Teneurs en coumarines de 15 ligneux fourragers du Burkina Faso

Les antinutritionnels ont été le plus souvent ignorés dans l’évaluation de la qualité des fourrages ligneux dont la part augmente continuellement dans le bol alimentaire des ruminants au Burkina Faso. L’objectif de l’étude a été de caractériser et de quantifier les coumarines dans les feuilles et/ou les fruits de 15 ligneux fourragers couramment appétés par les ruminants à Diarabakoko et Dionona. Des tests de caractérisation en tubes ont été réalisés sur les échantillons frais collectés pour détecter la présence des coumarines. Des dosages spectrophotométriques des coumarines ont été également réalisés à partir des extraits frais des échantillons. L’étude a révélé la présence des coumarines chez toutes les espèces à des teneurs oscillant respectivement entre 10,590 ±0,354 et 31,174±0,477 μg EC/g d’extraits frais des feuilles et entre 1,250 ±0,014 et 22,899±0,561 μg EC/g d’extraits frais des fruits (P˂0,05). L’analyse des variances a permis de distinguer 2 classes de teneurs en coumarines des feuilles dont la première a les plus faibles valeurs. Nos résultats constituent des critères supplémentaires pour le choix des ligneux fourragers en aménagement pastoral et en agroforesterie. Ils montrent aussi que le fourrage (feuilles et fruits) des espèces étudiées peut contribuer sans danger à la supplémentation des ruminants. Mots clés : Alimentation, antinutritionnels, fourrage, aménagement pastoral, ruminant

Time to Long-Acting Reversible Contraceptive Uptake Over Twelve Months Postpartum: Findings of the Yam Daabo Cluster Randomized-Controlled Trial in Burkina Faso and the Democratic Republic of the Congo.

Purpose: An earlier adoption of contraceptive methods during the postpartum period could help women to extend the inter-pregnancy interval. This article aimed to determine and compare the timing of long-acting reversible contraceptives (LARC) use (ie, intrauterine device and implant) in Burkina Faso (BF) and DR Congo (DRC) between the intervention and control groups. Patients and Methods: A total of 1120 postpartum women were enrolled and followed up to 12 months postpartum. We used Yam-Daabo trial data which was a multi-intervention, single-blinded, cluster-randomised controlled trial done in primary health-care centres (clusters) in both countries. Centres were randomly allocated to receive the six-component intervention or standard antenatal and postnatal care in matched pairs (1:1). We did a secondary analysis using Royston-Parmar’s semi-parametric model to estimate the effect of the interventions on the median time of LARC uptake. Results: Our analysis included 567 postpartum women in BF (284 in the intervention group and 283 in the control group) and 553 in the DRC (274 in the intervention group and 279 in the control group). After showing an increase in family planning use in these two African countries, Yam Daabo’s interventions showed a reduction of the median time of LARCs adoption in the intervention group compared to the control group in both countries (difference of 39 days in Burkina Faso; difference of 86 days in the DR Congo). Conclusion: The Yam Daabo intervention package resulted in increased and earlier adoption of LARC in rural settings in Burkina Faso and urban settings in DR Congo. Such an intervention could be relevant in similar contexts in Sub-Saharan Africa with very high fertility rates and high unmet needs for contraception

Corrigendum to “Counting adolescents in: the development of an adolescent health indicator framework for population-based settings”

The authors were recently made aware of an oversight such that parts of the text in the Introduction and Methods sections, which describe shortcomings in the existing literature and the methods in this work to identify frameworks and indicators, were missing attribution to published work cited elsewhere in the manuscript. To clarify, we adjust the relevant sections to fully attribute the prior work in three areas, as described below. Underlined text is additional to the original: While both school- and community-based modalities can provide nationally representative data among eligible adolescents, several shortcomings in adolescent health measurement in LMICs were noted by the GAMA Advisory Group (Reference 13 as in the original paper). First, these measurements do not equally cover all adolescent subgroups, with evidence gaps being largest for males, younger adolescents aged 10–14 years, adolescents of diverse genders, ethnicities, and religions, as well as those out of school and migrants. Second, age-disaggregated data are often lacking—due in part to incomplete age coverage—limiting their use for program planning. Third, several aspects of adolescent health are inadequately covered including mental health, substance use, injury, sexual and reproductive health among unmarried adolescents, and positive aspects of adolescent health and well-being. Fourth, the definitions and assessment methods used across adolescent health indicator frameworks are inconsistent. For example, adolescent overweight and obesity—a major cause of non-communicable diseases and a public health risk for future and intergeneration health—is inconsistently captured across indicator frameworks and strikingly absent from the SDGs (Reference 13 as in the original paper). Additional shortcomings include, current adolescent health data systems often lack intersectoral coordination beyond health (e.g., with education, water and sanitation, and social protection systems) and suffer from irregularities in coverage and timing (Reference 6 as in the original paper). Broadly, these indicator frameworks and strategy documents captured disease burden, health risks, and prominent social determinants of health during adolescence. To be congruent with the existing global recommendations and guidelines (References 3–7 as in the original paper) and global measurement efforts (References 10 and 16 as in the original paper), the indicator framework documents had to meet three inclusion criteria, as laid out by the GAMA Advisory Group (Reference 14 as in the original paper): (1) provide recommendations about the measurement of adolescents' health and well-being; (2) include indicators for “adolescents” covering the adolescent age range (10–19 years) in the whole or part; and (3) be global or regional in scope. Using the GAMA's approach (Reference 13 as in the original paper), the recommendations of Lancet Adolescent Health Commission (Reference 6 as in the original paper), and several other guidelines (References 7, 9, 12, 17–19 as in the original paper), we selected adolescent health and well-being domains based on four key aspects of adolescents in LMICs: a) population trends; b) disease burden; c) drivers of health inequality; and d) opportunity for interventions

Counting adolescents in: the development of an adolescent health indicator framework for population-based settings

Changing realities in low- and middle-income countries (LMICs) in terms of inequalities, urbanization, globalization, migration, and economic adversity shape adolescent development and health, as well as successful transitions between adolescence and young adulthood. It is estimated that 90% of adolescents live in LMICs in 2019, but inadequate data exist to inform evidence-based and concerted policies and programs tailored to address the distinctive developmental and health needs of adolescents. Population-based data surveillance such as Health and Demographic Surveillance Systems (HDSS) and school-based surveys provide access to a well-defined population and provide cost-effective opportunities to fill in data gaps about adolescent health and well-being by collecting population-representative longitudinal data. The Africa Research Implementation Science and Education (ARISE) Network, therefore, systematically developed adolescent health and well-being indicators and a questionnaire for measuring these indicators that can be used in population-based LMIC settings. We conducted a multistage collaborative and iterative process led by network members alongside consultation with health-domain and adolescent health experts globally. Seven key domains emerged from this process: socio-demographics, health awareness and behaviors; nutrition; mental health; sexual and reproductive health; substance use; and healthcare utilization. For each domain, we generated a clear definition; rationale for inclusion; sub-domain descriptions, and a set of questions for measurement. The ARISE Network will implement the questionnaire longitudinally (i.e., at two time-points one year apart) at ten sites in seven countries in sub-Saharan Africa and two countries in Asia. Integrating the questionnaire within established population-based data collection platforms such as HDSS and school settings can provide measured experiences of young people to inform policy and program planning and evaluation in LMICs and improve adolescent health and well-being

Discontinuation and switching of postpartum contraceptive methods over twelve months in Burkina Faso and the Democratic Republic of the Congo: a secondary analysis of the Yam Daabo trial.

IntroductionWomen who use contraceptive methods sometimes stop early, use methods intermittently, or switched contraceptive methods. All these events (discontinuations and switching) contribute to the occurrence of unwanted and close pregnancies. This study aimed to explore contraceptive discontinuation and switching during the Yam-Daabo project to measure the effect of interventions on the continuation of contraceptive methods use.MethodsWe conducted a secondary analysis of the Yam-Daabo trial data. We choose the discontinuation and switching of a modern contraceptive method as outcome measures. We performed a survival analysis using the Stata software package to estimate the effect of the interventions on contraceptive discontinuation. We also studied the main reasons for discontinuation and switching.ResultsIn total, 637 out of the 1120 women used at least one contraceptive method (of any type), with 267 women in the control and 370 in the intervention group. One hundred seventy-nine women of the control group used modern methods compared to 279 women of the intervention group with 24 and 32 who discontinued, respectively. We observed no statistically significant association between interventions and modern methods discontinuation and switching. However, modern methods' discontinuation was higher in pills and injectables users than implants and IUDs users. The pooled data comparison showed that, in reference to the women who had not switched while using a modern method, the likelihood of switching to a less or equal effectiveness method among the women of the control group was 3.8(95% CI: 1.8-8.0) times the likelihood of switching to a less or equal effectiveness method among the women of the intervention group. And this excess was statistically significant (p ConclusionThe results of this study show no statistically significant association between interventions and modern methods discontinuation. Discontinuation is more related to the methods themselves than to any other factor. It is also essential to set up specific actions targeting women's partners and influential people in the community to counter inhibiting beliefs.Trial registrationPan African Clinical Trials Registry (PACTR201609001784334, https://pactr.samrc.ac.za/TrialDisplay.aspx?TrialID=1784 )

Mortality from external causes in Africa and Asia: evidence from INDEPTH Health and Demographic Surveillance System Sites.

BACKGROUND: Mortality from external causes, of all kinds, is an important component of overall mortality on a global basis. However, these deaths, like others in Africa and Asia, are often not counted or documented on an individual basis. Overviews of the state of external cause mortality in Africa and Asia are therefore based on uncertain information. The INDEPTH Network maintains longitudinal surveillance, including cause of death, at population sites across Africa and Asia, which offers important opportunities to document external cause mortality at the population level across a range of settings. OBJECTIVE: To describe patterns of mortality from external causes at INDEPTH Network sites across Africa and Asia, according to the WHO 2012 verbal autopsy (VA) cause categories. DESIGN: All deaths at INDEPTH sites are routinely registered and followed up with VA interviews. For this study, VA archives were transformed into the WHO 2012 VA standard format and processed using the InterVA-4 model to assign cause of death. Routine surveillance data also provide person-time denominators for mortality rates. RESULTS: A total of 5,884 deaths due to external causes were documented over 11,828,253 person-years. Approximately one-quarter of those deaths were to children younger than 15 years. Causes of death were dominated by childhood drowning in Bangladesh, and by transport-related deaths and intentional injuries elsewhere. Detailed mortality rates are presented by cause of death, age group, and sex. CONCLUSIONS: The patterns of external cause mortality found here generally corresponded with expectations and other sources of information, but they fill some important gaps in population-based mortality data. They provide an important source of information to inform potentially preventive intervention designs

The use of biomedicine, complementary and alternative medicine, and ethnomedicine for the treatment of epilepsy among people of South Asian origin in the UK

Studies have shown that a significant proportion of people with epilepsy use complementary and alternative medicine (CAM). CAM use is known to vary between different ethnic groups and cultural contexts; however, little attention has been devoted to inter-ethnic differences within the UK population. We studied the use of biomedicine, complementary and alternative medicine, and ethnomedicine in a sample of people with epilepsy of South Asian origin living in the north of England. Interviews were conducted with 30 people of South Asian origin and 16 carers drawn from a sampling frame of patients over 18 years old with epilepsy, compiled from epilepsy registers and hospital databases. All interviews were tape-recorded, translated if required and transcribed. A framework approach was adopted to analyse the data. All those interviewed were taking conventional anti-epileptic drugs. Most had also sought help from traditional South Asian practitioners, but only two people had tried conventional CAM. Decisions to consult a traditional healer were taken by families rather than by individuals with epilepsy. Those who made the decision to consult a traditional healer were usually older family members and their motivations and perceptions of safety and efficacy often differed from those of the recipients of the treatment. No-one had discussed the use of traditional therapies with their doctor. The patterns observed in the UK mirrored those reported among people with epilepsy in India and Pakistan. The health care-seeking behaviour of study participants, although mainly confined within the ethnomedicine sector, shared much in common with that of people who use global CAM. The appeal of traditional therapies lay in their religious and moral legitimacy within the South Asian community, especially to the older generation who were disproportionately influential in the determination of treatment choices. As a second generation made up of people of Pakistani origin born in the UK reach the age when they are the influential decision makers in their families, resort to traditional therapies may decline. People had long experience of navigating plural systems of health care and avoided potential conflict by maintaining strict separation between different sectors. Health care practitioners need to approach these issues with sensitivity and to regard traditional healers as potential allies, rather than competitors or quacks