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

Community implementation of human landing and non-human landing collection methods for Wuchereria bancrofti vectors

In the drive towards elimination of lymphatic filariasis, enhanced surveillance of vector mosquitoes requires sound sampling methods which can be easily implemented and accepted by communities. Several tools have been validated as alternatives to human landing catches (HLC) for this purpose, but little is known about their effectiveness compared to HLC in terms of the vector density patterns. This study aimed at assessing the efficiency of four mosquitoes collecting tools (HLC, Center for Diseases Control (CDC) light trap, Double Net trap, Window Exit trap). These four sampling tools were evaluated in three different villages (Bapla, Ouessa and Koudjo) in Burkina Faso, when mosquito collection was managed by local people in each community. The results showed that HLC remained the most effective collection method in terms of vector abundance in all villages, followed by double net traps. Except in Bapla, the double net trap collected more Anopheles than CDC light traps. Across the study, the prevalence of Wuchereria bancrofti infection was estimated to be 0.6% and observed only in Anopheles gambiae sensu stricto. The Double Net trap is the least expensive of all three methods and was well accepted by the community. In conclusion, double net traps can be recommended for communities to use for lymphatic filariasis (LF) vector surveillance program for xeno-monitoring of post transmission assessment survey evaluation. Based on prevalence the mass drug administration (MDA) could be stopped in these villages without risk of resurgence of the disease, according to the current recommendations of World Health Organization (WHO). Set up surveillance and continue to use vector control tools

Fécondité et scolarisation à Ouagadougou : le rôle des réseaux familiaux

En Afrique subsaharienne, pour alléger la charge d&#8217;une descendance nombreuse, il est courant de considérer la famille élargie comme une ressource. Mais on s&#8217;interroge de plus en plus sur la résistance des solidarités familiales aux changements socioéconomiques en cours. Ces solidarités sont-elles généralisées et assurent-elles un soutien efficace pour la scolarisation des enfants ? Quelles familles en sont bénéficiaires ? Dans cette perspective, Moussa Bougma, Laure Pasquier-Doumer, Thomas K. LeGrand et Jean-François Kobiané examinent le rôle du réseau familial dans la scolarisation des enfants. Ils étudient le cas des quartiers périphériques de la capitale du Burkina Faso pour laquelle ils disposent d&#8217;une enquête rétrospective sur la fécondité, la scolarisation et l&#8217;entraide familiale, adossée à l&#8217;Observatoire de population de Ouagadougou, et montrent notamment que les solidarités familiales de soutien à la scolarisation sont loin d&#8217;être généralisées

Elimination of lymphatic filariasis in west African urban areas: is implementation of mass drug administration necessary?

Lymphatic filariasis in Africa is caused by the parasite Wuchereria bancrofti and remains a major cause of morbidity and disability in 74 countries globally. A key strategy of the Global Programme for the Elimination of Lymphatic Filariasis, which has a target elimination date of 2020, is the treatment of entire endemic communities through mass drug administration of albendazole in combination with either ivermectin or diethylcarbamazine. Although the strategy of mass drug administration in combination with other interventions, such as vector control, has led to elimination of the infection and its transmission in many rural communities, urban areas in west Africa present specific challenges to achieving the 2020 targets. In this Personal View, we examine these challenges and the relevance of mass drug administration in urban areas, exploring the rationale for a reassessment of policy in these settings. The community-based mass treatment approach is best suited to rural areas, is challenging and costly in urban areas, and cannot easily achieve the 65% consistent coverage required for elimination of transmission. In our view, the implementation of mass drug administration might not be essential to interrupt transmission of lymphatic filariasis in urban areas in west Africa. Evidence shows that transmission levels are low and that effective mass drug distribution is difficult to implement, with assessments suggesting that specific control measures against filariasis in such dynamic settings is not an effective use of limited resources. Instead, we recommend that individuals who have clinical disease or who test positive for W bancrofti infection in surveillance activities should be offered antifilarial drugs through a passive surveillance approach, as well as morbidity management for their needs. We also recommend that more precise studies are done, so that mass drug administration in urban areas is considered if sustainable transmission is found to be ongoing. Otherwise, the limited resources should be directed towards other elements of the lymphatic filariasis programme. [Abstract copyright: Copyright © 2018 Elsevier Ltd. All rights reserved.

Transmission assessment surveys (TAS) to define endpoints for lymphatic filariasis mass drug administration: a multicenter evaluation.

BACKGROUND: Lymphatic filariasis (LF) is targeted for global elimination through treatment of entire at-risk populations with repeated annual mass drug administration (MDA). Essential for program success is defining and confirming the appropriate endpoint for MDA when transmission is presumed to have reached a level low enough that it cannot be sustained even in the absence of drug intervention. Guidelines advanced by WHO call for a transmission assessment survey (TAS) to determine if MDA can be stopped within an LF evaluation unit (EU) after at least five effective rounds of annual treatment. To test the value and practicality of these guidelines, a multicenter operational research trial was undertaken in 11 countries covering various geographic and epidemiological settings. METHODOLOGY: The TAS was conducted twice in each EU with TAS-1 and TAS-2 approximately 24 months apart. Lot quality assurance sampling (LQAS) formed the basis of the TAS survey design but specific EU characteristics defined the survey site (school or community), eligible population (6-7 year olds or 1(st)-2(nd) graders), survey type (systematic or cluster-sampling), target sample size, and critical cutoff (a statistically powered threshold below which transmission is expected to be no longer sustainable). The primary diagnostic tools were the immunochromatographic (ICT) test for W. bancrofti EUs and the BmR1 test (Brugia Rapid or PanLF) for Brugia spp. EUs. PRINCIPAL FINDINGS/CONCLUSIONS: In 10 of 11 EUs, the number of TAS-1 positive cases was below the critical cutoff, indicating that MDA could be stopped. The same results were found in the follow-up TAS-2, therefore, confirming the previous decision outcome. Sample sizes were highly sex and age-representative and closely matched the target value after factoring in estimates of non-participation. The TAS was determined to be a practical and effective evaluation tool for stopping MDA although its validity for longer-term post-MDA surveillance requires further investigation

Leveraging human resources for outbreak analysis: lessons from an international collaboration to support the sub-Saharan African COVID-19 response

Emerging infectious diseases are a growing threat in sub-Saharan African countries, but the human and technical capacity to quickly respond to outbreaks remains limited. Here, we describe the experience and lessons learned from a joint project with the WHO Regional Office for Africa (WHO AFRO) to support the sub-Saharan African COVID-19 response. In June 2020, WHO AFRO contracted a number of consultants to reinforce the COVID-19 response in member states by providing actionable epidemiological analysis. Given the urgency of the situation and the magnitude of work required, we recruited a worldwide network of field experts, academics and students in the areas of public health, data science and social science to support the effort. Most analyses were performed on a merged line list of COVID-19 cases using a reverse engineering model (line listing built using data extracted from national situation reports shared by countries with the Regional Office for Africa as per the IHR (2005) obligations). The data analysis platform The Renku Project ( https://renkulab.io ) provided secure data storage and permitted collaborative coding. Over a period of 6&#x2009;months, 63 contributors from 32 nations (including 17 African countries) participated in the project. A total of 45 in-depth country-specific epidemiological reports and data quality reports were prepared for 28 countries. Spatial transmission and mortality risk indices were developed for 23 countries. Text and video-based training modules were developed to integrate and mentor new members. The team also began to develop EpiGraph Hub, a web application that automates the generation of reports similar to those we created, and includes more advanced data analyses features (e.g. mathematical models, geospatial analyses) to deliver real-time, actionable results to decision-makers. Within a short period, we implemented a global collaborative approach to health data management and analyses to advance national responses to health emergencies and outbreaks. The interdisciplinary team, the hands-on training and mentoring, and the participation of local researchers were key to the success of this initiative

TAS sample size by sex for school and community-based surveys.

1<p><i>57 records were missing sex identification data.</i></p

Evaluation Unit key characteristics at time of TAS-1.

<p>Evaluation Unit key characteristics at time of TAS-1.</p