Opportunity Costs of Having a Child, Financial Constraints and Fertility.

Economic theory often assumes that the opportunity costs of having a child and financial constraints have a simultaneous but opposite influence on fertility. This empirical paper aims to test the concomitance of these effects using the answers to an original survey carried out in 2003 amongst nearly 1,000 French employees, giving information about the impact of their working schedule on the number of children they intend to have. The statistical analysis, based on a "ceteris paribus" approach using Log it estimates, strongly confirms the simultaneous presence of these two explanatory dimensions.Family Size ; Fertility ; Work-Life Balance

Polyphenolic composition of Lantana camara and Lippia chevalieri, and their Antioxidant and Antimicrobial Activities

In the present study, the antioxidant and antibacterial activities of methanolic extracts of two Verbenaceae (Lantana camara L. and Lippia chevalieri Moldenke: aerial part) were investigated. Their polyphenolic composition in the ethyl acetate and aqueous fractions were characterized by HPLC-DAD. The antioxidant capability of the methanolic extracts was assessed by the Ferric Reducing Antioxidant Power (FRAP) and the scavenging activity of the free radical 2,2-diphenyl-1-picrylhydrazyl (DPPH). The Minimum Inhibitory Concentrations (MIC) of the methanolic extracts (25 µg mL-1), and the minimum bactericidal concentrations (MBC) (12.5 µg mL-1) against 13 pathogenic bacteria and four serotyped bacteria from the American Type Culture Collection (ATCC) were also determined by the agar-well diffusion method. The results indicated that the L. chevalieri extracts are rich in phenolic compounds (among the 27 polyphenolic compounds detected, 20 belong to L. chevalieri) and showed the highest antioxidant activities, simultaneously on iron (III) to iron (II)-reducing activity and the radical scavenging activity. However, L. camara displayed the best and the broadest antimicrobial spectrum, especially on Shigella flexneri and Pantoea sp. (two Gram-negative strains of bacteria). The nature of polyphenolics compounds detected (phenol acid and flavone) in the L. camara can justify this activity.Key words: Verbenaceae, HPLC-DAD, antioxidant activity, antimicrobial activity, polyphenolic compound

Patients infected by tuberculosis and human immunodeficiency virus facing their disease, their reactions to disease diagnosis and its implication about their families and communities, in Burkina Faso: a mixed focus group and cross sectional study

BACKGROUND: Patients facing tuberculosis (TB) and human immunodeficiency virus (HIV) infection receive particular care. Despite efforts in the care, misconceptions about TB and HIV still heavily impact patients, their families and communities. This situation severely limits achievement of TB and HIV programs goals. This study reports current situation of TB patients and patients living with HIV/AIDS (PLWHA) facing their disease and its implications, by comparing results from both qualitative and quantitative study design. METHODS: Cross sectional study using mixed methods was used and excluded patients co-infected by TB and HIV. Focus group included 96 patients (6 patients per group) stratified by setting, disease profile and gender; from rural (Orodara Health District) and urban (Bobo Dioulasso) areas, all from Hauts-Bassins region in Burkina Faso. Quantitative study included 862 patients (309 TB patients and 553 PLWHA) attending TB and HIV care facilities in two main regions (Hauts-Bassins and Centre) of Burkina Faso. RESULTS: A content analysis of reports found TB patients and PLWHA felt discriminated and stigmatized because of misconceptions with its aftermaths (rejection, emotional and financial problems), mainly among PLWHA and women patients. PLWHA go to healers when facing limited solutions in health system. There are fewer associations for TB patients, and less education and sensitization sessions to give them opportunity for sharing disease status and learning from other TB patients. TB patients and PLWHA still need to better understand their disease and its implication. Access to care (diagnosis and treatment) remains one of the key issues in health system, especially for PLWHA. Individual counseling is centered among PLWHA but not for TB patients. With research progress and experiences sharing, TB patients and PLWHA have some hope to implement their life project, and to receive psychosocial and nutritional support. CONCLUSION: Despite international aid, TB patients and PLWHA are facing misconceptions effects. There is a need to reinforce health education towards patients and healers, inside community, health centers and associations, and for specific settings. International aid must be adapted to specific targets and strategies implementing programs. Maintaining psychosocial and nutritional support is crucial for better outcomes of medication adherence. Individual counseling has to be centered among TB patients and PLWHA

Rôles,impacts et services issus des élevages en Europe. Synthèse du rapport d’expertise scientifique collective

L’élevage, secteur majeur pour l’économie de nombreux territoires et structurant beaucoup de paysages ruraux européens, fait l’objet de controverses, depuis au moins une décennie, notamment du fait des dommages environnementaux qu’il engendre. Dans un tel contexte, il est apparu nécessaire d’étayer les débats en faisant le point sur l’état des connaissances scientifiques relatives aux rôles, impacts et services environnementaux, économiques et sociaux issus des élevages européens et leurs produits. Pour ce faire, les ministères français en charge de l’Environnement et de l’Agriculture ainsi que l’Agence de l’environnement et de la maîtrise de l’énergie (Ademe) ont sollicité l’Inra pour réaliser une expertise scientifique collective (ESCo) abordant conjointement les multiples conséquences sur les milieux et le climat, l’emploi et le travail, les marchés et certains enjeux sociaux et culturels, de la production et de la consommation humaine de produits d’origine animale (bovins, ovins, caprins, porcins et avicoles). L’analyse de ces diverses dimensions s’appuie sur les démarches d’évaluation rapportées dans la littérature scientifique internationale. Abordées, dans un premier temps, de manière analytique et globale, les connaissances ont ensuite été mobilisées par « bouquet de services » au sein de territoires contrastés. Les relations entre les différents impacts ou services permettent d’identifier des compromis et des leviers d’action envisageables pour les systèmes d’élevage. Livestock production is a sector of major economic importance that defines many European rural areas. It has become the focus of controversy over the past decade or more, particularly with regard to the environmental impacts it causes. In this context, it seemed useful to support this debate with a critical review of the state of scientific knowledge on the role, impacts, and services – environmental, economic, and social – associated with European livestock production. Accordingly, the French ministries responsible for Agriculture and the Environment, in cooperation with the French Environment and Energy Management Agency (ADEME), requested INRA to undertake a collective scientific assessment addressing the many consequences – for the environment and the climate, for employment and labor, for markets, and for a variety of social and cultural issues – related to the production and human consumption of animal products (cattle, sheep, goats, pigs, and poultry). Analysis of these diverse dimensions was based on assessment methods utilized and described in the international scientific literature. Using a broad, analytical overview as a starting point, the review proceeded by identifying the "service bundles" associated with livestock production in contrasting areas

Potentially inappropriate medication among community-dwelling older adults : A public health issue in Burkina Faso

PIM is defined as a lack of demonstrated indication, high risk of side effects, and a sub-optimal cost effectiveness and/or cost benefit. Little data on potentially inappropriate medications (PIM) in older adults with comorbidity are available in sub-Saharan Africa. The aim of this study was to assess the prevalence and the factors associated with the use of PIM in community-dwelling older adults in Burkina Faso. In 2012, we did a cross-sectional household survey which included 389 older adults in Bobo-Dioulasso. Updated 2012 Beers criteria were used to assess the PIM in older adults aged ≥ 60 years. Medications from formal medical source (prescribing) and informal source (informal market, over-the counter and traditional medicines) were included. A multivariate analysis was performed to determine factors associated with the use of PIM. Proportion of older adults used at least one PIM was 59% (196/332). The most common PIM were traditional medicines 28.97% (62/214), diclofenac 21.03% (45/214) 17.5% (45/214), ibuprofen 7.76% (38/214), aspirin 7.01% (15/214), nifedipine 5.61% (12/214) and reserpine 5.61% (12/214). Polypharmacy (≥ 3 drugs), is the independent factor associated with PIM. Our findings highlight the need to think about integrated health care system in order to reduce the PIM among older adults with multiple comorbidities..Keywords: potentially inappropriate medication, older adults, comorbidit

Intérêts de l’examen du fond d’œil en pratique de ville: bilan de 438 cas

L'examen du fond d'œil fait partie du bilan de nombreuses maladies générales en dehors de l'ophtalmologie. L'objectif de notre travail était d'étudier les aspects cliniques et épidémiologiques des patients adressés pour un fond d'œil afin de montrer l'intérêt de cet examen. Il s'est agi d'une étude rétrospective descriptive des examens du fond d'œil durant la période de janvier 2011 à décembre 2013 dans un cabinet d'ophtalmologie d'une polyclinique à Bobo Dioulasso. Au cours de la période étudiée, 5942 consultations ont été enregistrées, dont 438 pour fond d'œil soit 7,37%. Il y avait 225 hommes et 213 femmes soit un sex ratio de 1,056. La tranche d'âge 40-59 ans représentait 54%. La fréquence des principaux motifs de la demande était l'hypertension artérielle 43,15% (N=189), le diabète 39,04% (N=171), l'association HTA et diabète 10,27% (N=45), et la drépanocytose 7,53% (N=33). Le fond d'œil était anormal chez 175 patients soit 36,23%. La rétinopathie hypertensive était retrouvée dans 42,73% des cas, la rétinopathie diabétique 25,92%, et la rétinopathie drépanocytaire 7,53%. L'examen du fond d'œil en médecine de ville présente un intérêt majeur, et permet de retrouver des anomalies chez plus d'un tiers des patients

Méthodes pour cartographier les tendances régionales de la prévalence du VIH à partir des enquêtes démographiques et de santé (EDS)

For many countries, in particular in sub-Saharan Africa, Demographic and Health Surveys (DHS) are the main estimates of HIV prevalence at national levels in general population. Several DHS collect longitude and latitude of surveyed clusters.In this paper, we present three methodological approaches for mapping spatial variations of HIV prevalence from DHS. These approaches are applied to DHS simulation sampled from a model country. The estimated surfaces are then compared with the initial surface of the model.We show that a method using kernel estimators with adaptive bandwidths of the same number of observed people allows estimating main regional trends of the epidemics. Its application to data from 2003 DHS of Burkina Faso give a plausible picture of the epidemiological situation in this country

Direct cost of care for hypertensive patients in Burkina Faso

In Burkina Faso, the high blood pressure represents the first cardiovascular risk factor. Few data are available about the costs paid by hypertensive patients for public policies guidance. This study aimed to estimate the direct average cost for hypertensive patient care according to their income in urban area in Burkina Faso. In 2015, from January to December, we performed across-sectional study in the different levels of health care system in Bobo-Dioulasso. Study included hypertensive patients (more than 18 years old) who are regularly followed-up for at least twelve months and without complication of hypertension. We carried outa randomcluster sampling with a consecutive recruitment of the patients. One-way-ANOVA test was performed to compare the monthly average income and the direct average cost for hypertensive patient care. One hundred and fifty six (156) non-complicated hypertensive patients were included. The direct average cost was of 74 626.9 FCFA per patient-year (138 USD), IC95% [66 303.4 FCFA (123 USD) – 82 950.3 FFA (154 USD)] patient-year, corresponding to 6219 FCFA (11.5USD) per patient-month. The drugs represented 66.9% of the wholetotal costs. The monthly low income was associated with the high direct average cost for hypertensive patient care. Free health care policies are implementing in West Africa. Considering equity of access to health care by poorest, a subsidy of antihypertensive drug could be a great opportunity to reduce financial barrier to care for hypertensive patients, and so, avoiding its complications.Keywords: hypertension, direct cost, income, sub-saharan Africa

Estimating effect of non response on HIV prevalence estimates from Demographic and Health Surveys

In most countries in Sub‐Saharan Africa, Demographic and Health Surveys (DHS) with HIV testing became the only measure of HIV prevalence in general population. Significant non response rates were often cited to explain differences between DHS results and estimations from sentinel surveillance in antenatal clinics. The objective of this paper consists to predict with multivariate models the prevalence of non tested persons in order to estimate the effect of non response on national HIV prevalence measure.We used data from 9 DHS, conducted in sub‐Saharan Africa, where HIV results could be linked with data from household and individual questionnaires. Logistic regressions were performed for each country, separately for men and women 15‐49 years old, with a common set of predictor variables. For each group, adjusted prevalence was calculated by using observed prevalence for tested people and estimated probability to be HIV positive for non tested persons.The non response rates in these 9 studies vary from 7.9% to 39.3%. Estimated prevalence of non tested persons is usually higher than observed prevalence of tested persons (13 groups on 18) Nevertheless, ratios of adjusted prevalence to observed prevalence remain relatively close to 1 (from 0.970 to 1.109). Differences between adjusted and observed prevalence is less than 0.32. A significant negative correlation was found between non‐response rates and ratios of non‐tested to tested, but there is no correlation between ratios of adjusted to observed prevalence and proportions of non‐tested.The overall effect of non response biases on national HIV estimates tends to be small and remains inferior to sample variations. If adjustments need to be interpreted with caution due to the limited information available to predict the prevalence of non tested people, we can conclude that national population‐based surveys can provide quality and representative national HIV prevalence estimates