Magnitude and associated factors of latent tuberculosis infection due to Mycobacterium tuberculosis complex among high-risk groups in urban Bobo-Dioulasso, Burkina Faso

Objectives: To determine the prevalence and risk factors for latent tuberculosis infection (LTBI) among three high-risk groups - household contacts of TB index cases, healthcare workers and slaughterhouse workers - in Bobo-Dioulasso, Burkina Faso. Methods: Participants were recruited to this cross-sectional study from March to July 2020 after giving informed consent. Sociodemographic, clinical and biological data were collected using a structured questionnaire. The QuantiFERON-TB Gold Plus test (QFT-Plus) and the tuberculin skin test (TST) were used for detection of LTBI. Bivariate and multivariate logistic regression analyses were performed to identify risk factors for LTBI. Results: The prevalence of LTBI among 101 participants (age range 15-68 years) was 67.33% [95% confidence interval (CI) 57.27-76.33] and 84.16% (95% CI 75.55-90.66) based on QFT-Plus and TST results, respectively. Compared with healthcare workers and household contacts of TB index cases, the prevalence of LTBI among slaughterhouse workers was significantly higher for both QTF-Plus (96.8%; P /=15 years of exposure (AOR 5.617, 95% CI 1.202-32.198), having an animal at home (AOR 2.735, 95% CI 1.102-6.789) and protozoal infection (AOR 2.591, 95% CI 1.034-6.491) were significantly associated with LTBI on the QFT-Plus assay. Conclusion: The prevalence of LTBI was high in all three groups, particularly slaughterhouse workers. The risk factors identified could form the basis of targeted intervention

Determinants of health facility utilization for childbirth in rural western Kenya: cross-sectional study

Background: Skilled attendance at delivery is recognized as one of the most important factors in preventing maternal death. However, more than 50% of births in Kenya still occur in non-institutional locations supported by family members and/or traditional birth attendants (TBAs). To improve this situation, a study of the determinants of facility delivery, including individual, family and community factors, was necessary to consider effective intervention in Kenya.Methods: This study was conducted to identify the factors which influence the place of delivery in rural western Kenya, and to recommend ways to improve women\u27s access to skilled attendants at delivery. A community-based cross-sectional survey was carried out from August to September 2011 in all 64 sub-locations which were covered by community health workers (CHWs). An interviewer-administered questionnaire on seventeen comprehensive variables was administered to 2,560 women who had children aged 12-24 months.Results: The response rate was 79% (n = 2,026). Of the respondents, 48% of births occurred in a health facility and 52% in a non-institutional location. The significant determinants of facility delivery examined using multivariate analysis were: maternal education level, maternal health knowledge, ANC visits, birth interval, economic status of household, number of household members, household sanitation practices and traveling time to nearest health facility.Conclusions: The results suggest that the involvement of TBAs to promote facility delivery is still one of the most important strategies. Strengthening CHWs\u27 performance by focusing on a limited number of topics and clear management guidance might also be an effective intervention. Stressing the importance of regular attendance at ANC (at least four times) would be effective in enhancing motivation for a facility delivery. Based on our findings, those actions to improve the facility delivery rate should focus more on pregnant women who have a low education level, poor health knowledge and short pregnancy spacing. In addition, women with low economic status, a large number of family members and a long distance to travel to a health facility should also be targeted by further interventions

Effect of blood type on anti-a-Gal immunity and the incidence of infectious diseases

The identification of factors affecting the susceptibility to infectious diseases is essential toward reducing their burden on the human population. The ABO blood type correlates with susceptibility to malaria and other infectious diseases. Due to the structural similarity between blood antigen B and Gala1-3GalB1-(3)4GlcNAc-R (a-Gal), we hypothesized that self-tolerance to antigen B affects the immune response to a-Gal, which in turn affects the susceptibility to infectious diseases caused by pathogens carrying a-Gal on their surface. Here we found that the incidence of malaria and tuberculosis, caused by pathogens with a-Gal on their surface, positively correlates with the frequency of blood type B in endemic regions. However, the incidence of dengue fever, caused by a pathogen without a-Gal, was not related to the frequency of blood type B in these populations. Furthermore, the incidence of malaria and tuberculosis was negatively correlated with the anti-a-Gal antibody protective response. These results have implications for disease control and prevention.Peer reviewedVeterinary Pathobiolog

Global respiratory syncytial virus–related infant community deaths

Background Respiratory syncytial virus (RSV) is a leading cause of pediatric death, with >99% of mortality occurring in low- and lower middle-income countries. At least half of RSV-related deaths are estimated to occur in the community, but clinical characteristics of this group of children remain poorly characterized. Methods The RSV Global Online Mortality Database (RSV GOLD), a global registry of under-5 children who have died with RSV-related illness, describes clinical characteristics of children dying of RSV through global data sharing. RSV GOLD acts as a collaborative platform for global deaths, including community mortality studies described in this supplement. We aimed to compare the age distribution of infant deaths <6 months occurring in the community with in-hospital. Results We studied 829 RSV-related deaths <1 year of age from 38 developing countries, including 166 community deaths from 12 countries. There were 629 deaths that occurred <6 months, of which 156 (25%) occurred in the community. Among infants who died before 6 months of age, median age at death in the community (1.5 months; IQR: 0.8−3.3) was lower than in-hospital (2.4 months; IQR: 1.5−4.0; P < .0001). The proportion of neonatal deaths was higher in the community (29%, 46/156) than in-hospital (12%, 57/473, P < 0.0001). Conclusions We observed that children in the community die at a younger age. We expect that maternal vaccination or immunoprophylaxis against RSV will have a larger impact on RSV-related mortality in the community than in-hospital. This case series of RSV-related community deaths, made possible through global data sharing, allowed us to assess the potential impact of future RSV vaccines

Are some women more at risk of obstetric fistula in Uganda? Evidence from the Uganda demographic and health survey

With only four years left for the Millennium Development Goal’s 2015 deadline for reducing poor maternal health outcomes, developing countries are still bearing a huge burden of maternal morbidity worldwide. Estimates show that over 2 million women worldwide are suffering from obstetric fistula, the majority of which live in sub-Saharan Africa, Southeast Asia, and the Arab region. The purpose of this study is to shed a light on obstetric fistula by examining risk factors associated with this morbidity in Uganda. Descriptive and multivariate analyses were conducted using data from the 2006 Uganda Demographic and Health Survey. Older age at first sexual intercourse was significantly associated with a lower risk of obstetric fistula (OR=0.302) compared to younger age at first intercourse (7-14 years). Lack of autonomy was negatively associated with the risk of obstetric fistula; women who have problems securing permission from their husband to go seek care (OR=1.658) were more likely to suffer from this morbidity. Significant differentials in obstetric fistula have also been observed based on the region of residence: women living in Central (OR=4.923), East Central (OR=3.603), West Nile (OR=2.049), and Southwest (1.846) more likely to suffer from obstetric fistula than women living in North Central. Findings demonstrate the importance of improving geographical accessibility to maternal health care services, and emphasize the need to reinforce intervention programs, which seek to address gender inequalities

Proterozoic magmatic events recorded in <SUP>40</SUP>Ar/<SUP>39</SUP>Ar data from the northern part of the Kedougou Kenieba Inlier (eastern Senegal)

International audienceWe present a thermal history of the Kedougou Kenieba Inlier (eastern Senegal), the western-central outcropping part of the West African Craton, based on 40Ar/39Ar analyses performed on hornblende, biotite, and K-feldspar minerals from Paleoproterozoic plutonic rocks. 40Ar/39Ar age spectra obtained for hornblendes and biotites range between 2055 ± 26 and 2028 ± 28 Ma, in very good consistency. They suggest that magmatism in the Kedougou Kenieba Inlier happened at the end of the Eburnean Orogeny (2.25-2.00 Ga). Taking into account previous zircon U-Pb ages, these new results imply that initial cooling from magmatic temperature to about 300 °C (biotite closure temperature) occurred rapidly, and that these rocks did not experience any subsequent re-heating event above 300 °C. On the other hand, 40Ar/39Ar age spectra obtained on K-feldspars display strongly disturbed patterns revealing that these minerals experienced argon loss due to re-heating events. Altogether, these data constrain a thermal history for the studied area involving two thermal events with temperatures around 275 and 225 °C, at about 1750 and 1500 Ma, respectively. These thermal events, previously inferred from U-Pb ages of intruding mafic dykes, can be related to aborted attempts of continental breakup, as the West African Craton remained attached to Baltica and Amazonia cratons during the 1.8-1.3 Ga interval