Comparative Assessment of Health Workers Performance and The Performance Factors at Primary, Secondary and Tertiary Hospitals in Kwara State, Nigeria

L’objectif de cette étude est de décrire les aspects épidémiologiques, cliniques et paracliniques de l’hépatite virale découverte chez les donneurs de sang de Ouagadougou. Il s’est agi d’une étude prospective qui s’est déroulée du 18/10/2010 au 18/06/2011 chez les donneurs de sang de la ville de Ouagadougou. Le critère de sélection était antigène HBs (AgHBs) positif à l’issue d’un don de sang au Centre national de Transfusion Sanguine (CNTS). La prévalence du portage de l’Ag HBs chez les nouveaux donneurs de sang était de 7,06 %. L’âge moyen des patients était de 26,3 ans avec des extrêmes de 20 et 51 ans. Le sexratio était de 3,2. Les étudiants (42,10 %) et les élèves (23,70 %) étaient les plus représentés. La majorité des donneurs (77,63 %) ne présentaient aucun signe clinique. Le bilan biologique ainsi que l’échographie hépatique étaient normaux respectivement chez 89,13 % et 93,47 % des donneurs. La sérologie complète du VHB a mis en évidence une absence de stigmate de réplication virale chez 86,11 % des donneurs. L’hépatite virale B de découverte fortuite chez le donneur de sang est une affection asymptomatique. Des explorations mieux approfondies demeurent nécessaires pour déterminer le caractère actif ou non de cette affection ainsi que pour un meilleur suivi des donneurs.Mots-clés : antigène HBs, hépatite virale B, donneur de sang, découverte fortuite

Residual risk of hepatitis B virus transmission through blood donations in Burkina Faso screened with rapid diagnostic tests

Abstract Background and Aims hepatitis B virus (HBV), hepatitis C virus (HCV), and human immunodeficiency virus (HIV) represent the major transfusion–transmissible pathogens worldwide. The risk of transmission is relatively high in African countries, mainly due to unreliable screening methods of blood donations. In Burkina Faso, predonation screening using rapid diagnostic tests (RDTs) is widespread, raising the major question of the transfusion safety in the country. The objective of this study was to assess the risk of transmission of HBV, HCV, and HIV through blood transfusion in the context of the use of RDTs for screening of the blood donations. Methods In this cross‐sectional study, a total of 417 serum samples obtained from blood donors tested negative for HBsAg, anti‐HCV, and anti‐HIV using RDTs were retested for the same markers using chemiluminescent immunologic assays. Total antibodies to HBV core (anti‐HBc) were tested on randomly selected samples. HBV‐DNA and HCV‐RNA viral loads (VLs) were quantified on HBsAg and anti‐HCV positive samples, respectively. To assess possible occult hepatitis B infection (OBI), HBV‐DNA‐VL was quantified on 313 randomly selected HBsAg‐negative samples. Results HBsAg and anti‐HCV were found respectively in 6 (6/417; 1.4%) and 11 (11/417; 2.6%) samples. No samples were reactive for anti‐HIV. Total anti‐HBc were detected in 217 out of the 319 randomly selected samples (217/319; 68.02%). HBV‐DNA was detected in four (4/313; 1.27%) samples, including two (2/6; 33.33%) of the six HBsAg positive samples and two (2/313; 0.6%) of the HBsAg‐negative samples, suggesting two cases of occult HBV infection. All anti‐HCV antibody‐positive samples were HCV‐RNA negative. Conclusion This study shows that RDTs are not sufficiently sensitive for the screening of blood donations. Our results highlight the urgent need to think about the extension of sensitive immunological tests in all blood transfusion centers and also the implementation of nucleic acid amplification techniques

Malaria positivity following a single oral dose of azithromycin among children in Burkina Faso: a randomized controlled trial.

BackgroundAzithromycin is a broad-spectrum antibiotic that has moderate antimalarial activity and has been shown to reduce all-cause mortality when biannually administered to children under five in high mortality settings in sub-Saharan Africa. One potential mechanism for this observed reduction in mortality is via a reduction in malaria transmission.MethodsWe evaluated whether a single oral dose of azithromycin reduces malaria positivity by rapid diagnostic test (RDT). We conducted an individually randomized placebo-controlled trial in Burkina Faso during the high malaria transmission season in August 2020. Children aged 8 days to 59 months old were randomized to a single oral dose of azithromycin (20 mg/kg) or matching placebo. At baseline and 14 days following treatment, we administered a rapid diagnostic test (RDT) to detect Plasmodium falciparum and measured tympanic temperature for all children. Caregiver-reported adverse events and clinic visits were recorded at the day 14 visit.ResultsWe enrolled 449 children with 221 randomized to azithromycin and 228 to placebo. The median age was 32 months and 48% were female. A total of 8% of children had a positive RDT for malaria at baseline and 11% had a fever (tympanic temperature ≥ 37.5 °C). In the azithromycin arm, 8% of children had a positive RDT for malaria at 14 days compared to 7% in the placebo arm (P = 0.65). Fifteen percent of children in the azithromycin arm had a fever ≥ 37.5 °C compared to 21% in the placebo arm (P = 0.12). Caregivers of children in the azithromycin group had lower odds of reporting fever as an adverse event compared to children in the placebo group (OR 0.41, 95% CI 0.18-0.96, P = 0.04). Caregiver-reported clinic visits were uncommon, and there were no observed differences between arms (P = 0.32).ConclusionsWe did not find evidence that a single oral dose of azithromycin reduced malaria positivity during the high transmission season. Caregiver-reported fever occurred less often in children receiving azithromycin compared to placebo, indicating that azithromycin may have some effect on non-malarial infections. Trial registration Clinicaltrials.gov NCT04315272, registered 19/03/2020