Risk factors associated with HIV prevalence in pregnant women in Burkina Faso, from 2006 to 2014

Purpose of the study: To determine the socio-demographic factors influencing the dynamics of HIV prevalence among pregnant women in Burkina Faso.Material and methods: A total of 66,597 pregnant women from the 13 health regions of Burkina Faso were included in this study conducted between 2006 and 2014. Venous blood samples were collected and analyzed for the detection of HIV antibodies according to WHO / UNAIDS strategy II, using the mixed test Vironostika HIV Uniform II Plus O (Bio-Mérieux) and the test discriminating ImmunoCombII HIV-1 & 2 BiSpot (Orgenics). Samples with discordant results between the two tests, as well as those positive to HIV-2 or HIV-1 + 2, were retested with HIV BLOT 2.2 (MP Diagnostics). Sociodemographic data collected from the participants were correlated with their HIV status to determine key risk factors influencing HIV infection prevalence in Burkina Faso.Results: Sociodemographic data showed that the study population consisted mainly of married women (91.2%) at their first pregnancy (27.1%) with a large majority of them being housewives (86.2%) who did not attend any form of schooling (69.4%). About 88.4% had stayed longer than a year in the health region where they initially participated in the study and 55.8% were between 20 and 29 years of age. Overall HIV prevalence significantly dropped from 2.7 % in 2006 to 1.3% in 2014. However HIV seroprevalence in this study has varied significantly according to socio-demographic characteristics including marital status, parity, occupation, education, age group and the length of stay in the women's health community (p <0.0001). Factors sustaining HIV transmission included the status of being unmarried (OR=1.67 [1.42-1.97]), primigest (OR=1.64 [1.41-1.89]), having other occupations except being student (OR = 1.68 [1.20-2.33]), aged between 20-49 years (OR=3.14 [2.51-3.93]) and the duration of stay less than a year in their locality (OR=5.33 [4.61-10.16]) and these factors were identified as main risk factors associated with HIV prevalence.Conclusion: Burkina Faso remains among the countries with concentrated epidemics despite a significant reduction in the prevalence observed in this study. The inclusion of identified risk factors in the national HIV program could improve the quality of the response to the epidemic.Keywords: HIV-Pregnant Women-Risk Factors-Burkina Fas

Prevalence of Escherichia coli virulence genes in patients with diarrhoea in Ouagadougou, Burkina Faso

Objective: Diarrhoeagenic E. coli (DEC) strains are important causes of diarrhoea in the developing world and, to a lesser extent, inthe developed world. In this study, we investigated the prevalence of the virulence genes specific for five major pathogroups of diarrheagenic Escherichia coli (DEC) in primary cultures from diarrhoeagenic patients in Burkina Faso.Methodology: From September 2016 to Mars 2017, a total of 211 faecal samples from diarrhoeagenic patients from urban hospitals of Ouagadou, Burkina Faso have been analysed. A 16-plex PCR was used to detect simultaneously, the five major DEC pathotypes (enteropathogenic E. coli (EPEC), enterotoxigenic E. coli (ETEC), Shiga toxin-producing E. coli (STEC), enteroaggregative E. coli (EAEC) and enteroinvasive E. coli (EIEC)).Results: At least one diarrhoeagenic E. Coli pathotype was detected in 31 samples (14.7%) in children and adults with diarrhoea. EAEC was the most common pathotype detected 9.5% (20/211), followed by EIEC2.4% (05/211) and STEC 0.5% (01/211). More than one DEC pathotype were detected in 2.4% (05/211) patients. EPEC and ETEC were not detected in single infection but in co-infection with others pathotypes.Conclusion: DEC, especially enteroaggregative, may be important responsible of diarrhoeas in Burkina Faso from all ages patient.Key Words: Diarrhoeagenic Escherichia coli, 16-plex PCR, Burkina Faso, human diarrhoeas stool

Multi-Actors' Co-Implementation of Climate-Smart Village Approach in West Africa: Achievements and Lessons Learnt

Climate change and variability are significant challenges for the environment and food security worldwide. Development strategies focusing simultaneously on adaptive farming, productivity, and reducing greenhouse gas (GHG) emissions-known as climate-smart agriculture (CSA) strategies-are key to responding to these challenges. For almost a decade, within the framework of Climate Change, Agriculture and Food Security (CCAFS), World Agroforestry (ICRAF), and its partners have been using Participatory Action Research (PAR) to fully engage key stakeholders in co-creating such CSA development strategies. This includes the testing of Agricultural Research for Development (AR4D) CSA scalability options. The multidisciplinary teams include the National Research and Extension Systems (NARES), national meteorological services (NMS), non-profit organizations (NGOs), and local radio programs, among others. The CCAFS-West Africa Program,World Agroforestry-West and Central Africa (ICRAF-WCA), International Union for Conservation of Nature (IUCN), University of Reading, and Centre Régional de Formation et d’Application en Agro-météorologie et Hydrologie Opérationnelle (AGRHYMET) provide technical backstopping to the national teams. Climate information (CI) was used as an entry point to inform the development of CSA technologies and practices within Climate-Smart Villages (CSV). This groundwork has led to a greater understanding of three critical factors for successful CSV implementation: (1) Building strong partnerships to co-design and develop agricultural systems that improve ecosystemand population resilience, (2) Key stakeholders (researchers, farmers, development agents, and students) capacity strengthening through vocational and academic training, and (3) Using CI for livelihood planning at all scales. These three factors support more effective identification and testing of agricultural technologies and practices addressing climate variability and change at plot, community, and landscape levels. This paper discusses the PAR-CSA methodology and parameters for evaluation, including biophysical and social change. Keys to success, including communication, knowledge sharing tools, and scalability are also discussed. Finally, future opportunities for improvement are presented, including knowledge product development, CSA policy and investment planning, capacity building, further engagement of the private sector, and additional research on existing practices and tools

A systematic review on integration mechanisms in human and animal health surveillance systems with a view to addressing global health security threats

Lymphatic filariasis and onchocerciasis are neglected tropical diseases (NTDs) targeted for elimination by mass (antifilarial) drug administration. These drugs are predominantly active against the microfilarial progeny of adult worms. New drugs or combinations are needed to improve patient therapy and to enhance the effectiveness of interventions in persistent hotspots of transmission. Several therapies and regimens are currently in (pre-)clinical testing. Clinical trial simulators (CTSs) project patient outcomes to inform the design of clinical trials but have not been widely applied to NTDs, where their resource-saving payoffs could be highly beneficial. We demonstrate the utility of CTSs using our individual-based onchocerciasis transmission model (EPIONCHO-IBM) that projects trial outcomes of a hypothetical macrofilaricidal drug. We identify key design decisions that influence the power of clinical trials, including participant eligibility criteria and post-treatment follow-up times for measuring infection indicators. We discuss how CTSs help to inform target product profiles

Grand Challenges in global eye health: a global prioritisation process using Delphi method

Background We undertook a Grand Challenges in Global Eye Health prioritisation exercise to identify the key issues that must be addressed to improve eye health in the context of an ageing population, to eliminate persistent inequities in health-care access, and to mitigate widespread resource limitations. Methods Drawing on methods used in previous Grand Challenges studies, we used a multi-step recruitment strategy to assemble a diverse panel of individuals from a range of disciplines relevant to global eye health from all regions globally to participate in a three-round, online, Delphi-like, prioritisation process to nominate and rank challenges in global eye health. Through this process, we developed both global and regional priority lists. Findings Between Sept 1 and Dec 12, 2019, 470 individuals complete round 1 of the process, of whom 336 completed all three rounds (round 2 between Feb 26 and March 18, 2020, and round 3 between April 2 and April 25, 2020) 156 (46%) of 336 were women, 180 (54%) were men. The proportion of participants who worked in each region ranged from 104 (31%) in sub-Saharan Africa to 21 (6%) in central Europe, eastern Europe, and in central Asia. Of 85 unique challenges identified after round 1, 16 challenges were prioritised at the global level; six focused on detection and treatment of conditions (cataract, refractive error, glaucoma, diabetic retinopathy, services for children and screening for early detection), two focused on addressing shortages in human resource capacity, five on other health service and policy factors (including strengthening policies, integration, health information systems, and budget allocation), and three on improving access to care and promoting equity. Interpretation This list of Grand Challenges serves as a starting point for immediate action by funders to guide investment in research and innovation in eye health. It challenges researchers, clinicians, and policy makers to build collaborations to address specific challenge

The evolving SARS-CoV-2 epidemic in Africa: Insights from rapidly expanding genomic surveillance

INTRODUCTION Investment in Africa over the past year with regard to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) sequencing has led to a massive increase in the number of sequences, which, to date, exceeds 100,000 sequences generated to track the pandemic on the continent. These sequences have profoundly affected how public health officials in Africa have navigated the COVID-19 pandemic. RATIONALE We demonstrate how the first 100,000 SARS-CoV-2 sequences from Africa have helped monitor the epidemic on the continent, how genomic surveillance expanded over the course of the pandemic, and how we adapted our sequencing methods to deal with an evolving virus. Finally, we also examine how viral lineages have spread across the continent in a phylogeographic framework to gain insights into the underlying temporal and spatial transmission dynamics for several variants of concern (VOCs). RESULTS Our results indicate that the number of countries in Africa that can sequence the virus within their own borders is growing and that this is coupled with a shorter turnaround time from the time of sampling to sequence submission. Ongoing evolution necessitated the continual updating of primer sets, and, as a result, eight primer sets were designed in tandem with viral evolution and used to ensure effective sequencing of the virus. The pandemic unfolded through multiple waves of infection that were each driven by distinct genetic lineages, with B.1-like ancestral strains associated with the first pandemic wave of infections in 2020. Successive waves on the continent were fueled by different VOCs, with Alpha and Beta cocirculating in distinct spatial patterns during the second wave and Delta and Omicron affecting the whole continent during the third and fourth waves, respectively. Phylogeographic reconstruction points toward distinct differences in viral importation and exportation patterns associated with the Alpha, Beta, Delta, and Omicron variants and subvariants, when considering both Africa versus the rest of the world and viral dissemination within the continent. Our epidemiological and phylogenetic inferences therefore underscore the heterogeneous nature of the pandemic on the continent and highlight key insights and challenges, for instance, recognizing the limitations of low testing proportions. We also highlight the early warning capacity that genomic surveillance in Africa has had for the rest of the world with the detection of new lineages and variants, the most recent being the characterization of various Omicron subvariants. CONCLUSION Sustained investment for diagnostics and genomic surveillance in Africa is needed as the virus continues to evolve. This is important not only to help combat SARS-CoV-2 on the continent but also because it can be used as a platform to help address the many emerging and reemerging infectious disease threats in Africa. In particular, capacity building for local sequencing within countries or within the continent should be prioritized because this is generally associated with shorter turnaround times, providing the most benefit to local public health authorities tasked with pandemic response and mitigation and allowing for the fastest reaction to localized outbreaks. These investments are crucial for pandemic preparedness and response and will serve the health of the continent well into the 21st century