Knowledge, practices and beliefs of students regarding health effects of shisha use in Ouagadougou, Burkina Faso: A cross‐sectional study

Background. The tobacco epidemic is one of the biggest public health threats the world has ever faced. Shisha use has recently been gaining increased popularity in many developed and developing countries. Objective. To determine the prevalence of shisha use among students in Ouagadougou, Burkina Faso, and associated knowledge, smoking practices and beliefs about health effects. Method. A total of 443 students were selected for this cross-sectional study, using a stratified sampling method. Data on shisha use, knowledge about shisha, shisha smoking practices, and factors associated with use of shisha were collected via a questionnaire. The association between the independent variables and shisha use was assessed using a χ2 test (p<0.05). Binary logistic regression analysis was used to determine variables that were independently associated with shisha smoking. Results. Of the 421 respondents, 162 (38.5%) indicated that they had smoked shisha; 14.0% were regular smokers. We found that 183 students (43.5%) had poor knowledge about the health effects of shisha. The main reasons for shisha smoking were being in the company of friends who were users (57.4%), the pleasant flavour and fragrance of shisha (25.9%), and fashion (22.2%). Ninety-nine shisha smokers (61.1%) also consumed alcohol. Factors associated with shisha smoking included age <20 years (p<0.001), gender (p=0.034), and educational level of the respondent’s father (p=0.0001) and mother (p=0.0004). Conclusion. We found a relatively high prevalence of shisha smoking among the students, and that 43.5% of them had poor knowledge about its effects on health. Developing surveillance, intervention and regulatory/policy frameworks specific to shisha has become a public health priority

Tabagisme et dysfonction erectile chez les personnes vivant avec le VIH au CHU Yalgado Ouedraogo (Burkina Faso)

La dysfonction erectile (DE) est un probleme de sante publique qui altere la qualite de vie des patients. Chez les personnes infectees par le VIH, le tabagisme en association ii d'autres facteurs pourrait accroitre le risque de survenue de ce trouble. L'objectif de cette etude est de determiner la prevalence de laDE, les facteurs associes chez les fumeurs infectes par le VIH. Une etude transversale a ete menee a l'Hopital de jour du Centre Hospitalier Universitaire Yalgado Ouedraogo durant six mois. Les patients declarant etre incapables, depuis au moins trois mois, d' obtenir ou de maintenir une erection suffisante au cours de 1' activite sexuelle ont ete consideres comme souffrant de DE. Une regression logistique a ete realisee afin de determiner les facteurs associes. Nous avons inclus 104 patients  tabagiques. La prevalence de laDE etait de 55,8 %. L'age moyen de ces patients etait de 44,6 ± 7,6 ans. En analyse univariee les troubles anxio-depressifs (p = 0,017), le surpoids (p = 0,024), la dependance nicotinique (p = 0,031) et le nombre de cigarettes fumees par jour (p = 0,013) etaient associes ii la survenue de DE. La prevalence de la DE est elevee chez les personnes infectees par le VIH. Les troubles psychologiques et le tabac constituent des facteurs de risques non negligeables dans la survenue de cette pathologie, d'ou la necessite de leur prise en charge.Mots-cles : dysfonction erectile, tabagisme, infection ii VIH.Smoking and erectile dysfunction between people living with the HIV in the CHU Yalgado Ouedraogo The erectile dysfunction is a problem of public health which alters the quality of life of the patients For people infected by the HIV, smoking in association with other factors could increase the risk of arisen this disorder The objective of this study is to determine prevalence of erectile dysfunction and others factors associated between smokers infected by the HIV. A transverse study was led to the Day hospital of the University hospital Y algado Ouedraogo for six months. The declaring patients to be incapable, for at least three months, to obtain or to maintain a sufficient erection during the sexual activity were considered as suffering of erectile dysfunction. A logistic regression was realized to determine the associated factors. We included 104 smoking patients. Prevalence of erectile dysfunction was 55,8 %. The average age of these patients was of 44,6 ± 7,6 years. In univariate analysis the anxious and depressive disorders p = 0,017), the overweight (p = 0,024), the nicotine dependence (p = 0,031) and the number of cigarettes smoked a day (p = 0,013) were associated to the arisen of erectile dysfunction. Prevalence of erectile dysfunction is high between people infected by the mv. The psychological disordersand the tobacco constitute significant risk factors in the arisen of this pathology, which is necessary to be care.Keywords: Erectile dysfunction, smoking, lllV infection

Profil des sensibilisations aux pneumallergènes courants chez les patients asthmatiques à Bobo-Dioulasso, Burkina Faso

Dans le but d’améliorer la qualité de la prise en charge des patients asthmatiques, nous avons étudié le profil des sensibilisations aux pneumallergènes courants chez les sujets asthmatiques reçus en consultation de pneumologie à Bobo-Dioulasso, Burkina Faso. Nous avons réalisé une étude prospective portant sur 896 patients asthmatiques reçus de janvier 2005 à décembre 2012. La recherche de  sensibilisations a été réalisée grâce aux prick-tests cutanés effectués sur l’avant-bras avec des extraits allergéniques standardisés des Laboratoires Stallergènes- France. Sept cent quatre vingt et un (781) patients, soit 87,1% des patients, ont présenté des réactions positives aux pneumallergènes testés. Chez ces sujets atopiques, les sensibilisations aux allergènes d’acariens ont été les plus fréquentes (87,3 %) dont 91 % à Dermatophagoides ptéronyssinus, 89 % à  Dermatophagoides farinae et 51 % à Blomia topicalis. Les sensibilisations aux allergènes de blattes germaniques ont été de 38,1 %. Les moisissures ont été responsables de sensibilisation chez 37 % des patients atopiques : Aspergillus 22 % et Alternaria, 15 %. Des réactions positives aux phanères de chat (14 %), de chien (10,8 %), au latex (7,9 %) et de la souris (1,4 %) ont été également rencontrées. Les sources allergéniques identifiées pourraient être des facteurs déclenchant ou aggravant l’asthme en raison du lien démontré entre sensibilisations et risque d’asthme dans plusieurs études. La mise en évidence de l’atopie ouvre la voie à une meilleure prise en charge de ces patients.Mots-clés : Sensibilisation, Pneumallergènes perannuels, Asthme, Bobo-Dioulasso (Burkina Faso).In order to improve the quality of care for asthmatic patients, we studied the profile of sensitization to aeroallergens in asthmatic subjects received in the teaching hospital (pulmonology unit) of Bobo-Dioulasso, Burkina Faso. We performed a prospective study of 896 patients with asthma, received from January 2005 to December 2012. A skin prick test was performed. Seven hundred eighty-one patients (87.1%) showed positive reactions to aeroallergens tested. Amongthese atopic patients, sensitization to mite allergens was the most frequent (87.3%), followed by those to cockroach allergens (38.1%) and molds (37%). Positive reactions to cat allergen (14%), dog (10.8%), latex (7.9%) and mouse (1.4%) were also observed. The allergenic sources identified are factors triggering or aggravating asthma, as demonstrated by several studies. Identification of atopy is a great step of these patients asthma management.Keywords: Sensitization, per annual aeroallergens, asthma, Bobo-Dioulasso (Burkina Faso)

Le diagnostic des pleurésies malignes : peut-on se contenter de la cytologie dans un pays à ressources limitées ?

Nous avons mené cette étude dans le but d’analyser les performances de la cytologie du liquide pleural dans le diagnostic des pleurésies malignes à Ouagadougou. Il s’est agi d’une étude rétrospective sur la base de dossiers de patients reçus dans trois formations sanitaires de la ville de Ouagadougou du 1er août 2009 au 30 juillet 2015. Ont été inclus les cas de pleurésies malignes prouvées ainsi que les cas de pleurésies d’origine très probablement maligne. Quatre-vingts dossiers ont été retenus. Le taux de positivité de la cytologie était de 55%, contre 36,9% de positivité à l’histologie. Le cancer du poumon a été le plus souvent à l’origine des pleurésies néoplasiques (27,5%) suivi du cancer du sein (18,7%). Il y avait concordance entre l’histologie de la tumeur primitive et le compte rendu de la cytologie pleurale dans 12 cas. La biopsie pleurale à l’aveugle a permis le diagnostic de pleurésie maligne dans 36,1% des cas de cytologie négative. La survie des patients était indépendante de la positivité de la cytologie. Dans notre contexte de pays à ressources limitées, la cytologie du liquide pleurale reste incontournable, mais sa sensibilité pourrait être améliorée par le respect des recommandations en matière de bonnes pratiques.Mots-clés : Pleurésie malignes, cytologie, cancer, Ouagadougo

Changes in body mass index and hemoglobin concentration in breastfeeding women living with HIV with a CD4 count over 350: Results from 4 African countries (The ANRS 12174 trial)

Introduction: Breastfeeding is recommended for infants born to HIV-infected women in low-income settings. Both breastfeeding and HIV-infection are energy demanding. Our objective was to explore how exclusive and predominant breastfeeding changes body mass index (BMI) among breastfeeding HIV1-positive women participating in the ANRS12174 trial (clinical trial no NCT0064026). Methods: HIV-positive women (n = 1 267) with CD4 count >350, intending to breastfeed HIV-negative infants were enrolled from Burkina Faso, South Africa, Uganda and Zambia and counselled on breastfeeding. N = 1 216 were included in the analysis. The trial compared Lamivudine and Lopinavir/Ritonavir as a peri-exposure prophylaxis. We ran a linear mixed-effect model with BMI as the dependent variable and exclusive or predominant breastfeeding duration as the key explanatory variable. Results: Any breastfeeding or exclusive/predominant) breastfeeding was initiated by 99.6% and 98.6% of the mothers respectively in the first week after birth. The median (interquartile range: IQR) duration of the group that did any breastfeeding or the group that did exclusive /predominant breastfeeding were 9.5 (7.5; 10.6) and 5.8 (5.6; 5.9)) months, respectively. The median (IQR) age, BMI, CD4 count, and HIV viral load at baseline (day 7) were 27 (23.3; 31) years, 23.7 (21.3; 27.0) kg/m2, 530 (432.5; 668.5) cells/μl and 0.1 (0.8; 13.7)1000 copies/mL, respectively. No major change in mean BMI was seen in this cohort over a 50-week period during lactation. The mean change between 26 and 50 weeks after birth was 0.7 kg/m2. Baseline mean BMI (measured on day 7 postpartum) and CD4 count were positively associated with maternal BMI change, with a mean increase of 1.0 kg/m2 (0.9; 1.0) per each additional baseline-BMI kilogram and 0.3 kg/m2 (0.2; 0.5) for each additional CD4 cell/μl, respectively. Conclusion: Breastfeeding was not negatively correlated with the BMI of HIV-1 infected Sub-Saharan African mothers. However, a higher baseline BMI and a CD4 count >500 cells/μl were associated with maternal BMI during the exclusive/ predominant breastfeeding period. Considering the benefits of breast milk for the infants and the recurrent results from different studies that breastfeeding is not harmful to the HIV-1-infected mothers, this study also supports the WHO 2016 guidelines on infant feeding that mothers living with HIV should breastfeed where formula is not safe for at least 12 months and up to 24 months, given that the right treatment or prophylaxis for the infection is administered. These findings and conclusions cannot be extrapolated to women who are immune-compromised or have AIDS