Geographic and Sociodemographic Disparities in Cardiovascular Risk in Burkina Faso: Findings from a Nationwide Cross-Sectional Survey.

BACKGROUND: Cardiovascular disease (CVD) risk assessment is a critical step in the current approach to the primary prevention of CVD, particularly in low-income countries such as Burkina Faso. In this study, we aimed to assess the geographic and sociodemographic disparities of the ten-year cardiovascular risk in Burkina Faso. METHODS: We conducted a secondary analysis of the data from the first nationwide survey using the World Health Organization (WHO) STEPwise approach. Ten-year cardiovascular risk was determined using the WHO 2019 updated risk chart (WHO risk) as main outcome, and the Framingham risk score (FRS) and the Globorisk chart for secondary outcomes. We performed a modified Poisson regression model using a generalized estimating equation to examine the association between CVD risk and sociodemographic characteristics. RESULTS: A total of 3081 participants aged 30 to 64 years were included in this analysis. The overall age and sex-standardized mean of absolute ten-year cardiovascular risk assessed using the WHO risk chart was 2.5% (95% CI: 2.4-2.6), ranging from 2.3% (95% CI: 2.2-2.4) in Centre Est to 3.0% (95% CI: 2.8-3.2) in the Centre region. It was 4.6% (95% CI: 4.4-4.8) for FRS and 4.0% (95% CI: 3.8-4.1) for Globorisk. Regarding categorized CVD risk (absolute risk ≥10%), we found out that the age and sex-standardized prevalence of elevated risk was 1.7% (95% CI: 1.3-2.1) for WHO risk, 10.4% (95% CI: 9.6-11.2) for FRS, and 5.9% (95% CI: 5.1-6.6) for Globorisk. For all of the three risk scores, elevated CVD risk was associated with increasing age, men, higher education, urban residence, and health region (Centre). CONCLUSION: We found sociodemographic and geographic inequalities in the ten-year CVD risk in Burkina Faso regardless of risk score used. Therefore, population-wide interventions are needed to improve detection and management of adult in the higher CVD risk groups in Burkina Faso

Molecular diagnosis of COVID-19 in Burkina Faso: successful challenge

COVID-19 has worsened the health situation in Burkina Faso. In fact, the country has known a peak of the second wave, which began in November, and ended around January 2021. Biological diagnosis has played a key role in the management of COVID-19. The aim of this review paper is to address the practical aspects that laboratories have faced in order to meet the challenge of SARS-CoV-2 diagnosis in Burkina Faso. According to international requirements, Burkina Faso has used real-time Reverse Transcription Polymerase Chain Reaction (rRT-PCR) as the “gold standard” for the diagnosis of COVID-19. From March 9, 2020 to July 31, 2021, in Burkina Faso, laboratories involved in COVID-19 diagnosis analyzed 226,189 samples by molecular tests and 2, 352 samples by rapid antigenic tests, whose peak was in January 2021 with 35,984 samples analyzed. The daily average rate of samples analysis was 456.02 tests. The majority of the individuals requesting COVID-19 tests were travelers (62.00%), followed by contact cases (18.42%), suspected cases (7.95%), voluntary screening (7.57%), and 4.06% of other applicants consisting of health care personnel and at-risk patients. In terms of prevention, vaccines are being administered to the general population. However, some efforts must be made to provide automated sample analysis equipment and complete sequencing of SARS-CoV-2 remains among the challenges

Frequency and management of maternal infection in health facilities in 52 countries (GLOSS): a 1-week inception cohort study

Background: Maternal infections are an important cause of maternal mortality and severe maternal morbidity. We report the main findings of the WHO Global Maternal Sepsis Study, which aimed to assess the frequency of maternal infections in health facilities, according to maternal characteristics and outcomes, and coverage of core practices for early identification and management. Methods: We did a facility-based, prospective, 1-week inception cohort study in 713 health facilities providing obstetric, midwifery, or abortion care, or where women could be admitted because of complications of pregnancy, childbirth, post-partum, or post-abortion, in 52 low-income and middle-income countries (LMICs) and high-income countries (HICs). We obtained data from hospital records for all pregnant or recently pregnant women hospitalised with suspected or confirmed infection. We calculated ratios of infection and infection-related severe maternal outcomes (ie, death or near-miss) per 1000 livebirths and the proportion of intrahospital fatalities across country income groups, as well as the distribution of demographic, obstetric, clinical characteristics and outcomes, and coverage of a set of core practices for identification and management across infection severity groups. Findings: Between Nov 28, 2017, and Dec 4, 2017, of 2965 women assessed for eligibility, 2850 pregnant or recently pregnant women with suspected or confirmed infection were included. 70·4 (95% CI 67·7–73·1) hospitalised women per 1000 livebirths had a maternal infection, and 10·9 (9·8–12·0) women per 1000 livebirths presented with infection-related (underlying or contributing cause) severe maternal outcomes. Highest ratios were observed in LMICs and the lowest in HICs. The proportion of intrahospital fatalities was 6·8% among women with severe maternal outcomes, with the highest proportion in low-income countries. Infection-related maternal deaths represented more than half of the intrahospital deaths. Around two-thirds (63·9%, n=1821) of the women had a complete set of vital signs recorded, or received antimicrobials the day of suspicion or diagnosis of the infection (70·2%, n=1875), without marked differences across severity groups. Interpretation: The frequency of maternal infections requiring management in health facilities is high. Our results suggest that contribution of direct (obstetric) and indirect (non-obstetric) infections to overall maternal deaths is greater than previously thought. Improvement of early identification is urgently needed, as well as prompt management of women with infections in health facilities by implementing effective evidence-based practices.Fil: Althabe, Fernando. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Parque Centenario. Centro de Investigaciones en Epidemiología y Salud Pública. Instituto de Efectividad Clínica y Sanitaria. Centro de Investigaciones en Epidemiología y Salud Pública; ArgentinaFil: Espinoza, Marisa Mabel. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Parque Centenario. Centro de Investigaciones en Epidemiología y Salud Pública. Instituto de Efectividad Clínica y Sanitaria. Centro de Investigaciones en Epidemiología y Salud Pública; ArgentinaFil: Pasquale, Julia. No especifíca;Fil: Hernández Muñoz, Rosalinda. No especifíca;Fil: Carvajal, Javier. No especifíca;Fil: Escobar, María Fernanda. No especifíca;Fil: Cecatti, José Guilherme. No especifíca;Fil: Ribeiro Do Valle, Carolina C.. No especifíca;Fil: Mereci, Wilson. No especifíca;Fil: Vélez, Paola. No especifíca;Fil: Pérez, Aquilino M.. No especifíca;Fil: Vitureira, Gerardo. No especifíca;Fil: Leroy, Charlotte. No especifíca;Fil: Roelens, Kristien. No especifíca;Fil: Vandenberghe, Griet. No especifíca;Fil: Aguemon, Christiane Tshabu. No especifíca;Fil: Cisse, Kadari. No especifíca;Fil: Ouedraogo, Henri Gautier. No especifíca;Fil: Kannitha, Cheang. No especifíca;Fil: Rathavy, Tung. No especifíca;Fil: Tebeu, Pierre Marie. No especifíca;Fil: Bustillo, Carolina. No especifíca;Fil: Bredy, Lara. No especifíca;Fil: Herrera Maldonado, Nazarea. No especifíca;Fil: Abdosh, Abdulfetah Abdulkadir. No especifíca;Fil: Teklu, Alula M.. No especifíca;Fil: Kassa, Dawit Worku. No especifíca;Fil: Kumar, Vijay. No especifíca;Fil: Suri, Vanita. No especifíca;Fil: Trikha, Sonia. No especifíca

Exploitation optimale des données de santé existantes pour orienter les stratégies de prévention et de contrôle du risque cardiométabolique :cas d’un pays au stade précoce de la transition épidémiologique, le Burkina Faso

Les maladies cardiométaboliques (MCM) sont un ensemble de pathologies courantes le plus souvent évitables regroupant les maladies cardiovasculaires et le diabète. La transition démographique et épidémiologique en cours dans la plupart des pays d’Afrique subsaharienne dont le Burkina Faso fait craindre une future épidémie de ces maladies dans ces pays. Des évidences scientifiques sur l’ampleur, les facteurs de risque et la capacité du système de santé à les prendre en charge sont nécessaires pour mieux orienter les stratégies de prévention et contrôle de ces maladies. Les données existantes notamment celles de l’enquête STEPS réalisée au sein de la population adulte du Burkina Faso et de l’enquête SARA qui a concerné tous les établissements de santé au Burkina Faso, ainsi que les données des recensements de la population et de l’habitat et celles du système d’information géographique ont été compilées et analysées pour répondre à nos objectifs de recherche. Cette compilation a permis d’obtenir une base de données contenant des informations sur l'état de santé de la population, les infrastructures sanitaires, l’offre des soins de santé nécessaires pour les analyses. Les résultats obtenus indiquent qu’une proportion importante de la population est affectée par les facteurs de risque notamment l’obésité abdominale (22,5%) et le syndrome métabolique (10,9%). Aussi, 10,4% de la population avait un risque élevé de maladies cardiovasculaires. Des baisses importantes et persistantes de la capacité du système de santé à prendre charge les MCM ont été observées au cours des 10 dernières années. Enfin, des disparités sociodémographiques et géographiques ont également été identifiées. La réadaptation des stratégies de prévention primaire et secondaire tenant compte des disparités identifiées constitue une piste de solution pour freiner la progression des MCM dans le pays.Doctorat en Sciences de la santé Publiqueinfo:eu-repo/semantics/nonPublishe

Awareness, Treatment, and Control of Hypertension among the Adult Population in Burkina Faso: Evidence from a Nationwide Population-Based Survey.

Hypertension is the leading cause of cardiovascular disease, particularly in low- and middle-income countries. Improved awareness of hypertension status can significantly increase early treatment, thereby reducing cardiovascular complications and premature death. This study aimed to report the prevalence of the awareness, treatment, and control of hypertension among the adult population in Burkina Faso.info:eu-repo/semantics/publishe

Prevalence of abdominal obesity and its association with cardiovascular risk among the adult population in Burkina Faso: Findings from a nationwide cross-sectional study

Objective The objective of this study is to determine the prevalence of abdominal obesity, its predictors and its association with cardiovascular risk among adults in Burkina Faso. Design We performed a secondary analysis of data from a national cross-sectional study, using WHO STEPwise approach. Setting The study was conducted in Burkina Faso, in all the 13 regions of the country. Participants Our study involved 4308 adults of both sexes, aged between 25 and 64 years. Primary and secondary outcomes Our primary outcome was abdominal obesity, which was defined using a cut-off point of waist circumference (WC) of ≥94 cm for men and ≥80 cm for women. The secondary outcome was very high WC (≥102 cm for men and ≥88 cm for women) (for whom weight management is required). Results The mean age of participants was 38.5±11.1 years. The age-standardised prevalence of abdominal obesity was 22.5% (95% CI 21.3% to 23.7%). This prevalence was 35.9% (95% CI 33.9% to 37.9%) among women and 5.2% (95% CI 4.3% to 6.2%) among men. In urban areas, the age-standardised prevalence of abdominal obesity was 42.8% (95% CI 39.9% to 45.7%) and 17.0% (95% CI 15.7% to 18.2%) in rural areas. The age-standardised prevalence of very high WC was 10.2% (95% CI 9.3% to 11.1%). The main predictors of abdominal obesity were being female, increased age, married status, high level of education and living in urban areas. Abdominal obesity was also significantly associated with high blood pressure (adjusted prevalence ratio (aPR): 1.30; 95% CI 1.14 to 1.47) and hypercholesterolaemia (aPR: 1.52; 95% CI 1.18 to 1.94). According to the combination matrix between body mass index and WC, 14.6% of the adult population in Burkina Faso had an increased cardiometabolic risk. Conclusion Our study showed a high prevalence of abdominal obesity and a high proportion of adults who require weight management strategies to prevent cardiometabolic complications. Strategies to reduce the burden of abdominal obesity and very high WC should be considered by Burkina Faso's policy-makers.SCOPUS: ar.jinfo:eu-repo/semantics/publishe

Alcohol consumption and associated risk factors in Burkina Faso: Results of a population-based cross-sectional survey

Objectives Lifestyle modifiable risk factors are a leading preventable cause of non-communicable diseases, with alcohol consumption among the most important. Studies characterising the prevalence of alcohol consumption in low-income countries are lacking. This study describes the prevalence of different levels of alcohol consumption in Burkina Faso and its associated factors. Design Data from the 2013 Burkina Faso WHO STEPwise Approach to Surveillance survey were analysed. The prevalence of alcohol consumption over the last 30 days was recoded into categories according to WHO recommendations: low, mid or abusive alcohol consumption. Multinomial logistic regression analyses identified factors associated with the different levels of alcohol consumption. Setting Population-based cross-sectional survey in Burkina Faso. Participants 4692 participants of both sexes aged 25-64 years were included in the study. Results In the whole sample, 3559 participants (75.8% (72.5%-78.7%)) were not consuming any alcohol, 614 (12.9% (10.9%-15.3%)) had low alcohol consumption, 399 (8.5% (7.1%-10.1%)) had mid alcohol consumption and 120 (2.7% (2.0%-3.7%)) had abusive consumption. Age was associated with alcohol intake with a gradient effect and older people having a higher level of consumption (adjusted OR (AOR): 2.36, 95% CI (1.59 to 3.51) for low consumption, 2.50 (1.54 to 4.07) for mid consumption and 2.37 (1.01 to 5.92) for abusive consumption in comparison with no consumption). Tobacco consumption was also significantly associated with alcohol intake with a gradient effect, those with higher tobacco consumption being at higher risk of abusive alcohol intake (AOR: 6.08 (2.75 to 13.4) for moderate consumption and 6.58 (1.96 to 22.11) for abusive consumption). Conclusion Our data showed an important burden of alcohol consumption in Burkina Faso, which varied with age and tobacco use. To effectively reduce alcohol consumption in Burkina Faso, comprehensive control and prevention campaigns should consider these associated factors.SCOPUS: ar.jinfo:eu-repo/semantics/publishe

Using the first nationwide survey on non-communicable disease risk factors and different definitions to evaluate the prevalence of metabolic syndrome in Burkina Faso.

The burden of cardiovascular diseases is rising in the developing world including Sub-Saharan Africa. The rapid rise of cardiovascular disease burden is in part due to undetected and uncontrolled cardiovascular risk factors. The clustering of metabolic syndrome (MetS) components is associated with a high risk of cardiovascular diseases. This complex biochemical disorder is still poorly studied in western Africa. In this study, we aimed to determine the prevalence of metabolic syndrome and its determinants among the adult population in Burkina Faso.info:eu-repo/semantics/publishe

Prognosis of peripartum cardiomyopathy in sub-Saharan Africa (Burkina Faso South-West PPCM register)

Peripartum cardiomyopathy is one of the curable cardiomyopathy. It’s a severe and frequent disease arising among women of childbearing age. Its evolution in the long-term among some patients leads to chronic heart failure. Our study aims to determine from a prospective cohort, the factors associated with the non-recovery of myocardial function upon 12 months of diagnosis. Sociodemographic, clinical and echocardiographic data were collected at the time of diagnosis and then in months 3, 6 and 12. The outcome was the non-recovery of myocardial function at one year, defined by a left ventricular ejection fraction (LVEF) below 50%. 60 patients were analyzed after 12 months of follow-up. Mortality was about 13.3% and recovery rate of myocardial function reached 42.3%. After logistic regression, delay diagnosis and observance were the factors related to non- recovery of myocardial function

Mortalité à 3 mois des infarctus cérébraux au Burkina Faso : une étude de cohorte prospective

La mortalité à 3 mois des infarctus cérébraux demeure encore élevée en Afrique Sub Saharienne. L’objectif de notre étude était d’évaluer la mortalité intra hospitalière, à un mois et à 3 mois des patients hospitalisés pour infarctus cérébral au Burkina Faso. Il s’agissait d’une étude de cohorte prospective de patients consécutivement hospitalisés pour infarctus cérébral, de mars 2015 à février 2016, puis suivis en consultation externe durant au moins 3 mois après l’AVC au Centre Hospitalier Universitaire de Tingandogo, à Ouagadougou, au Burkina Faso. Les caractéristiques sociodémographiques, cliniques et paracliniques des patients à l’admission, les complications et la mortalité cumulée respectivement à la sortie d’hospitalisation, à un mois et à 3 mois, ont été analysées. En tout, 151 patients ont été enregistrés, avec une prédominance masculine (59,6 %) et une moyenne d’âge de 63,4 ans. Lors de l’admission, le National Institute of Health Stroke Score (NIHSS) moyen était de 14. L’oedème cérébral (39,7 %) et l’effet de masse (35,1 %) était les complications neuroradiologiques précoces les plus fréquentes. La durée moyenne d’hospitalisation était de 13,4 jours. Les taux de mortalité, intra hospitalière, à un mois et 3 mois étaient respectivement de 17,9 %, 19 % et 25,9 %. La mortalité des infarctus cérébraux reste élevée en Afrique Sub Saharienne. L’utilisation de la fibrinolyse, la mise en place des unités neurovasculaires et un accès des patients à la rééducation fonctionnelle, contribueront à l’amélioration de la survie des patients après infarctus cérébraux.Mots-clés: infarctus cérébral ; complications ; taux de mortalité ; Afrique Sub-SaharienneEnglish Title: Month mortality of cerebral infarction in Burkina Faso: a prospective cohort studyEnglish AbstractMortality at 3 months of cerebral infarction remains high in sub-Saharan Africa. The aim of our study was to evaluate the intra-hospital mortality, at one month and at three months, of patients hospitalized for cerebral infarction in Burkina Faso. This was a prospective cohort study of patients consecutively hospitalized for cerebral stroke, at the Tingandogo University-Teaching Hospital in Ouagadougou, Burkina Faso from  March 2015 to February 2016. Then they were followed-up as neurology outpatients for at least 3 months after the stroke. The baseline characteristics of the patients at admission, complications and cumulative mortality rates using survival curves, were analyzed at the discharge from hospital, at 1 and 3 months post-stroke. A total of 151 patients were registered, among which male patients represented 59.6%. The mean age was 63.4 years. At the end of the hospitalization, then at 1 and 3 months post-stroke, 27 (17.9%), 30 (19%) and 39 (25.9 %) patients died, respectively. The mortality rates from cerebral stroke remains high in Sub Saharan Africa, mainly due to the weaknesses of the health systems. An improvement in the quality of care, including fibrinolysis, early admission to stroke units, adequate management of comorbidities, complications and elderly patients, will contribute to an improvement of the survival of patients following the first three months after the stroke.Keywords: cerebral stroke; mortality rate; Sub-Saharan Afric