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

Importance of the confirmatory assay for the detection of the HBsAg in the epidemiological studies and in the diagnosis of the viral Hepatitis B

Several epidemiological studies have reported high prevalence of HBsAg among pregnant women in Burkina Faso. They used various algorithms, as it is also done for the routine diagnostic. Knowing this antigen carriage rate in such a population or in other clinic attendees is important for the implementation of a national immunisation programme and the monitoring of patients with hepatitis B. Often, the screening tests were not confirmed in spite of the existence of known false positive and false negative results. The aim of this study was to determine a more accurate prevalence of HBsAg, among the pregnant women in Burkina Faso. From October 2006 to January 2007, blood samples were collected from 1139 pregnant women. Each sample was analyzed for HBsAg, using two assays and according to manufacturers’ instructions vis, Hepanostika®HBsAg Uniform II B9 (Bio-Mérieux; France) and HBsAg (V2) Abbott AxSYM® system (Abbott Diagnostics). All the positive samples were tested with a confirmatory neutralization assay- Hepanostika®HBsAg Uniform II B9 Confirmatory (Bio-Merieux). The mean age of the pregnant women was 24.85years [range: 15-45years] and the age range of 20-24 (37%) and 25-29 (25.4%) years were the most represented. The overall rate of HBsAg-positive pregnant women with the two screening assays was 20.9%. The HBsAg detection rate was significantly higher with Hepanostika® UniformII B9 (16.9%) than with HBsAg (V2) AxSYM system assay (12.1%), with

Women's sexual health and contraceptive needs after a severe obstetric complication ("near-miss"): a cohort study in Burkina Faso

BACKGROUND: Little is known about the reproductive health of women who survive obstetric complications in poor countries. Our aim was to determine how severe obstetric complications in Burkina Faso affect reproductive events in the first year postpartum. METHODS: Data were collected from a prospective cohort of women who either experienced life threatening (near-miss) pregnancy-related complications or an uncomplicated childbirth, followed from the end of pregnancy to one year postpartum or post-abortum. Documented outcomes include menses resumption, sexual activity resumption, dyspareunia, uptake of contraceptives, unmet needs for contraception and women's reproductive intentions.Participants were recruited in seven hospitals between December 2004 and March 2005 in six towns in Burkina Faso. RESULTS: Reproductive events were associated with pregnancy outcome. The frequency of contraceptive use was low in all groups and the method used varied according to the presence or not of a live baby. The proportion with unmet need for contraception was high and varied according to the time since end of pregnancy. Desire for another pregnancy was highest among near-miss women with perinatal death or natural abortion. Women in the near-miss group with induced abortion, perinatal death and natural abortion had significantly higher odds of subsequent pregnancy. Unintended pregnancies were observed mainly in women in the near-miss group with live birth and the uncomplicated delivery group. CONCLUSIONS: Considering the potential deleterious impact (on health and socio-economic life) of new pregnancies in near-miss women, it is important to ensure family planning coverage includes those who survive a severe complication

A new approach to prevent, diagnose, and treat hepatitis B in Africa

There are 82 million people living with hepatitis B (PLWHB) in the World Health Organization Africa region, where it is the main cause of liver disease. Effective vaccines have been available for over 40 years, yet there are 990,000 new infections annually, due to limited implementation of hepatitis B birth dose vaccination and antenatal tenofovir prophylaxis for highly viraemic women, which could eliminate mother-to-child transmission. Despite effective and cheap antiviral treatment which can suppress hepatitis B virus replication and reduce the risk of hepatocellular carcinoma (HCC), < 2% of PLWHB are diagnosed, and only 0.1% are treated. As a result, PLWHB are frequently diagnosed only when they have already developed decompensated cirrhosis and late-stage HCC, and consequently 80,000 hepatitis B-associated deaths occur each year. Major barriers include complex treatment guidelines which were derived from high-income settings, lack of affordable diagnostics, lack or insufficient domestic funding for hepatitis care, and limited healthcare infrastructure. Current treatment criteria may overlook patients at risk of cirrhosis and HCC. Therefore, expanded and simplified treatment criteria are needed. We advocate for decentralized community treatment programmes, adapted for low-resource and rural settings with limited laboratory infrastructure. We propose a strategy of treat-all except patients fulfilling criteria that suggest low risk of disease progression. Expanded treatment represents a financial challenge requiring concerted action from policy makers, industry, and international donor agencies. It is crucial to accelerate hepatitis B elimination plans, integrate hepatitis B care into existing healthcare programmes, and prioritize longitudinal and implementation research to improve care for PLWHB

How to strengthen a health research system: WHO's review, whose literature and who is providing leadership?

Background Health research is important for the achievement of the Sustainable Development Goals. However, there are many challenges facing health research, including securing sufficient funds, building capacity, producing research findings and using both local and global evidence, and avoiding waste. A WHO initiative addressed these challenges by developing a conceptual framework with four functions to guide the development of national health research systems. Despite some progress, more is needed before health research systems can meet their full potential of improving health systems. The WHO Regional Office for Europe commissioned an evidence synthesis of the systems-level literature. This Opinion piece considers its findings before reflecting on the vast additional literature available on the range of specific health research system functions related to the various challenges. Finally, it considers who should lead research system strengthening. Main text The evidence synthesis identifies two main approaches for strengthening national health research systems, namely implementing comprehensive and coherent strategies and participation in partnerships. The literature describing these approaches at the systems level also provides data on ways to strengthen each of the four functions of governance, securing financing, capacity-building, and production and use of research. Countries effectively implementing strategies include England, Ireland and Rwanda, whereas West Africa experienced effective partnerships. Recommended policy approaches for system strengthening are context specific. The vast literature on each function and the ever-growing evidence-base are illustrated by considering papers in just one key journal, Health Research Policy and Systems, and analysing the contribution of two national studies. A review of the functions of the Iranian system identifies over 200 relevant and mostly national records; an analysis of the creation of the English National Institute for Health Research describes the key leadership role played by the health department. Furthermore, WHO is playing leadership roles in helping coordinate partnerships within and across health research systems that have been attempting to tackle the COVID-19 crisis. Conclusions The evidence synthesis provides a firm basis for decision-making by policy-makers and research leaders looking to strengthen national health research systems within their own national context. It identifies five crucial policy approaches — conducting situation analysis, sustaining a comprehensive strategy, engaging stakeholders, evaluating impacts on health systems, and partnership participation. The vast and ever-growing additional literature could provide further perspectives, including on crucial leadership roles for health ministries.Health Evidence Network Evidence Synthesis; NIH

From evaluating skilled care initiative in rural Burkina Faso to policy implications for safe motherhood in Africa

The definitive version is available at www3.interscience.wiley.comEvaluation findings from a particular setting need to be generalized into policy implications if they are to find widespread use. Skilled attendance at delivery is widely regarded as one of the most important intervention strategies for safe motherhood in low-resource settings, particularly in Africa, but implementations of such strategies are often not rigorously evaluated or interpreted into future policy. Initiative for Maternal Mortality Programme Assessment (Immpact) has applied a package of research-based monitoring and evaluation tools to assess the Family Care International Skilled Care Initiative in Ouargaye District, Burkina Faso. This evaluation research aimed to generate reliable, evidence-based policies for accelerating safe motherhood programmes in Burkina Faso and elsewhere in Africa. Five policy priorities were identified as representing real chances of improving the safety of motherhood: (1) enhancing national coverage of delivery by professionally skilled attendants; (2) to provide a network of 24-h basic emergency obstetric care within 5 km; (3) to have an effective referral system, equipped and resourced to undertake a reasonable number of Caesarean sections; (4) to promote community mobilization activities as a lever to increasing delivery care utilization; and (5) to implement strategies to remove financial barriers to delivery care. To meet Millennium Development Goal five by 2015, both supply and demand side constraints on the provision of quality maternity care have to be addressed, which in turn need greater political commitment and funding