Traitement préventif intermittent à la sulfadoxine – pyriméthamine du paludisme chez les femmes enceintes: efficacité et observance dans deux hôpitaux urbains du Burkina Faso

Introduction: La présente étude prospective se propose dévaluer l’efficacité thérapeutique du traitement préventif intermittent à la sulfadoxine - pyriméthamine et son observance chez la femme enceinte dans deux hôpitaux urbains au Burkina Faso. Méthodes: Chaque femme répondant aux critères d’inclusion a été soumise à un questionnaire pour la collecte des données socio - démographiques et des renseignements sur la grossesse. A l’accouchement, une apposition placentaire a été réalisée systématiquement. La lecture a été faite au microscope à lobjectif 100 à immersion. Résultats: Au total, 542 femmes ont été incluses avec un âge moyen de 26,0 ± 6,45 ans (extrêmes 13- 43 ans). Le taux de couverture du TPI à la sulfadoxine- pyriméthamine a été de 80%. Le taux d’infestation placentaire a été de 4,7 %. Il a diminué avec le nombre de dose de traitement préventif intermittent. Il a augmenté cependant de juillet à octobre. De 42,9% en octobre, il a diminué significativement à 9,5% en novembre (p<0,05). Le taux global de bonne d'observance a été de 55%. Il a augmenté avec l'âge (p<0,05). Conclusion: Le taux de couverture de la sulfadoxine - pyriméthamine a été de 80%. Ce résultat est en conformité avec les objectifs du plan stratégique 2006-2010 de lutte contre le paludisme au Burkina Faso, qui préconisait un taux de couverture en sulfadoxine - pyriméthamine de 80% pour 2010. L’augmentation de la fréquence d’infestation de juillet à octobre, serait liée à la recrudescence de la transmission palustre pendant la saison des pluies (mai-octobre).Pan African Medical Journal 2013; 14: 10

Epidemiological profile of cutaneous leishmaniasis: Retrospective analysis of 7444 cases reported from 1999 to 2005 at Ouagadougou, Burkina Faso

This retrospective study was aimed to describe the trend of the cases and to determine the annual incidence rate of cutaneous leishmaniasis from 1999 to 2005 in the city of Ouagadougou. To achieve these objectives, a retrospective study was conducted. Data collection was conducted from January 1999 to December 2005. In total, 7444 cases of cutaneous leishmaniasis were recorded with an annual average of 1063.30 ± 270. 8 cases. The sex ratio M/F was 0.9. The average age was 22.8 ± 13.5 years. Patients more than 15 year-old accounted for 72.5%. A decrease in the cases of the disease was noted during the months of March, April, May, June, and December. The peak was recorded during the months of September and October. Over 7 years, the average incidence rate was 0.1% ± 0.04 but does not reflect the importance of this pathology. Thus, a prospective study was recommended.Pan African Medical Journal 2013: 10

Personal protection of long lasting insecticide-treated nets in areas of Anopheles gambiae s.s. resistance to pyrethroids

BACKGROUND: The development of mosquito nets pre-treated with insecticide, Long Lasting Impregnated Nets (LLINs) that last the life span of the net, is a solution to the difficulty of the re-impregnation of conventional nets. Even if they showed a good efficacy in control conditions, their efficacy in the field, particularly in areas with resistance of Anopheles gambiae to pyrethroids, is not well documented. This study compares wide (Olyset(®)) and small (Permanet(®)) mesh LLINs in field conditions, using entomological parameters. METHODS: The two LLINs were tested in a rice-growing area of south-western Burkina Faso (West Africa) with year around high density of the main malaria vector An. gambiae s.s. In the study village (VK6), there is a mixed population of two molecular forms of An. gambiae, the S-form which dominates during the rainy season and the M-form which dominates the rest of the year. The two LLINs Olyset(® )and Permanet(® )were distributed in the village and 20 matched houses were selected for comparison with four houses without treated nets. RESULTS: Mosquito entrance rate was ten fold higher in control houses than in houses with LLINs and there was no difference between the two net types. Among mosquitoes found in the houses, 36 % were dead in LLIN houses compared to 0% in control houses. Blood feeding rate was 80 % in control houses compared to 43 % in LLIN houses. The type of net did not significantly impact any of these parameters. No mosquitoes were found inside Permanet(®), whereas dead or dying mosquitoes were collected inside the Olyset(®). More than 60% of mosquitoes found on top or inside the nets had had blood meals from cattle, as shown by ELISA analysis. CONCLUSION: The percentage of blood-fed mosquitoes in a bed net study does not necessarily determine net success. The efficacy of the two types of LLINs was comparable, during a period when the S-form of An. gambiae was carrying the kdr gene. Significantly higher numbers of mosquitoes were collected in control houses compared to intervention houses, indicating that the LLINs provided an additional deterrent effect, which enhanced their expected prevention capacity

Localisation vaginale de Mansonella perstans: à propos d’un cas au centre hospitalier universitaire de Bobo-Dioulasso, Burkina Faso

Mansonella perstans est une filaire dont les adultes sont à localisation péritonéale et les microfilaires à localisation sanguine, qui sévit principalement en Amérique Equatoriale et aux bords de rivières, de plages en Afrique tropicale humide. Sa transmission est assurée par la piqûre de culicoïdes. Nous rapportons le cas d’une patiente souffrant de prurit dans un contexte biologique d’hyperéosinophilie au cours d’un dépistage du cancer du col de l’utérus. Une microfilaire de Mansonella perstans a été observée sur son frottis cervico-vaginal mais aussi dans son sang. La patiente a été traitée avec succès par une prise unique combinée de 400 mg d’albendazole et d’ivermectine (150 μg/kg). La localisation cervico-vaginale de Mansonella perstans est atypique et exceptionnelle. Nous proposons une recherche systématique de microfilaires lors de frottis cervico-vaginaux des femmes souhaitant un dépistage du cancer du col de l’utérus au Centre Hospitalier de Bobo-Dioulasso pour déterminer la fréquence réelle de cette localisation atypique. Pan African Medical Journal 2012; 12:4

First Detection of Leishmania infantum in Domestic Dogs from Burkina Faso (West Africa)

Background and Objective: Human Visceral Leishmaniasis (HVL) is a systemic neglected tropical diseases and potentially lethal disease caused by infection with protozoan parasites of the Leishmania genus. In the causal, agent of HVL is L. infantum and dogs are a major reservoir host. Visceral leishmaniasis is rarely found in West Africa and no cases have been reported to date in Burkina Faso. The purpose of the current study was to investigate the presence of L. infantum in population of domestic dogs in Bobo-Dioulasso city in Burkina Faso. Materials and Methods: The study was carried out in five districts of the city Bobo-Dioulasso, Burkina Faso. An active survey was conducted in households with dogs in five districts of the city for canine leishmaniasis screening. Epidemiological data and clinical signs were collected for each dog. Venous blood collection and skin lesions biopsies were performed in dogs after informed consent of the owners. The plasma was used for the immunological diagnosis (DiaMed-IT LEISH) and positive samples were confirmed by nested PCR. Results: A total of 85 dogs were included in the study. For the first time, the occurrence of L. infantum in Burkina Faso was confirmed in five domestic dogs presenting symptomatic signs by immunochromatographic tests. Biopsy samples were positive for L. infantum in PCR analysis. Conclusion: The findings indicated that L. infantum is circulating within canine populations in Bobo-Dioulasso. Infected dogs would be the reservoir hosts of this visceralising species. Several priorities for public and veterinary health research have been highlighted by this study

Ex vivo anti-malarial drugs sensitivity profile of Plasmodium falciparum field isolates from Burkina Faso five years after the national policy change.

BACKGROUND: The recent reports on the decreasing susceptibility of Plasmodium falciparum to artemisinin derivatives along the Thailand and Myanmar border are worrying. Indeed it may spread to India and then Africa, repeating the same pattern observed for chloroquine resistance. Therefore, it is essential to start monitoring P. falciparum sensitivity to artemisinin derivatives and its partner drugs in Africa. Efficacy of AL and ASAQ were tested by carrying out an in vivo drug efficacy test, with an ex vivo study against six anti-malarial drugs nested into it. Results of the latter are reported here. METHODS: Plasmodium falciparum ex-vivo susceptibility to chloroquine (CQ), quinine (Q), lumefantrine (Lum), monodesethylamodiaquine (MDA), piperaquine (PPQ) and dihydroartemisinin (DHA) was investigated in children (6 months - 15 years) with a parasitaemia of at least ≥4,000/μl. The modified isotopic microtest technique was used. The results of cellular proliferation were analysed using ICEstimator software to determine the 50% inhibitory concentration (IC50) values. RESULTS: DHA was the most potent among the 6 drugs tested, with IC50 values ranging from 0.8 nM to 0.9 nM (Geometric mean IC50 = 0.8 nM; 95% CI [0.8 - 0.9]). High IC50 values ranged between 0.8 nM to 166.1 nM were reported for lumefantrine (Geometric mean IC50 = 25.1 nM; 95% CI [22.4 - 28.2]). MDA and Q IC50s were significantly higher in CQ-resistant than in CQ-sensitive isolates (P = 0.0001). However, the opposite occurred for Lum and DHA (P < 0.001). No difference was observed for PPQ. CONCLUSION: Artemisinin derivatives are still very efficacious in Burkina Faso and DHA-PPQ seems a valuable alternative ACT. The high lumefantrine IC50 found in this study is worrying as it may indicate a decreasing efficacy of one of the first-line treatments. This should be further investigated and monitored over time with large in vivo and ex vivo studies that will include also plasma drug measurements

Therapeutic efficacy of sulphadoxine-pyrimethamine and chloroquine for the treatment of uncomplicated malaria in pregnancy in Burkina Faso

BACKGROUND: A reduction in the therapeutic efficacy of chloroquine (CQ) and sulphadoxine-pyrimethamine (SP) has recently been observed in Burkina Faso. As these two drugs are used in pregnancy, their efficacy in pregnant women was studied to directly assess the level of drug resistance in this specific population, rather than to extrapolate results of studies conducted in children < 5 years of age. METHODS: During the malaria transmission season of 2003 in Ouagadougou, the clinical efficacy of SP and CQ, using the WHO 28-day protocol, was assessed in primigravidae and secundigravidae presenting with uncomplicated malaria. RESULTS: PCR-corrected results by day 28 showed that among 62 women treated with SP, eight (12.9%) experienced late parasitological failure, but no clinical failures. Among 60 women treated with CQ, the overall failure rate was 46.7% including 1.7% early treatment failures, 5% late clinical failures and 40% late parasitological failures. SP induced a haemoglobin gain of 0.3 g/dL by day 14 and 0.9 g/dL by day 28. Treatment responses were independent of gravidity, gestational age and prior antenatal care visits. CONCLUSION: While CQ should no longer be used, the efficacy of SP is still compatible with use for intermittent preventive treatment (IPT) in pregnancy. However, given the possible spread of resistance, the drug should be restricted in its use

Chlorproguanil−Dapsone−Artesunate versus Artemether−Lumefantrine: A Randomized, Double-Blind Phase III Trial in African Children and Adolescents with Uncomplicated Plasmodium falciparum Malaria

Chlorproguanil−dapsone−artesunate (CDA) was developed as an affordable, simple, fixed-dose artemisinin-based combination therapy for use in Africa. This trial was a randomized parallel-group, double-blind, double-dummy study to compare CDA and artemether−lumefantrine (AL) efficacy in uncomplicated Plasmodium falciparum malaria and further define the CDA safety profile, particularly its hematological safety in glucose-6-phosphate dehydrogenase (G6PD) -deficient patients

Decreased motivation in the use of insecticide-treated nets in a malaria endemic area in Burkina Faso

<p>Abstract</p> <p>Background</p> <p>The use of insecticide-treated nets (ITN) is an important tool in the Roll Back Malaria (RBM) strategy. For ITNs to be effective they need to be used correctly. Previous studies have shown that many factors, such as wealth, access to health care, education, ethnicity and gender, determine the ownership and use of ITNs. Some studies showed that free distribution and public awareness campaigns increased the rate of use. However, there have been no evaluations of the short- and long-term impact of such motivation campaigns. A study carried out in a malaria endemic area in south-western Burkina Faso indicated that this increased use declined after several months. The reasons were a combination of the community representation of malaria, the perception of the effectiveness and usefulness of ITNs and also the manner in which households are organized by day and by night.</p> <p>Methods</p> <p>PermaNet 2.0^®and Olyset^®were distributed in 455 compounds at the beginning of the rainy season. The community was educated on the effectiveness of nets in reducing malaria and on how to use them. To assess motivation, qualitative tools were used: one hundred people were interviewed, two hundred houses were observed directly and two houses were monitored monthly throughout one year.</p> <p>Results</p> <p>The motivation for the use of bednets decreased after less than a year. Inhabitants' conception of malaria and the inconvenience of using bednets in small houses were the major reasons. Acceptance that ITNs were useful in reducing malaria was moderated by the fact that mosquitoes were considered to be only one of several factors which caused malaria. The appropriate and routine use of ITNs was adversely affected by the functional organization of the houses, which changed as between day and night. Bednets were not used when the perceived benefits of reduction in mosquito nuisance and of malaria were considered not to be worth the inconvenience of daily use.</p> <p>Conclusion</p> <p>In order to bridge the gap between possession and use of bednets, concerted efforts are required to change behaviour by providing accurate information, most particularly by convincing people that mosquitoes are the only source of malaria, whilst recognising that there are other diseases with similar symptoms, caused in other ways. The medical message must underline the seriousness of malaria and the presence of the malaria vector in the dry season as well as the wet, in order to encourage the use of bednets whenever transmission can occur. Communities would benefit from impregnated bednets and other vector control measures being better adapted to their homes, thus reducing the inconvenience of their use.</p

Investigation of antiplasmodial compounds from two plants, Cochlospermum tinctorium A. rich and Gardenia sokotensis Hutch

Efforts in malaria treatment are currently directed towards the discovery and development of new antimalarial compounds. In this way two plants Cochlospermum tinctorium A. Rich. (Cochlospermaceae) and Gardenia sokotensis Hutch (Rubiaceae) traditionally used to treat symptoms of malaria in Burkina Faso were screened for antimalarial activity in vivo with Plasmodium berghei. Dichloromethane extract of Cochlospermum tinctorium and dichloromethane-methanol (7/3v/v) of Gardenia sokotensis showed a promising in vivo antiplasmodial activity with 50% effective dose of 17.59 mg/kg and 115 mg/kg respectively. Water extracts from the two plants showed an interesting antiplasmodial activity of Cochlospermum tinctorium and a weak activity for Gardenia sokotensis. Paradoxically chromatographic fractions issued from the active crude extract of Cochlospermum tinctorium appear less active. The fraction FGs2 of Gardenia has showed a pronounced activity with 42% inhibition rate at 50 mg /kg. These results reflected in part the previous in vitro studies conducted on the two plants. Phytochemical screening revealed mostly the presence of triterpenes, carotenoids and flavonoids more or less in pure state. Keywords: Cochlospermum tinctorium; Gardenia sokotensis; Malaria; Plasmodium berghei African Journal of Traditional, Complementary and Alternative Medicines Vol. 3(4) 2006: 34-4