Survey of urinary crystals identified in residents of Ouagadougou, Burkina Faso: Implications for the diagnosis and management of renal dysfunctions

The first step of renal lithiasis process is crystals formation. Because of this link, a prospective study on the profile of urinary crystals was conducted in Ouagadougou with the aim of describing profiles of these crystals in the context of a Sahelian tropical country. This study showed strong prevalence (78.69%) crystals within the population from 15 to 59 years old. Male subjects were the most concerned with 55.93 % prevalence. Among the crystals, we distinguished those who were without compulsory pathological interest with strong prevalence of the crystals of calcium oxalate (56.11%) and uric acid (20.55%). Crystals with immediate pathological interest were bilirubin (0.66%), the cystine (0.36%), leucine (0.06%) and tyrosine (0.06%). Prevalence of crystals derived from drugs were sulfamides (0.18%) and mycostatine (0.06%). Besides, 20.8% of the patients having urinary crystals had urinary tract infection. Bacteriological analysis of urines showed a presence of producing urease bacteria: Klebsiella (12.96%), Proteus (3.0%), Enterobacter (1.66%) and, Pseudomonas (1.66%). In conclusion, this work showed the interest to pay more attention on urinary crystals. Indeed this study brought to light crystals with compulsory pathological interest, in particular crystals of bilirubin, cystine, leucine, tyrosine, evidence of abnormalities of protein metabolism

Hepatic safety of repeated treatment with pyronaridine‐artesunate versus artemether–lumefantrine in patients with uncomplicated malaria: a secondary analysis of the WANECAM 1 data from Bobo-Dioulasso, Burkina Faso

International audienceBackground: The use of pyronaridine-artesunate (PA) has been associated with scarce transaminitis in patients. This analysis aimed to evaluate the hepatic safety profile of repeated treatment with PA versus artemether-lumefantrine (AL) in patients with consecutive uncomplicated malaria episodes in Bobo-Dioulasso, Burkina Faso. Methods: This study analysed data from a clinical trial conducted from 2012 to 2015, in which participants with uncomplicated malaria were assigned to either PA or AL arms and followed up to 42 days. Subsequent malaria episodes within a 2-years follow up period were also treated with the same ACT initially allocated. Transaminases (AST/ ALT), alkaline phosphatase (ALP), total and direct bilirubin were measured at days 0 (baseline), 3, 7, 28 and on some unscheduled days if required. The proportions of non-clinical hepatic adverse events (AEs) following first and repeated treatments with PA and AL were compared within study arms. The association of these AEs with retreatment in each arm was also determined using a logistic regression model. Results: A total of 1379 malaria episodes were included in the intention to treat analysis with 60% of all cases occurring in the AL arm. Overall, 179 non-clinical hepatic AEs were recorded in the AL arm versus 145 in the PA arm. Elevated ALT was noted in 3.05% of treated malaria episodes, elevated AST 3.34%, elevated ALP 1.81%, and elevated total and direct bilirubin in 7.90% and 7.40% respectively. Retreated participants were less likely to experience elevated ALT and AST than first episode treated participants in both arms. One case of Hy's law condition was recorded in a first treated participant of the PA arm. Participants from the retreatment group were 76% and 84% less likely to have elevated ALT and AST, respectively, in the AL arm and 68% less likely to present elevated ALT in the PA arm. In contrast, they were almost 2 times more likely to experience elevated total bilirubin in both arms. Conclusions: Pyronaridine-artesunate and artemether-lumefantrine showed similar hepatic safety when used repeatedly in participants with uncomplicated malaria. Pyronaridine-artesunate represents therefore a suitable alternative to the current first line anti-malarial drugs in use in endemic areas. Trial registration Pan African Clinical Trials Registry