points différents et en trois périodes de la journée correspondant aux différents niveaux d´ensoleillement. Plusieurs clés d´identification des diptères et des analyses microbiologiques en laboratoire ont été utilisées pour estimer la biodiversité et le portage des microorganismes par les mouches synanthropes. Les données collectées ont été soumises à des analyses écologiques et statistiques.Résultatshuit espèces de mouches synanthropes appartenant à quatre familles ont été identifiées dans la ville de Maroua et la répartition de ces espèces a varié en fonction des saisons, des quartiers et de la période de la journée (P<0,05). Musca domestica et Chrysomya putoria ont été les espèces les plus abondantes, dans les quartiers où les activités de transformation agroalimentaire et l´élevage sont intenses notamment Hardé, Pont-vert, Doualaré, Kongola et Makabaye. Escherichia coli a été plus porté que les salmonelles et le portage des bactéries par les mouches synanthropes a été abondance-dépendant.Conclusionla diversité des mouches synanthropes varie en fonction des activités anthropiques, de la saison de l´année et de la période de la journée. Ces mouches constituent d´importants vecteurs mécaniques potentiels des bactéries fécales pathogènes à Maroua.

  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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  Diversité génétique, variation géographique et flux géniques chez quelques Lépidoptères Rhopalocères français

  Henri Descimon, Marie Zimmermann, Emmanuel Cosson, Bernard Barascud, Gabriel Neve

  Nous présentons une étude synthétique et comparative de la structure génétique des populations de trois papillons diurnes français, Proclossiana eunomia, Parnassius apollo et Euphydryas aurinia. Grâce à l’électrophorèse des allozymes, il a été possible d’estimer comparativement le niveau de variation génétique à l’intérieur des divers peuplements des espèces étudiées. Ces données permettent également de proposer des éléments d’explication de cette variation: fonctionnement actuel des populations et métapopulations, histoire des biomes ouest-européens au cours des vingt derniers millénaires. Chacun des cas étudiés possède une spécificité biogéographique: distribution de type „ relique glaciaire ” très disjointe (P. eunomia), espèce de montagne largement répandue, mais en forte régression (P. apollo), espèce très diversifiée écologiquement (E. aurinia). D’une manière générale, les populations méridionales montrent des variations importantes au niveau local et régional et présentent une structuration géographique nette. Les populations septentrionales montrent une diversité génétique plus faible et une structuration spatiale confuse, avec un effet d’isolement par la distance faible ou absent. Ce phénomène est le plus accusé pour les populations du Nord-Est du Massif Central de P. eunomia, qui résultent d’une introduction délibérée datant de 25 ans. Dans le cas d’ E. aurinia, l’adaptation à des plantes nourricières différentes est aussi liée à la différenciation génétique et à sa variation géographique. Ces caractéristiques peuvent être au moins partiellement expliquées par la colonisation postglaciaire du nord de l’Europe à partir des refuges méridionaux où les biomes tempérés et méditerranéens étaient concentrés pendant les glaciations. Cette colonisation s’est accompagnée d’une perte de diversité génétique et d’une variation sans structuration géographique nette. Par ailleurs, la diversification écologique très élevée du sud de l’Europe permet et a permis une plus gr

  Biologie cellulaire et moléculaireGénétiquePharmacognosie, phytothérapie et médecine traditionnelleLicence : https://creativecommons.org/licenses/by/4.0/

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• Article libreArticleEn anglais

  Diversity and plant growth promoting ability of rice root-associated bacteria in Burkina-Faso and cross-comparison with metabarcoding data

  Plant-associated bacteria are essential partners in plant health and development. In addition to taking advantage of the rapid advances recently achieved in high-throughput sequencing approaches, studies on plant-microbiome interactions require experiments with culturable bacteria. A study on the rice root microbiome was recently initiated in Burkina Faso. As a follow up, the aim of the present study was to develop a collection of corresponding rice root-associated bacteria covering maximum diversity, to assess the diversity of the obtained isolates based on the culture medium used, and to describe the taxonomy, phenotype and abundance of selected isolates in the rice microbiome. More than 3,000 isolates were obtained using five culture media (TSA, NGN, NFb, PCAT, Baz). The 16S rRNA fragment sequencing of 1,013 selected isolates showed that our working collection covered four bacterial phyla (Proteobacteria, Firmicutes, Actinobacteria and Bacteroidetes) and represented 33% of the previously described diversity of the rice root microbiome at the order level. Phenotypic in vitro analysis of the plant growth promoting capacity of the isolates revealed an overall ammonium production and auxin biosynthesis capacity, while siderophore production and phosphate solubilisation were enriched in Burkholderia, Ralstonia, Acinetobacter and Pseudomonas species. Of 45 representative isolates screened for growth promotion on seedlings of two rice cultivars, five showed an ability to improve the growth of both cultivars, while five others were effective on only one cultivar. The best results were obtained with Pseudomonas taiwanensis ABIP 2315 and Azorhizobium caulinodans ABIP 1219, which increased seedling growth by 158% and 47%, respectively. Among the 14 best performing isolates, eight appeared to be abundant in the rice root microbiome dataset from previous study. The findings of this research contribute to the in vitro and in planta PGP capacities description of rice root-assoc

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

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• Article libreArticleEn anglais

  Diversity in anopheline larval habitats and adult composition during the dry and wet seasons in Ouagadougou (Burkina Faso)

  Florence Fournet, Maud Cussac, Ali Ouari, Pierre-Erwann Meyer, Hyacinthe K Toé, Louis-Clément Gouagna, Roch K Dabiré

  BackgroundSeveral cases of malaria are frequently recorded during the dry period in Ouagadougou town (Burkina Faso). This has led to the design of a series of studies focusing on both parasitological and entomological investigations intended to provide relevant health data on the risk of local malaria transmission according to the way of urbanisation.MethodsA cross-sectional entomological survey was carried out in various districts of Ouagadougou in April and October 2006. Adult malaria vectors were collected using CDC traps and indoor insecticide spraying performed in four houses during four consecutive days/nights. Intensive larval sampling was also done in available water ponds throughout the study sites.ResultsIn April, the anopheline breeding sites consisted only of semi-permanent or permanent swamps located mainly in the two peripheral districts. Despite the presence of anopheline larvae in these breeding sites, less than five Anopheles gambiae s.l. adults were caught by CDC traps and indoor insecticide spraying. In October, additionally to the permanent breeding sites reported in April, some rainfall swamps were also found positive to anophelines. The number of adults' mosquitoes was higher than that collected in April (2 vs 159 in October). Out of 115 larvae of An. gambiae s.l. analysed by PCR in April, 59.1% (68/115) were identified as Anopheles arabiensis, 39.1% (45/115) as An. gambiae M while the S form represented less than 2%. Overall 120 larvae and 86 females were identified by PCR in October as An. gambiae M form (51%) and An. arabiensis (42.2%). The S form represented only 6.8%. The global sporozoite rate recorded was high (6.8%) and did not differ between the districts except in the central district where no positive mosquito was detected.ConclusionAlthough only few adults' mosquitoes were actively caught during the driest month, malaria vectors persisted all year long that increases the risk of urban malaria transmission. The distribution of breedi

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

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• Article libreArticleEn anglais

  Diversity of Termites Used in Poultry Feed in Burkina Faso

  Aïchatou Nadia Christelle Dao, Fernand Sankara, Mouhamadou Moustapha Ndiaye, Abdoulaye Baïla Ndiaye, Salimata Pousga, Irénée Somda, Marc Kenis

  Simple SummaryThere are various species of termites in West Africa. Some of them are used as protein sources in poultry feed by rural poultry farmers. The diversity of species depends on the climatic zone. As a result, the species actually used by poultry farmers are not well known. To improve knowledge of the termite species used by poultry farmers in Burkina Faso, information was collected from poultry farmers on their local knowledge of termites and samples of termites were taken. They were analysed in the laboratory on the basis of morphological criteria. The results will help to improve poultry farmers’ knowledge of termites and facilitate their use in West Africa and Burkina Faso. AbstractThe aim of the study was to assess the diversity of termites used in poultry feed in Burkina Faso. Termite samples were collected in eight of the thirteen regions of the country by poultry farmers, then conserved in 70° alcohol. The criteria used by poultry farmers for identifying the termite were also characterised and discussed with farmers in a village where the use of termites as poultry feed is well developed. Morphological identifications were carried out in the laboratory. Twenty species were identified in two families, six subfamilies, and thirteen genera. In the Heterotermitidae family, a single species belonging to the Coptotermitinae subfamily was identified. The rest belonged to the family Termitidae and the subfamilies Amitermitinae, Microcerotermitinae, Macrotermitinae, Nasutitermitinae, and Cubitermitinae. Three species, Microcerotermes fuscotibialis, Megagnathotermes notandus, and Isognathotermes fungifaber, were found for the first time in Burkina Faso. The largest number of species (eleven) was collected in the Cascades region. Poultry farmers are able to recognise eight genera of termites by the shape, size, and colour of the termites; by the termite mounds; and often by the location of the nest. These results may facilitate the promotion of the use of term

  Santé 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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• Article libreArticleEn anglais

  Diverticule congénital de la vessie chez un enfant de 13 ans diabétique en sepsis à point de départ urinaire

  Zine El Abidine Benali, Houssam Ahmaidi

  Médecine interne (cardiologie, endocrinologie, néphrologie…)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.

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  Diverticule de l'urètre après urétro-méatoplastie: à propos d'un cas

  Mahdi Graiouid, Youness Chakir, Issam Jandou, Messian Gallouo, Yassine Larrache

  Nous rapportons l'observation d'un diverticule de l'urètre pénien chez un garçon de 14 ans survenu après une urétro et méatoplastie suite à un accident de circoncision. À travers cette observation et une revue de la littérature, nous décrirons les aspects diagnostiques et thérapeutiques des diverticules de l'urètre.

  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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  Diverticule de Meckel compliqué d'un abcès rétro péritonéal: à propos d'un cas rare

  Hicham El Bouhaddouti, Khalid El Haoudi

  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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  Diverticule de Zenker chez une patiente en hémodialyse

  Mbengue Mansour, Fall Alioune Badara, Lemrabott Tall Ahmed, Ndiaye Babacar, Faye Maria, Fall Khodia, Faye Moustapha, Ba Bakary, Diagne Seynabou, Keita Niakhaleen, Ba Mamadou Aw, Dieng Ameth, Ndongo Modou, Sy Abou, Ka El Hadji Fary, Diouf Boucar

  Le diverticule de Zenker est une pathologie rare et généralement bénigne. Sa présence chez le malade en hémodialyse a des implications thérapeutiques et pronostiques et constitue un facteur de risque de morbi-mortalité du fait de ses complications comme la dénutrition protéino-énergétique et la pneumopathie. Nous rapportons le cas d´un diverticule de Zenker diagnostiqué chez une patiente hémodialysée chronique. Il s´agissait d´une patiente âgée de 61 ans, qui était reçue pour une hémorragie digestive haute accompagnée d´une dysphagie. L´examen physique trouvait une altération de l´état général avec une perte de poids estimée à 5 kg en 3 mois. Le transit œsogastroduodénal objectivait un refoulement de la portion cervicale de l´œsophage par une volumineuse image d´addition hétérogène dont le pôle supérieur se situe au niveau de la jonction pharyngo-œsophagienne. Le diagnostic d´un diverticule de Zenker avait été retenu. Une diverticulectomie par voie cervicale externe avait été réalisé. La patiente est décédée dans les suites postopératoires précoces d´une pneumopathie d´inhalation. Le diverticule de Zenker est une pathologie rare qui est généralement bénigne mais sa présence chez le malade hémodialysé chronique augmente sa morbi-mortalité.

  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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  Diverticules de Meckel compliqués: à propos de 15 cas

  Abib Diop, Ousmane Thiam, Mouhamadou Lamine Guèye, Mamadou Seck, Alpha Oumar Touré, Mamadou Cissé, Madieng Dieng

  Le diverticule de Meckel (DM) est une persistance du canal omphalo-mésentérique. Généralement bénin et asymptomatique, il est surtout découvert fortuitement. Sa découverte se fait souvent à l’occasion de complications. Le but de notre étude est de décrire les aspects épidémiologiques, cliniques, anatomopathologiques et thérapeutiques des complications des DM. Il s’agissait d’une étude rétrospective sur 13 ans (Janvier 2003-Juin 2016) portant sur 15 cas de diverticules de Meckel compliqués pris en charge aux urgences chirurgicales de l’Hôpital Aristide Le Dantec de Dakar. Il s’agissait de 10 hommes et de 5 femmes dont l’âge moyen était de 27,8 ans avec des extrêmes de 1 mois et 73 ans. Les 2 principales circonstances de découverte étaient le syndrome occlusif et l’irritation péritonéale. La laparotomie en urgence avait permis d’affirmer l’implication d’un DM dans le tableau clinique. Dans les cas d’occlusion, le mécanisme était toujours une bride. Dix patients présentaient une nécrose intestinale avec perforation au moment du diagnostic. Tous les 15 patients avaient eu une résection segmentaire du grêle emportant le diverticule. Cette résection était suivie d’une anastomose immédiate dans 12 cas. La morbidité était constituée par 2 cas de fistules et 2 cas de péritonites post opératoires. Un décès par choc septique a été noté. Trois cas d’hétérotopie muqueuse ont été constatés dont une hétérotopie gastrique, une colique et une association d’hétérotopies colique et gastrique chez le même patient. Les complications de DM constituent des urgences digestives nécessitant une prise en charge chirurgicale précoce et adaptée. Cette dernière est greffée d’une morbidité non négligeable.

  Biostatistiques et épidémiologieSanté 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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  Diverticulite de Meckel d´origine ascaridienne chez l´enfant: à propos d´un cas

  Papa Alassane Mbaye, Mbaye Fall, Mohamed Salsabil Sabounji, Ndeye Aby Ndoye, Florent Tshibwid A Zeng, Ibrahima Bocar Wellé, Ndeye Fatou Seck, Gabriel Ngom

  Nous rapportons l´observation d´un enfant âgé de 4 ans de sexe masculin, qui a été reçu pour un bourgeon ombilical congénital accompagné de saignements récents. L´examen physique retrouvait un bourgeon ombilical de couleur rosée, taché de sang sans fistule objectivée, d´environ 1,5 cm de diamètre. Une échographie abdominale a été demandée faisant évoquer un sinus de l´ouraque. L´exploration chirurgicale a mis en évidence un bourgeon ombilical communiquant en intra-abdominal avec un diverticule de Meckel à 90 cm de l´angle iléo-caecal hyperhémié, inflammatoire à l´intérieur duquel siégeait beaucoup d´ascaris. L´examen anatomo-pathologique de la pièce opératoire était en faveur d´une diverticulite. Ainsi, le diagnostic d´une diverticulite de Meckel d´origine ascaridienne a été retenu. Une résection-anastomose avec exérèse du bourgeon fut réalisée. Les suites opératoires étaient simples et après un recul de 6 mois.

  PédiatrieLicence : 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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  Diverticulite duodénale: complication inhabituelle pas toujours facile à gérer

  Abderrahman Elhjouji, Lamine Jaiteh, Ahmed Bounaim, Abdelmounaim Aitali, Khalid Sair

  Les diverticules duodénaux sont assez fréquents, la majorité reste asymptomatique. Les complications les plus fréquemment rapportées sont les hémorragies et les pancréatites. Contrairement aux diverticules coliques, la survenue de diverticulite est rare. Nous rapportons le cas d'une infection d'un gros diverticule duodénal en mettant le point sur la difficulté de la prise en charge de cette entité pathologique.

  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

  DMPA-SC stock: Cross-site trends by facility type

  Sophia Magalona, Shannon N. Wood, Frederick Makumbi, Funmilola M. OlaOlorun, Elizabeth Omoluabi, Akilimali Z. Pierre, Georges Guiella, Jane Cover, Philip Anglewicz

  ObjectivesTo measure trends in the supply of DMPA-SC in public and private health facilities and compare with other prominent modern methods.Study designWe used repeated cross-sectional data from service-delivery-point surveys in six settings: Burkina Faso, Democratic Republic of Congo (Kinshasa and Kongo Central), Nigeria (Kano and Lagos), and Uganda, each with 3-5 rounds of data collected between 2016 and 2020. We analyzed trends in DMPA-SC availability using percent of service delivery points offering the method and percent experiencing stockouts; trends were compared with those for DMPA-IM, IUD, implants, and other short-acting methods, by facility type.ResultsAll settings showed increased offering of DMPA-SC over time for both private and public facilities. Larger proportions of public facilities provided DMPA-SC compared to private facilities (66%–97% vs 16%–50% by 2019–2020). DMPA-SC was provided by fewer facilities than DMPA-IM (90%–100% public, 34%–69% private by 2019–2020), but comparable to implants (83%–100% public, 15%–52% private by 2019–2020) and IUDs (55%–91% public, 0%–44% private by 2019–2020). Trends of DMPA-SC stock varied by setting, with more consistent stock available in private facilities in the DRC and in public facilities in Burkina Faso and Nigeria. Uganda showed decreasing stock in public facilities but increasing stock in private facilities.ConclusionDMPA-SC availability has been increasing since its introduction in sub-Saharan Africa, yet significant gaps in stock exist. Countries should consider alternative distribution models to address these issues.ImplicationsOur findings may help inform countries about the need to monitor DMPA-SC availability and to consider solutions that ensure contraceptive options are available to women who need them and disruptions to contraceptive use are minimized.

  Biostatistiques et épidémiologieSanté publiqueLicence : This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).

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  DNA testing for sickle cell anemia in Africa: Implementation choices for the Democratic Republic of Congo

  Mamy Ngole, Valerie Race, Gloire Mbayabo, Paul Lumbala, Cathy Songo, Prosper Tshilobo Lukusa, Koenraad Devriendt, Gert Matthijs, Aimé Lumaka

  AbstractBackgroundHemoglobin‐based tests form the reference diagnostic test for SCA. In limited resource countries, these tests face limitations including cost, low sensitivity due to recurrent transfusions in endemic malaria region, and interference from fetal hemoglobin in neonatal diagnostic. This study aimed at adapting DNA‐based SCA tests to limited resource countries and evaluating the economic benefit.Methods338 participants were recruited in the Democratic Republic of Congo, sorted in 3 cohorts based on venous blood, umbilical cord blood (UCB) and buccal swab sampling. RFLP was performed to identify mutated allele. The feasibility and technical validity of this RFLP was evaluated for specimens collected on DBS cards and on EDTA tubes. RFLP on DBS stored at room temperature was regularly repeated to assess sample conservation. Finally, the cost analysis was performed.ResultsDBS cards yielded identical results to extracted DNA. Repeated testing returned the same result after four years. The DBS‐based test performed on UCB or on buccal swab had a sensitivity and a precision of 100%. Cost comparison indicated that our approach costs half price of the widely used isoelectrofocussing of hemoglobin.ConclusionThe implemented DNA‐based test approach overcomes the limitations faced by hemoglobin‐based tests, while being more affordable. We propose to implement the RFLP test as a first line diagnostic test after transfusion and as second tiers for newborn screening. However, users should be aware that this test is unable to differentiate HbC from HbS or identify other point mutation of gene deletion of HBB gene. The DNA‐based test for SCA using DBS is efficient on all three types of biologic samples and costs half cheaper than the widely used hemoglobin electrophoresis method. Moreover, repeated testing on DBS stored at local conditions returned the same results after 4 years. Due to its technical validity and economic benefits, this DNA‐based SCA test appears to be su

  Biostatistiques et épidémiologieParasitologie et mycologieHématologieLicence : 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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  Do Out-of-Pocket Payments for Care for Children under 5 Persist Even in a Context of Free Healthcare in Burkina Faso? Evidence from a Cross-Sectional Population-Based Survey

  Background: In April 2016, Burkina Faso began free healthcare for children aged from 0 to 5 years. However, its implementation faces challenges, and the goal of this study is to estimate the fees paid for this child care and to determine the causes of these direct payments. Methods: Data gathering involved 807 children aged from 0 to 5 years who had contact with the public healthcare system. The estimation of the determinants of out-of-pocket health payments involved the application of a two-part regression model. Results: About 31% of the children made out-of-pocket payments for healthcare (an average of 3407.77 CFA francs per case of illness). Of these, 96% paid for medicines and 24% paid for consultations. The first model showed that out-of-pocket payments were positively associated with hospitalization, urban area of residence, and severity of illness, were made in the East-Central and North-Central regions, and were negatively associated with the 7 to 23 month age range. The second model showed that hospitalization and severity of illness increased the amount of direct health payments. Conclusion: Children targeted by free healthcare still make out-of-pocket payments. The dysfunction of this policy needs to be studied to ensure adequate financial protection for children in Burkina Faso.

  Biostatistiques et épidémiologiePédiatrieSanté 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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  Do support groups members disclose less to their partners? The dynamics of HIV disclosure in four African countries

  Anita Hardon, Gabriela B Gomez, Eva Vernooij, Alice Desclaux, Rhoda K Wanyenze, Odette Ky-Zerbo, Emmy Kageha, Ireen Namakhoma, John Kinsman, Clare Spronk, Edgar Meij, Melissa Neuman, Carla Makhlouf Obermeyer

  BackgroundRecent efforts to curtail the HIV epidemic in Africa have emphasised preventing sexual transmission to partners through antiretroviral therapy. A component of current strategies is disclosure to partners, thus understanding its motivations will help maximise results. This study examines the rates, dynamics and consequences of partner disclosure in Burkina Faso, Kenya, Malawi and Uganda, with special attention to the role of support groups and stigma in disclosure.MethodsThe study employs mixed methods, including a cross-sectional client survey of counselling and testing services, focus groups, and in-depth interviews with HIV-positive individuals in stable partnerships in Burkina Faso, Kenya, Malawi and Uganda, recruited at healthcare facilities offering HIV testing.ResultsRates of disclosure to partners varied between countries (32.7% – 92.7%). The lowest rate was reported in Malawi. Reasons for disclosure included preventing the transmission of HIV, the need for care, and upholding the integrity of the relationship. Fear of stigma was an important reason for non-disclosure. Women reported experiencing more negative reactions when disclosing to partners. Disclosure was positively associated with living in urban areas, higher education levels, and being male, while being negatively associated with membership to support groups.ConclusionsUnderstanding of reasons for disclosure and recognition of the role of support groups in the process can help improve current prevention efforts, that increasingly focus on treatment as prevention as a way to halt new infections. Support groups can help spread secondary prevention messages, by explaining to their members that antiretroviral treatment has benefits for HIV positive individuals and their partners. Home-based testing can further facilitate partner disclosure, as couples can test together and be counselled jointly.

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

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  Do Targeted User Fee Exemptions Reach the Ultra-Poor and Increase their Healthcare Utilisation? A Panel Study from Burkina Faso

  Yvonne Beaugé, Manuela De Allegri, Samiratou Ouédraogo, Emmanuel Bonnet, Naasegnibe Kuunibe, Valéry Ridde

  Background: A component of the performance-based financing intervention implemented in Burkina Faso was to provide free access to healthcare via the distribution of user fee exemption cards to previously identified ultra-poor. This study examines the factors that led to the receipt of user fee exemption cards, and the effect of card possession on the utilisation of healthcare services. Methods: A panel data set of 1652 randomly selected ultra-poor individuals was used. Logistic regression was applied on the end line data to identify factors associated with the receipt of user fee exemption cards. Random-effects modelling was applied to the panel data to determine the effect of the card possession on healthcare service utilisation among those who reported an illness six months before the surveys. Results: Out of the ultra-poor surveyed in 2017, 75.51% received exemption cards. Basic literacy (p = 0.03), living within 5 km from a healthcare centre (p = 0.02) and being resident in Diébougou or Gourcy (p = 0.00) were positively associated with card possession. Card possession did not increase health service utilisation (β = −0.07; 95% CI = −0.45; 0.32; p = 0.73). Conclusion: A better intervention design and implementation is required. Complementing demand-side strategies could guide the ultra-poor in overcoming all barriers to healthcare access.

  Biostatistiques et épidémiologieSanté publiqueLicence : http://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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  Do users of long-acting reversible contraceptives receive the same counseling content as other modern method users? A cross-sectional, multi-country analysis of women's experiences with the Method Information Index in six sub-Saharan African countries

  Brooke W. Bullington, Katherine Tumlinson, Celia Karp, Leigh Senderowicz, Linnea Zimmerman, Pierre Z. Akilimali, Musa Sani Zakirai, Funmilola M. OlaOlorun, Simon P.S. Kibira, Frederick Edward Makumbi, Solomon Shiferaw

  ObjectiveThere has been a growing focus on informed choice in contraceptive research. Because removal of long-acting reversible contraception (LARC), including implants and IUDs, requires a trained provider, ensuring informed choice in the adoption of these methods is imperative. We sought to understand whether information received during contraceptive counseling differed among women using LARC and those using other modern methods of contraception.Study DesignWe used cross-sectional data from Burkina Faso, Côte d'Ivoire, the Democratic Republic of Congo (DRC), Kenya, Nigeria, and Uganda collected in 2019–2020 by the Performance Monitoring for Action project. We included 7969 reproductive-aged women who reported use of modern contraception. Our outcome of interest, information received during contraceptive counseling, was measured using a binary indicator of whether respondents answered “yes” to all 4 questions that make up the Method Information Index Plus (MII+). We used modified Poisson models to estimate the prevalence ratio between method type (LARC vs. other modern methods) and the MII+, controlling for individual- and facility-level covariates.ResultsReported receipt of the full MII+ during contraceptive counseling ranged from 21% in the DRC to 51% in Kenya. In all countries, a higher proportion of LARC users received the MII+ compared to other modern method users. A greater proportion of LARC users answered “yes” to all questions that make up the MII+ at the time of counseling compared to other modern method users in DRC, Kenya, Nigeria, and Uganda. There was no significant difference in the prevalence of reporting the full MII+ between users of LARC and other modern methods in Burkina Faso (Adjusted prevalence ratio (aPR): 1.16; 95% confidence interval (CI): 0.91, 1.48) and Côte d'Ivoire (aPR: 1.13; 95% CI: 0.87, 1.45).ConclusionInformation received during contraceptive counseling was limited for all modern contraceptive users. LARC users had significantly h

  Biostatistiques et épidémiologieSanté publiqueLicence : This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).

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• Lien vers la sourceBase de donnéesEn anglais

  DOAJ – Directory of Open Access Journals

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  Répertoire des revues scientifiques en accès libre de qualité, avec leur licence.

  Méthodologie de la recherche et thèseLicence : variable

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  Docteur! regardez ma langue!

  Amina Kissou, Badr Eddine Hassam

  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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  Documenting Community Health Worker Compensation Schemes and Their Perceived Effectiveness in Seven sub-Saharan African Countries: A Qualitative Study

  Alyssa L. Davis, Lola Flomen, Jehan Ahmed, Djibrilla Maiga Arouna, Amos Asiedu, Maman Bacharou Badamassi, Ousmane Badolo, Moumouni Bonkoungou, Ciro Franco, Zachariah Jezman, Victoria Kalota, Beh Kamate, Daniel Koko, John Munthali, Raphael Ntumy, Patrick Sichalwe, Oumar Yattara

  Systematic documentation of the tasks and time commitment of CHWs, particularly those with a volunteer status, could support more recognition of their health system contributions and better determination of commensurate compensation. Key Findings Financial compensation schemes and service delivery models varied greatly across Benin, Burkina Faso, Ghana, Malawi, Mali, Niger, and Zambia, with each country engaging community health workers (CHWs) with different responsibilities, catchment areas, and relationships to health facilities.The majority of the countries used a dual-cadre service delivery model in which CHWs who were at least partially based at facilities were considered to be full-time employees and paid a salary, while CHWs who were based in communities were considered part-time volunteers and given a stipend or activity-based incentive.Key informants described several challenges with compensation schemes for volunteer status CHWs, including irregular payments, inconsistent distribution, and insufficient amount of compensation, which led to demotivation and attrition of CHWs and, in turn, negatively affected health service continuity.Key Implications Policymakers should consider these findings in the design of compensation schemes for CHWs engaged in routine, continuous health service delivery within the context of their country’s health service delivery model.Greater sensitization of the 2018 World Health Organization recommendation on CHW compensation, along with practical guidance on how to assess CHW responsibilities, workload, and training, may be needed to support the practical application of this global normative guidance at the country level. ABSTRACTIntroduction:Community health worker (CHW) incentives and remuneration are core issues affecting the performance of CHWs and health programs. There is limited documentation on the implementation details of CHW financial compensation schemes used in sub-Saharan African countries, including their mechanism

  Santé publiqueLicence : https://creativecommons.org/licenses/by/4.0/ https://doi.org/10.9745/GHSP-D-24-00008 This is an open-access article distributed under the terms of the Creative Commons Attribution 4.0 International License (CC BY 4.0), which permits unrestricted use, distribution, and reproduction in any medium, pro

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  Does a school-based intervention increase girls’ sexual and reproductive health attitudes and intentions? Results from a mixed-methods cluster-randomized trial in Burkina Faso

  Adolescent girls in Burkina Faso face unintended pregnancy risk due to a lack of contraceptive use. The (re)solve project was designed to address contraceptive misperceptions and increase girls’ perceptions of their pregnancy risk, primarily through a participatory game and a health passport aimed at easing health facility access. The intervention components were implemented for girls in private and public school in grades 4ème and 3ème (grades 9 and 10) in Ouagadougou and Bobo Dioulasso, Burkina Faso. We conducted an impact evaluation using a mixed-methods cluster randomized control trial design to evaluate (re)solve’s impact on girls’ intentions to use contraception, among other outcomes. Thirty-two schools were randomly allocated intervention or control. The evaluation included quantitative longitudinal surveys at baseline (N = 2,372) and endline (N = 2,072), qualitative in-depth interviews with girls in the intervention group at baseline (N = 41) and endline (N = 48) and with implementation staff (N = 35) and experts (N = 14) at endline. We used generalized estimating equations (GEE) analysis for the main analysis. Girls receiving the intervention had more positive attitudes related to contraception at endline compared to girls at control schools. (re)solve had a positive effect on girls’ intention to use contraception (aOR = 1.59, 95% CI 0.97–2.61), though this did not reach statistical significance. The impact was particularly large among girls who had never had sex, girls who attended public schools, and girls in 3ème. Qualitative findings suggest the intervention was well received and positively shifted attitudes and facility-seeking behaviors for many girls, but that myths and misconceptions related to contraceptive use persist in this mostly young, sexually naïve population. That the (re)solve intervention appears to have shifted adolescent girls’ attitudes toward using contraception, coupled with positive trends in intention to use contraception, indicate

  Biostatistiques et épidémiologieGynécologie-obstétriqueSanté 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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  Does abolishing user fees for family planning increase contraception use? An impact evaluation of the national policy in Burkina Faso

  Cheick Oumar Tiendrebeogo, Vena Joseph, Frank Bicaba, Alice Bila, Abel Bicaba, Thomas Druetz

  BackgroundUnmet needs for contraception constitute a major public health problem in sub-Saharan Africa. Several mechanisms have been tested to reduce the financial barrier and facilitate access to family planning services, with inconclusive results. Based on the positive impacts following the introduction of free health care for pregnant women, Burkina Faso decided to extend its national policy and abolished direct payment for family planning services. This study aims to evaluate the impact of this policy on contraceptive use and unmet needs for contraception among women of reproductive age (WRA) in Burkina Faso.MethodsThis study uses two different study designs to examine the impact of a user fee removal policy on contraceptive use across a panel of 1400 households randomly selected across eight health districts. Data were collected using a standardized socio-demographic questionnaire at three different time points during the pilot and scale-up phases of the fee abolition program. The questionnaire was administered six months after the launch of the pilot fee abolition program in four health districts. For the remaining four health districts, the survey was conducted one year prior to and six months after the implementation of the program in those areas. All WRA in the households were eligible to participate. A cross-sectional study design was used to determine the association between knowledge of the fee abolition policy among WRA and actual use of contraceptives by WRA six months after the policy’s implementation and across all eight districts. Additionally, a pre-post study with a non-randomized, reflexive control group was designed using repeated surveys in four health districts. Hierarchical logistic mixed effects models were adjusted for a set of time-variant individual variables; the impact was assessed by a difference-in-differences approach that compared pre-post changes in contraception use in women who knew about the new policy and those who did not.Resu

  Biostatistiques et épidémiologieGynécologie-obstétriqueSanté publiqueLicence : This work is licensed under a Creative Commons Attribution 4.0 International License.

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