La cardiothyréose au centre hospitalier universitaire de Bobo-Dioulasso, Burkina Faso

Introduction: La cardiothyréose est une affection fréquente et grave à l’ouest du Burkina Faso. Notre objectif était d’étudier les caractéristiques épidémiologiques, cliniques, thérapeutiques et évolutives des cardiothyréoses au centre hospitalier universitaire de Bobo-Dioulasso.Méthodes: Etude prospective de 12 mois pourtant sur des cas de cardiothyréose colligés dans les services de cardiologie et de médecine interne.Résultats: Quatorze (14) cas de cardiothyréose ont été colligés soit 33,3% des patients hospitalisés pour hyperthyroïdies. L’âge moyen des patients était de 53,57 ans ± 9,97. Les femmes au foyer (71,40%) aux conditions socio-économiques défavorables étaient les plus touchées. Parmi nos cas 21,42% des patients avaient déjà un antécédent d’hyperthyroïdie et l’HTA était le facteur de risque cardiovasculaire majeur (64,28%). Tous les patients présentaient une insuffisance cardiaque associée à un trouble du rythme (57,14%), essentiellement à type de fibrillation auriculaire (42,9%), une insuffisance coronarienne (7,14%) et un trouble de la conduction (7,14%). Le goitre multi-nodulaire a été l’entité étiopathogénique la plus fréquente (57,10%). Les antithyroïdiens de synthèse, les mesures hygiéno-diététiques et un traitement spécifique de l’insuffisance cardiaque ont été constamment utilisés pendant une durée d’hospitalisation moyenne de 23,57 jours ± 7,54. Si l’évolution immédiate peut être satisfaisante avec une euthyroïdie à 28,5% à moyen terme, les ruptures thérapeutiques peuvent être mortelles (un patient soit 7,14%) chez des patients généralement âgés majoritairement de sexe féminin avec un niveau socio-économique bas. Conclusion: Le traitement de la cardiothyréose est efficace d’où l’intérêt d’une politique sanitaire pour une prise en charge adéquate

Leafy amaranthus consumption patterns in Ouagadougou, Burkina Faso

There is a new attention to vegetables as vital components of daily diet. A concerted effort to raise their standing has begun to change mentalities and to fuel a rapid growth of traditional leafy vegetables marketing and consumption in African cities. However, little is known about the production and consumption patterns of these plant foods. This study examined, through a field survey the socio-economic, food consumption and conservation aspects of leafy vegetables in the region of Ouagadougou. It was found that leafy vegetables are cultivated under both rain-fed and irrigated conditions in the villages and also in the city’s gardens. The study has demonstrated that there is considerable indigenous knowledge on the leafy vegetables of the region. Amaranth species are the most cultivated and marketed and have potential for commercialization. They are used for many dishes in the local kitchen. Leafy Amaranths are consumed during all seasons even though they are more available (and cheap) during rainy season (June to end October). Ninety-four per cent of the interviewed people use vegetable Amaranth in sauce. There is a growing trend to use cultivated (introduced) species of Amaranth, which were brought to Africa by colonial powers and gained popularity because they were associated with high status. The introduced species are spreading quickly in a spontaneous manner. This can be a threat to biodiversity. There is need for a conservation initiative for the native species. In the commercialization of leafy vegetable and in particular for Amaranth, women play an important role. That could be optimized for marketing purpose to improve leafy vegetable adding-value. Because transportation is a cost increase factor, and given that cities should be targets for increased consumption, it is necessary to promote peri-urban agriculture of leafy vegetables, by policy guidelines. There is a need of documentation and dissemination of indigenous knowledge on indigenous leafy vegetables.Key words: vegetables, African greens, Amaranthus, micronutrients, biodiversity, horticulture, Ouagadougou, Burkina Fas

Nutritional properties of enriched local complementary flours

Abstract: This study aimed to identify the nutritional, functional, sensory and microbiological profile of experimental nutritional flours, produced with local products in Burkina Faso. The raw materials included maize (Zea mays), millet (Pennisetum glaucum) and rice (Oryza sativa). Local ingredients were pulps of Adansonia digitata and Parkia biglobosa and seeds of Cucurbita maxima and Moringa oleifera. Three formula were developed, the first (F1) with maize, the second (F2) with rice and the last (F3) with millet. Each of these cereals was mixed with predetermined portions of seeds and pulps in order to obtain enriched flour. Nutritional, microbiological and functional analysis and the acceptability criteria of these enriched flours were assessed and compared to Misola (F4), the existing local complementary flour. The fat content of experimental flours were respectively in the first (F1), second (F2) and third formula (F3) 15.91±0.01%, 11.82±0.02% and 17.02±0.02%. The carbohydrate range was 65.46±0.06%, 70.81±0.01% and 64.51±0.01% for F1, F2 and F3, while the energetic value is higher than recommended (453.07±0.05, 424.56±0.03 and 458.96±0.05 kcal respectively for F1, F2 and F3). Functional characteristics indicated the good viscosity (117, 119 and 121 mm/30 sec for F1, F2 and F3) least gelation (9, 6 and 7%) and water absorption capacity (2, 4 and 1 g/g). Trained sensory evaluation panellists gore the enriched flour porridge a score of acceptable. These enriched flours have great potential as a weaning food in resource-poor and technologically under-developed countries

Malaria mortality in Africa and Asia: evidence from INDEPTH health and demographic surveillance system sites.

BACKGROUND: Malaria continues to be a major cause of infectious disease mortality in tropical regions. However, deaths from malaria are most often not individually documented, and as a result overall understanding of malaria epidemiology is inadequate. INDEPTH Network members maintain population surveillance in Health and Demographic Surveillance System sites across Africa and Asia, in which individual deaths are followed up with verbal autopsies. OBJECTIVE: To present patterns of malaria mortality determined by verbal autopsy from INDEPTH sites across Africa and Asia, comparing these findings with other relevant information on malaria in the same regions. DESIGN: From a database covering 111,910 deaths over 12,204,043 person-years in 22 sites, in which verbal autopsy data were handled according to the WHO 2012 standard and processed using the InterVA-4 model, over 6,000 deaths were attributed to malaria. The overall period covered was 1992-2012, but two-thirds of the observations related to 2006-2012. These deaths were analysed by site, time period, age group and sex to investigate epidemiological differences in malaria mortality. RESULTS: Rates of malaria mortality varied by 1:10,000 across the sites, with generally low rates in Asia (one site recording no malaria deaths over 0.5 million person-years) and some of the highest rates in West Africa (Nouna, Burkina Faso: 2.47 per 1,000 person-years). Childhood malaria mortality rates were strongly correlated with Malaria Atlas Project estimates of Plasmodium falciparum parasite rates for the same locations. Adult malaria mortality rates, while lower than corresponding childhood rates, were strongly correlated with childhood rates at the site level. CONCLUSIONS: The wide variations observed in malaria mortality, which were nevertheless consistent with various other estimates, suggest that population-based registration of deaths using verbal autopsy is a useful approach to understanding the details of malaria epidemiology

Malaria mortality in Africa and Asia: evidence from INDEPTH health and demographic surveillance system sites

This paper is part of the Special Issue: INDEPTH Network Cause-Specific Mortality. A Corrigendum has been published for this paper. Please see http://www.globalhealthaction.net/index.php/ gha/article/view/27833Malaria continues to be a major cause of infectious disease mortality in tropical regions. However, deaths from malaria are most often not individually documented, and as a result overall understanding of malaria epidemiology is inadequate. INDEPTH Network members maintain population surveillance in Health and Demographic Surveillance System sites across Africa and Asia, in which individual deaths are followed up with verbal autopsies.To present patterns of malaria mortality determined by verbal autopsy from INDEPTH sites across Africa and Asia, comparing these findings with other relevant information on malaria in the same regions.From a database covering 111,910 deaths over 12,204,043 person-years in 22 sites, in which verbal autopsy data were handled according to the WHO 2012 standard and processed using the InterVA-4 model, over 6,000 deaths were attributed to malaria. The overall period covered was 1992-2012, but two-thirds of the observations related to 2006-2012. These deaths were analysed by site, time period, age group and sex to investigate epidemiological differences in malaria mortality.Rates of malaria mortality varied by 1:10,000 across the sites, with generally low rates in Asia (one site recording no malaria deaths over 0.5 million person-years) and some of the highest rates in West Africa (Nouna, Burkina Faso: 2.47 per 1,000 person-years). Childhood malaria mortality rates were strongly correlated with Malaria Atlas Project estimates of Plasmodium falciparum parasite rates for the same locations. Adult malaria mortality rates, while lower than corresponding childhood rates, were strongly correlated with childhood rates at the site level.The wide variations observed in malaria mortality, which were nevertheless consistent with various other estimates, suggest that population-based registration of deaths using verbal autopsy is a useful approach to understanding the details of malaria epidemiology.P. Kim Streatfield ... Yohannes A. Melaku ... et. al

Immune Reconstitution During the First Year of Antiretroviral Therapy of HIV-1-Infected Adults in Rural Burkina Faso

There are no data on the outcome of highly active antiretroviral therapy (HAART) in HIV-infected adults in rural Burkina Faso. We therefore assessed CD4+ T-cell counts and HIV-1 plasma viral load (VL), the proportion of naive T-cells (co-expressing CCR7 and CD45RA) and T-cell activation (expression of CD95 or CD38) in 61 previously untreated adult patients from Nouna, Burkina Faso, at baseline and 2 weeks, 1, 3, 6, 9 and 12 months after starting therapy. Median CD4+ T-cell counts increased from 174 (10th-90th percentile: 33-314) cells/µl at baseline to 300 (114- 505) cells/µl after 3 months and 360 (169-562) cells/µl after 12 months of HAART. Median VL decreased from 5.8 (4.6- 6.6) log10 copies/ml at baseline to 1.6 (1.6-2.3) log10 copies/ml after 12 months. Early CD4+ T-cell recovery was accompanied by a reduction of the expression levels of CD95 and CD38 on T-cells. Out of 42 patients with complete virological follow-up under HAART, 19 (45%) achieved concordant good immunological (gain of ≥100 CD4+ T-cells/µl above baseline) and virological (undetectable VL) responses after 12 months of treatment (intention-to-treat analysis). Neither a decreased expression of the T-cell activation markers CD38 and CD95, nor an increase in the percentage of naive T-cells reliably predicted good virological treatment responses in patients with good CD4+ T-cell reconstitution. Repeated measurement of CD4+ T-cell counts during HAART remains the most important parameter for immunologic monitoring. Substitution of repeated VL testing by determination of T-cell activation levels (e.g., CD38 expression on CD8+ T-cells) should be applied with caution

Advancing Access to Diagnostic Tools Essential for Universal Health Coverage and Antimicrobial Resistance Prevention: An Overview of Trials in Sub-Saharan Africa.

We introduce the Antimicrobial Resistance Diagnostic Use Accelerator program, and the articles in this Supplement, which cover the program in 3 sub-Saharan Africa countries

Abundances of Iron-Binding Photosynthetic and Nitrogen-Fixing Proteins of Trichodesmium Both in Culture and In Situ from the North Atlantic

Marine cyanobacteria of the genus Trichodesmium occur throughout the oligotrophic tropical and subtropical oceans, where they can dominate the diazotrophic community in regions with high inputs of the trace metal iron (Fe). Iron is necessary for the functionality of enzymes involved in the processes of both photosynthesis and nitrogen fixation. We combined laboratory and field-based quantifications of the absolute concentrations of key enzymes involved in both photosynthesis and nitrogen fixation to determine how Trichodesmium allocates resources to these processes. We determined that protein level responses of Trichodesmium to iron-starvation involve down-regulation of the nitrogen fixation apparatus. In contrast, the photosynthetic apparatus is largely maintained, although re-arrangements do occur, including accumulation of the iron-stress-induced chlorophyll-binding protein IsiA. Data from natural populations of Trichodesmium spp. collected in the North Atlantic demonstrated a protein profile similar to iron-starved Trichodesmium in culture, suggestive of acclimation towards a minimal iron requirement even within an oceanic region receiving a high iron-flux. Estimates of cellular metabolic iron requirements are consistent with the availability of this trace metal playing a major role in restricting the biomass and activity of Trichodesmium throughout much of the subtropical ocean

Fear and rumours regarding placental biopsies in a malaria-in-pregnancy trial in Benin.

BACKGROUND: A multi-country, community-based trial on scheduled screening and treatment for malaria in pregnancy was conducted in Benin, The Gambia and Burkina Faso. Despite standardized procedures and outcomes, the study became subject to rumours and accusations of placenta being sold for mystical and financial gain by trial staff, leading to drop-out rates of 30% and the consequent halting of placental biopsy sampling in Benin. This paper explores the role of socio-cultural beliefs related to placenta and identified additional factors contributing these rumours. METHODS: A qualitative comparative emergent-theory design was used to assess social factors related to trial implementation and uptake in the three countries. Data from participant observation, informal conversations, group discussions and interviews were triangulated and analysed with NVivo Qualitative Analysis software. RESULTS: Despite similar sociocultural beliefs about the sacred nature of the placenta in all three study countries, these beliefs did not affect participation rates in Burkina Faso and The Gambia and placenta-related rumours only emerged in Benin. Therefore, the presence of beliefs is not a sufficient condition to have generated placenta-selling fears. The rumours in Benin reflected the confluence of placenta-related beliefs and factors related to the implementation of the trial (including a catalysing adverse event and miscommunication during the informed consent procedure). Furthermore, distinct socio-political factors contributed to the emergence of rumours, including the historical distrust in governmental organizations and the tense relationship between some of the actors involved in the trial. CONCLUSION: Transdisciplinary social science research designs should accompany the implementation of the trial. The integration of multiple stakeholders' knowledge and involvement is required to define and solve upcoming barriers