Notification des effets indésirables de la spiruline chez l’homme : revus systématique

La spiruline est une algue utilisée pour ses effets nutritionnels et thérapeutiques. Cependant son innocuité et ses éventuelles interactions avec les médicaments semblent peu étudier. Le présent travail se propose de résumer les quelques étude et les rapports de pharmacovigilance de la spiruline chez l’homme. La méthode a consisté à l’interrogation des bases de données PubMed, OMS, Medline, base des données des universités de Grenoble, centre de pharmacovigilance de Grenoble et de Bordeaux. Seules les études effectuées chez l’homme avec la spiruline, publiées et ayant notifiées les effets indésirables ont été retenues. Les critères de jugements ont porté sur les paramètres anthropométriques, biologiques, cliniques et les données des protocoles. Trois essais cliniques, trois études de cas cliniques et trente un rapports de pharmacovigilance dans le monde de 1996 à 2009 ont été retenus pour l’étude. Dans trois études randomisées contrôlées par un placebo, des décès ainsi que des perdues de vue dans le bras de la spiruline ont été notés. Les cas cliniques et les rapports de pharmacovigilance ont notifié des effets indésirables au niveau hépatique, dermatologique, digestif, des troubles hématologiques, rénaux et électrolytiques. Les effets indésirables liés au foie ont occupé la première place.Mots clés : Notification, Effets indésirables, Spiruline

A locally adapted functional outcome measurement score for total hip replacement in west Africa: introduction of the Ouaga score

Background: Functional outcome scores are often used to measure results of Total Hip Replacement (THR). Most current scoring systems were designed for use in Europe or North America and seem not optimally suited for a general West African setting. We introduce a cross-cultural adaptation of the Lequesne index as a new score.Method: A new functional hip score, adapted to the West African setting and based on the Lequesne Index was introduced. To evaluate this score, the score questionnaire was completed by a group of patients in the Paul VI Hospital in Ouagadougou, Burkina Faso, who were possible candidates for hip replacement. Patients with hip fractures were excluded. Double scores acquired with a minimal interval of four weeks were analysed and test-retest reliability was assessed using intra-class correlation coefficient.Results: Mean patient age was 43,3 years. All patients were able to answer all questions. Double scores were available in 21 patients. Intra-class correlation coefficient was 0.896 indicating very good correlation.Conclusion: The current study has shown that the cross-cultural adaptation of the Lequesne Index, used as Ouaga Score. It can be obtained easily and is reliable in a general West African patient population. We recommend the use of the Ouaga Score for functional evaluation and follow-up of THR in West Africa.Keywords: THR, Hip, Africa, Functional score, Hip replacement, Arthroscop

L'élevage du "mouton de case" : aspects techniques, socio-économiques et perspectives d'amélioration au Yatenga (Burkina Faso)

peer reviewe

Self-reported estimation of usual walking speed improves the performance of questionnaires estimating walking capacity in patients with vascular-type claudication

OBJECTIVE: Most questionnaires do not estimate the usual walking speed of the patient, although it is well known that patients may experience apparently different walking capacities if walking slow or fast. We hypothesized that correcting the self-reported estimated walking capacity by a coefficient issued from the self-reported estimation of usual walking speed would significantly improve the correlation between questionnaire-estimated and treadmill-measured walking capacity. METHODS: Three hundred ten consecutive patients complaining of vascular-type claudication were asked to estimate their usual walking speed in comparison to people of their age (or friends or relatives) with ratings ranging from much slower (1 pt) to much faster (5 pts), in addition to the filling out of the walking impairment questionnaire (WIQ) and the estimated ambulatory capacity by history questionnaire (EACH-Q). Corrected WIQ (WIQc) and corrected EACH-Q (EACH-Qc) scores were obtained by multiplying the scores of each questionnaire by the "usual-speed" coefficient and dividing by 5. Results for questionnaire scores were compared to maximal walking time (MWT) on a treadmill. RESULTS: All but four patients self-completed the usual-speed question. Median scores (25-75 centiles) were 41% (26-59) for the WIQ and 24% (11-41) for the EACH-Q. Coefficients of correlation of the three WIQ subscales and of the EACH-Q with treadmill results were significantly improved after correction by the "usual-speed" question. Overall, WIQ (mean of the three WIQ subscales) tended to improve but did not reach significance. CONCLUSION: Correcting the self-reported estimation of walking capacity by a self-reported estimation of usual walking pace significantly improves the correlation of all WIQ subscale scores and of the EACH-Q score with treadmill measurements of capacity. This confirms the interest of speed estimation in patients with peripheral arterial occlusive disease and claudication

Géomorphologie et productivité des forages dans le nord du bassin du fleuve Comoé en Côte d’Ivoire

L’objectif de cette étude est de caractériser les aquifères et la productivité des forages dans le haut bassin versant de la Comoé, spécifiquement dans la partie nord de la Côte d’Ivoire. La réalisation de ce travail a nécessité des fiches de 952 forages, des cartes géologiques et la base de données  cartographiques de la Côte d’Ivoire. Les épaisseurs d’altération y sont importantes avec 87,92% des forages supérieurs à la classe des épaisseurs moyennes selon le CIEH. Les forages y sont plus profonds et plus productifs sur les schistes que sur les granitoïdes. La profondeur optimale des forages dans cette zone peut être définie entre 40 et 60 m. Les valeurs de transmissivité varient de 5,59.10-6 m2/s à 2,01.10-4 m2/s.Mots clés : Fleuve Comoé, bassin versant, aquifère de socle, transmissivité, épaisseur d’altération, forage

Effects of a four-year health systems intervention on the use of maternal and infant health services: results from a programme evaluation in two districts of rural Chad

BACKGROUND: Attendance of maternal and infant care services in rural Chad are consistently low. Our study aimed to assess the use of antenatal (ANC) and postnatal care (PNC) services, health facility delivery and infant health services after 4 years of a health systems intervention for improving the infrastructure, supplies, training and sensitization for maternal and infant health in two districts of rural Chad. METHODS: Data from a repeated cross-sectional household survey conducted in Yao and Danamadji in 2015 and in 2018 were analyzed. A stratified two-stage cluster sampling methodology was applied to achieve a representative sample of the rural settled and mobile population groups in the study area. A generalized linear model was applied to determine the health care utilization rates. Multivariate regression models were used to assess the association between the programme intervention and utilization outcomes of selected maternal and infant health services. RESULTS: Complete datasets were available for 1284 households at baseline. The endline analysis included 1175 households with complete survey data. The use of at least one ANC amongst pregnant women increased in both settled communities (from 80% in 2015 to 90% in 2018) and amongst mobile pastoralist communities (from 48% in 2015 to 56% in 2018). The rate of home delivery among settled communities and mobile pastoralists changed little between baseline and endline and remained high for both population groups. Individuals that were covered by the health systems intervention were however significantly more likely to attend ANC and less likely to give birth at home. PNC services only showed improvements amongst the settled communities (of 30%). Infants' reported health outcomes and vaccination coverage considerably improved; the latter especially among mobile pastoralist (from 15% in 2015 to 84% in 2018). CONCLUSION: A combination of health systems strengthening interventions was associated with an increased use of certain maternal and infant health services. However, to facilitate equitable access to and use of health care services in particular in times of increased vulnerability and by certain population groups in hard-to-reach areas, reinforced health education and culturally adapted communication strategies, including gender-specific messaging will be needed over a sustained period

Numerical and experimental study of an air-soil heat exchanger for cooling habitat in Sahelian zone: case of Ouagadougou

The use of air-soil heat exchangers for the cooling home has developed considerably in recent years. In this work, we have leaded the numerical study of an air-soil heat exchanger by using a nodal approach. We have also presented our experimental prototype implemented in Ouagadougou. This study has allowed determining the evolution of air temperature along the exchanger and also validating our numerical results with those of the literature and the experiment

Uses and vulnerability of ligneous species exploited by local population of northern Burkina Faso in their adaptation strategies to changing environments

Background Arid and semi-arid areas of West Africa are highly subject to climate change effects. This is combined to other drivers such as population growth and livestock number increase. To cope with such changing environment, endogenous adaptation strategies of poor local communities rely on the use of natural resources through empirical knowledge. Unfortunately, these knowledge and practices are insufficiently known to policy makers, and this hampers their consideration in the elaboration of adaptation strategies. A household survey was conducted in the Sillia village in northern Burkina Faso using semi-structured interviews. This study identified most used (preferred) species in this changing environment together with their ethnobotanical use value (VUET). Results Overall, 86 ligneous species were listed in seven (7) use categories: human nutrition, fodder, fuel, traditional medicine, handicraft, construction and trade. From the 86 species, 11 appeared the most preferred by local population (VUET ≥ 6). Except Piliostigma reticulatum and Boscia senegalensis, all these species were part of the 21 very vulnerable species as revealed by the study. Tamarindus indica, Balanites aegyptiaca, Lannea microcarpa and Vitellaria paradoxa are the first most preferred species (VUET ≥ 7) and also most vulnerable (IV > 2.5). In this changing environment, Cassia sieberiana, Combretum micranthum, Balanites aegyptica have, for instance, become the main species used in traditional medicine replacing Ximenia americana, Coclospermum tinctorim, Maytenus senegalensis and Securidaca longepedunculata, formerly used for this need. Also, Piliostigma reticulatum is the main species used in farm lands to combat low soil fertility. Pterocarpus lucens and Adansonia digitata are the main fodder species both during dry and rainy seasons. Apart from the household surveys, vegetation survey was conducted on 96 plots in Sillia. The results showed that 25 species cited in the household surveys had locally disappeared, 22 were rare, 5 were abundant and the others were relatively abundant. Certain collection practices of given species in many use categories increase their vulnerability. Conclusion This study documented preferred species in the adaptation strategies to changing environments and also assessed their vulnerability status under human influence; it is therefore of great use for designing sustainable management