Reporting Caesarean Delivery in district hospitals in Ouagadougou Using the Robson Classification System

The aim of this study was to provide a description of caesarean section rates in district hospitals in Ouagadougou according to Robson's classification. Delivery data were collected over a 6 months period in the three public district hospitals in Ouagadougou. We reported the relative size of each Robson group, the caesarean section rate in each group, and the absolute and relative contributions of each group to the overall caesarean section rate. A total of 5111 deliveries were recorded, of which 1248 were by caesarean section, giving a global caesarean section rate of 24.41%. According to Robson's classification, the main contributors to the overall rate of caesarean section were multiparous women with a singleton fetus in cephalic presentation at term and a previous caesarean section ( group 5) with a relative contribution of 27.64%. The other contributors were women without previous uterine scar, at term in spontaneous labour , with a single foetus in cephalic presentation (group 1: nulliparous and group 3: multiparous) with relative contributions of 19.87% and 12.09 % respectively for group 1 and group 3. These three groups represented 60% of the total caesarean sections. Our results indicate that in district hospitals in Ouagadougou, the practice of caesarean section for women in groups 1, 3 and 5 should be given special attention.Keywords: caesarean section, Robson classification, Ouagadougou, Burkina Faso

Mycobacterium bovis in Burkina Faso : epidemiologic and genetic links between human and cattle isolates

Background: In sub-Saharan Africa, bovine tuberculosis (bTB) is a potential hazard for animals and humans health. The goal of this study was to improve our understanding of bTB epidemiology in Burkina Faso and especially Mycobacterium bovis transmission within and between the bovine and human populations. Methodology/principal findings: Twenty six M. bovis strains were isolated from 101 cattle carcasses with suspected bTB lesions during routine meat inspections at the Bobo Dioulasso and Ouagadougou slaughterhouses. In addition, 7 M. bovis strains were isolated from 576 patients with pulmonary tuberculosis. Spoligotyping, RDAf1 deletion and MIRU-VNTR typing were used for strains genotyping. The isolation of M. bovis strains was confirmed by spoligotyping and 12 spoligotype signatures were detected. Together, the spoligotyping and MIRU-VNTR data allowed grouping the 33 M. bovis isolates in seven clusters including isolates exclusively from cattle (5) or humans (1) or from both (1). Moreover, these data (genetic analyses and phenetic tree) showed that the M. bovis isolates belonged to the African 1 (Af1) clonal complex (81.8%) and the putative African 5 (Af5) clonal complex (18.2%), in agreement with the results of RDAf1 deletion typing. Conclusions/Significance: This is the first detailed molecular characterization of M. bovis strains from humans and cattle in Burkina Faso. The distribution of the two Af1 and putative Af5 clonal complexes is comparable to what has been reported in neighbouring countries. Furthermore, the strain genetic profiles suggest that M. bovis circulates across the borders and that the Burkina Faso strains originate from different countries, but have a country-specific evolution. The genetic characterization suggests that, currently, M. bovis transmission occurs mainly between cattle, occasionally between cattle and humans and potentially between humans. This study emphasizes the bTB risk in cattle but also in humans and the difficulty to set up proper disease control strategies in Burkina Faso