Essais de production et de collecte d'embryons chez la vache Somba

Des essais de collecte d'embryons ont été menés dans un troupeau de vaches trypanotolérantes de race Somba, pendant quatre cycles de polyovulation réalisés en différentes saisons. Un progestatif (Norgestomet, Crestar® Intervet) et des gonadotrophines (soit p-FSH Pluset® Serono, soit Folltropin® Vetrepharm) ont été utilisés selon des dosages modifiés en raison du poids des animaux. Les donneuses ont été ensuite fécondées deux fois à 12 heures d'intervalle, par saillie naturelle ou insémination artificielle, la semence de trois taureaux ayant été récoltée et congelée sur place en paillettes. Le taux général de réponse à la polyovulation a été de 72 p. 100. Les embryons ont été collectés à 6,5 jours, au stade de morula compactée ou de jeune blastocyste. Sur l'ensemble des 30 collectes, 87 embryons ont pu être récupérés. Parmi ces embryons, 39 (45 p. 100) appartenaient aux catégories Q1 et Q2 et étaient congelables, 19 (22 p. 100) appartenaient à la catégorie Q3 et les 29 restants (33 p. 100) appartenaient à la catégorie Q4 (non transférables). La production moyenne d'embryons transférables (1,9 par donneuse) n'a pas été affectée significativement par le type de gonadotrophine utilisé, mais le taux d'embryons congelables a été plus élevé en saison humide fraîche qu'en saison humide chaude (respectivement 59 vs 38 p. 100)

Serial analysis of gene expression (SAGE) in bovine trypanotolerance: preliminary results

In Africa, trypanosomosis is a tsetse-transmitted disease which represents the most important constraint to livestock production. Several indigenous West African taurine (Bos taurus) breeds, such as the Longhorn (N'Dama) cattle are well known to control trypanosome infections. This genetic ability named "trypanotolerance" results from various biological mechanisms under multigenic control. The methodologies used so far have not succeeded in identifying the complete pool of genes involved in trypanotolerance. New post genomic biotechnologies such as transcriptome analyses are efficient in characterising the pool of genes involved in the expression of specific biological functions. We used the serial analysis of gene expression (SAGE) technique to construct, from Peripheral Blood Mononuclear Cells of an N'Dama cow, 2 total mRNA transcript libraries, at day 0 of a Trypanosoma congolense experimental infection and at day 10 post-infection, corresponding to the peak of parasitaemia. Bioinformatic comparisons in the bovine genomic databases allowed the identification of 187 up- and down- regulated genes, EST and unknown functional genes. Identification of the genes involved in trypanotolerance will allow to set up specific microarray sets for further metabolic and pharmacological studies and to design field marker-assisted selection by introgression programmes

A review of factors associated with the utilization of healthcare services and strategies for improving postpartum care in Africa

Reducing maternal mortality continues to be a major challenge for African countries. We conducted a literature review to identify the factors associated with the utilization of maternal and child healthcare services during the postpartum period and the strategies for strengthening postpartum healthcare in Africa. We carried out an electronic search in several databases of texts published between 1995 and 2012 related to maternal and child health. Seventy-five publications fitted the eligibility criteria. Our analysis shows that to a large extent the socio-economic context was dominant among the factors associated with the quality and utilization of postpartum services. The best interventions were those on immediate postpartum maternal care combining several intervention packages such as community mobilization and provision of services, community outreach services and health training. The integration within health facilities of mother and child clinics was shown to contribute significantly to improving the frequency of mothers’ postpartum visits

Integration of postpartum care into child health and immunization services in Burkina Faso: Findings from a cross-sectional study

Background: The Missed Opportunities for Maternal and Infant Health (MOMI) project, which aimed at upgrading maternal and infant postpartum care (PPC), implemented a package of interventions including the integration of maternal PPC in infant immunization services in 12 health facilities in Kaya Health district in Burkina Faso from 2013 to 2015. This paper assesses the coverage and the quality of combined mother-infant PPC in reproductive, maternal, newborn and child health services (RMNCH).Methods: We conducted a mixed methods study with cross-sectional surveys before and after the intervention in the Kaya health and demographic surveillance system. On the quantitative side, two household surveys were performed in 2012 (N = 757) and in 2014 (N = 754) among mothers within one year postpartum. The analysis examines the result of the intervention by the date of delivery at three key time points in the PPC schedule: the first 48 h, days 6–10 and during weeks 6–8 and beyond. On the qualitative side, in depth interviews, focus group discussions and observations were conducted in four health facilities in 2012 and 2015. They involved mothers in the postpartum period, facility and community health workers, and other stakeholders. We performed a descriptive analysis and a two-sample test of proportions of the quantitative data. The qualitative data were recorded, transcribed and analysed along the themes relevant for the intervention.Results: The findings show that the WHO guidelines, in terms of content and improvement of maternal PPC, were followed for physical examinations and consultations. They also show a significant increase in the coverage of maternal PPC services from 50% (372/752) before the intervention to 81% (544/672) one year after the start of the intervention. However, more women were assessed at days 6–10 than at later visits. Integration of maternal PPC was low, with little improvements in history taking and physical examination of mothers in immunization services. While health workers are polyvalent, difficulties in restructuring and organizing services hindered the integration.Conclusion: Unless a comprehensive strategy of integration within RMNCH services is implemented to address the primary health care challenges within the health system, integration will not yield the desired results

Integration of maternal postpartum services in maternal and child health services in Kaya health district (Burkina Faso): an intervention time trend analysis

Background: The Missed Opportunities in Maternal and Infant Health (MOMI) project aimed at reducing maternal and newborn mortality and morbidity within the year after childbirth in four sub-Saharan African countries. MOMI interventions including the integration of maternal and infant services in the postpartum (PP) period at day 6–10, week 6–8, and month 9 were implemented from September 2013 to December 2015. We hereby assess the effect of integrating maternal postpartum care (PPC) in infant immunization services in Kaya health district in Burkina Faso. Methods: We apply a longitudinal mixed method on monthly monitoring data collected from 12 months before the project start to the end. Outcome indicators were: attendance of PPC at day 6–10 and week 6–8, provision of PP family planning counselling, and management of PP morbidity in mother and infant. We tested the significance level of changes in the different indicators by performing an interrupted time series analysis with Newey–West standard errors and one lag. Additional data were extracted at the individual level which allowed to link infant immunization with maternal PPC from September 2013 to August 2014 in the health facilities’ (HF) PP and immunization registers. We also conducted a review of documents that allowed for a qualitative evaluation of the effects. Results: Show an increasing trend of all monitored indicators during the interventions, particularly at day 6–10 when PPC increased from 61% in 2013 to 81% in 2015 and especially in rural areas (p \u3c 0.05). We found large improvements in the detection and management of PP maternal hemorrhage, sepsis and newborn fever or low temperature. However, the intervention was less successful in raising PPC at week 6–8 and later due to the existence of structural barriers, caused for instance by the lack of collaboration among health workers and high turnover in the staff of HF. Conclusion: The overall package of community and facility interventions contributed to improve integrated PPC at day 6–10, particularly the role of community health workers. While the integration of maternal and child health services seems to be a valid concept, it needs to be rethought within the primary health care syste

Selection assisted by a BoLA-DR/DQ haplotype against susceptibility to bovine dermatophilosis

Bovine dermatophilosis is a severe skin infection of tropical ruminants inducing a severe loss in productivity and a 15% mortality rate. This disease is caused by the actinomycete bacterium Dermatophilus congolensis associated with the tick Amblyomma variegatum. Currently there are no prospects for a vaccine, and acaricide or antibiotic control is hampered by the development of chemoresistance. Animal breeders have observed that dermatophilosis susceptibility seems to be determined genetically, and we previously identified a BoLA-DRB3-DQB class II haplotype marker for high (R2 = 0.96) susceptibility to the disease. With this marker, we developed a successful eugenic selection procedure for zebu Brahman cattle in Martinique (FWI). Over a period of five years, a marked reduction in disease prevalence, from 0.76 to 0.02 was achieved, and this low level has been maintained over the last two years. The selection procedure, based on a genetic marker system targeting the highly polymorphic BoLA locus, eliminates only those individuals which are at the highest risk of contracting the disease. In the present work, we discuss the properties of this system, including the "heterozygote advantage" and the "frequency dependence" theories, and examine their involvement in the biological mechanisms at the host/pathogen interface. We speculate on the exact role of the MHC molecules in the control of the disease, how the natural selection pressure imposed by the pathogens selectively maintains MHC diversity, and how our results can be practically applied for integrated control of dermatophilosis in developing countries

Assessing changes in costs of maternal postpartum services between 2013 and 2014 in Burkina Faso

Introduction In Africa, a majority of women bring their infant to health services for immunization, but few are checked in the postpartum (PP) period. The Missed opportunities for maternal and infant health (MOMI) EU-funded project has implemented a package of interventions at community and facility levels to uptake maternal and infant postpartum care (PPC). One of these interventions is the integration of maternal PPC in child clinics and infant immunization services, which proved to be successful for improving maternal and infant PPC. Aim Taking stock of the progress achieved in terms of PPC with the implementation of the interventions, this paper assesses the economic cost of maternal PPC services, for health services and households, before and after the project start in Kaya health district (Burkina Faso). Methods PPC costs to health services are estimated using secondary data on personnel and infrastructure and primary data on time allocation. Data from two household surveys collected before and after one year intervention among mothers within one year PP are used to estimate the household cost of maternal PPC visits. We also compare PPC costs for households and health services with or without integration. We focus on the costs of the PPC intervention at days 6–10 that was most successful. Results The average unit cost of health services for days 6–10 maternal PPC decreased from 4.6 USD before the intervention in 2013 (Jan-June) to 3.5 USD after the intervention implementation in 2014. Maternal PPC utilization increased with the implementation of the interventions but so did days 6–10 household mean costs. Similarly, the household costs increased with the integration of maternal PPC to BCG immunization. Conclusion In the context of growing reproductive health expenditures from many funding sources in Burkina Faso, the uptake of maternal PPC led to a cost reduction, as shown for days 6–10, at health services level. Further research should determine whether the increase in costs for households would be deterrent to the use of integrated maternal and infant PPC

Gaps and opportunities for the integrated delivery of mother-child care, postpartum family planning and nutrition services in Burkina Faso, Côte d'Ivoire and Niger

# Background Maternal and infant deaths can be prevented through integrated service delivery during pregnancy, postpartum, and early childhood. Our study analyses the gaps and opportunities associated with integrating maternal, newborn, and child health (MNCH) services with postpartum family planning (PPFP) and nutrition services at different points of contact in health facilities in a preintervention context in west Africa. # Methods We conducted a qualitative study from June to July 2018 in Burkina Faso, Côte d'Ivoire and Niger. The points of contact studied at the health facility level were the prenatal care, postpartum care and immunisation/growth monitoring services. Individual in-depth interviews were used to collect data from key informants (providers, community health workers and mother-child health programme managers). To measure the degree of service integration, we used the dimensions and indicators included in the Integra Initiative framework concerning four aspects of integration: physical (the availability of multiple services in the health facility), temporal (the availability of care more than one day per week), provider level, and functional (the receipt of integrated services by the client). # Results The findings of this study show that the integrated delivery of MNCH, PPFP, and nutrition services is configured in similar ways in Burkina Faso, Côte d'Ivoire and Niger and is insufficient at all points of contact. Physical integration is high. However, the study found important gaps in temporal, functional and provider-level integration. The main barriers to integrated service delivery are the shortage of providers, the lack of training in integrated service delivery, and insufficient service organisation. However, the availability of multiple services throughout the week, the multiple points of contact between the mother-child pair and the health system, and the multiple skills of providers represent opportunities for functional integration through the establishment of a formal referral system between the different care units with follow-up and feedback among service providers. # Conclusions The provision of training and the development of a well-organised referral system in different health facilities, taking into account the specific characteristics of each health facility (urban/rural, primary health facility/district hospital), can improve the delivery of integrated MNCH, PPFP, and nutrition care to the mother-child pair

Opportunities to improve postpartum care for mothers and infants: design of context-specific packages of postpartum interventions in rural districts in four sub-Saharan African countries

Background: Postpartum maternal and infant mortality is high in sub-Saharan Africa and improving postpartum care as a strategy to enhance maternal and infant health has been neglected. We describe the design and selection of suitable, context-specific interventions that have the potential to improve postpartum care. Methods: The study is implemented in rural districts in Burkina Faso, Kenya, Malawi and Mozambique. We used the four steps ‘systems thinking’ approach to design and select interventions: 1) we conducted a stakeholder analysis to identify and convene stakeholders; 2) we organised stakeholders causal analysis workshops in which the local postpartum situation and challenges and possible interventions were discussed; 3) based on comprehensive needs assessment findings, inputs from the stakeholders and existing knowledge regarding good postpartum care, a list of potential interventions was designed, and; 4) the stakeholders selected and agreed upon final context-specific intervention packages to be implemented to improve postpartum care. Results: Needs assessment findings showed that in all study countries maternal, newborn and child health is a national priority but specific policies for postpartum care are weak and there is very little evidence of effective postpartum care implementation. In the study districts few women received postpartum care during the first week after childbirth (25 % in Burkina Faso, 33 % in Kenya, 41 % in Malawi, 40 % in Mozambique). Based on these findings the interventions selected by stakeholders mainly focused on increasing the availability and provision of postpartum services and improving the quality of postpartum care through strengthening postpartum services and care at facility and community level. This includes the introduction of postpartum home visits, strengthening postpartum outreach services, integration of postpartum services for the mother in child immunisation clinics, distribution of postpartum care guidelines among health workers and upgrading postpartum care knowledge and skills through training. Conclusion: There are extensive gaps in availability and provision of postpartum care for mothers and infants. Acknowledging these gaps and involving relevant stakeholders are important to design and select sustainable, context-specific packages of interventions to improve postpartum care