Les manifestations oculaires au cours de la pré-éclampsie sévère ou l’éclampsie au Centre Hospitalier Universitaire Sourô Sanou de Bobo Dioulasso

La pré-éclampsie sévère est un problème de santé publique. L'atteinte oculaire est une de ses nombreuses complications. Le but de notre travail était de décrire les atteintes oculaires chez les patientes présentant une pré-éclampsie et/ou éclampsie afin de contribuer à leur meilleure prise en charge. Il s'est agi d'une étude transversale descriptive à collecte prospective allant du 1er novembre 2013 au 31 juillet 2014, chez les patientes ayant souffert de pré-éclampsie sévère/éclampsie. Nous avons inclus 127 patientes dans notre étude. La moyenne d'âge des patientes de notre étude était de 26,37 ans (ET= 6,8 ans), avec des extrêmes de 15 et 40 ans. Les tranches d'âge les plus représentées étaient celles de 26 à 30 ans avec 29,1% des cas et celle des 15 à 20 ans avec 25,2%. Le diagnostic de pré-éclampsie sévère a été retenu dans 69,3% des cas. Les primigestes représentaient 40,9% de la population. Les troubles visuels à type de phosphènes ont été observés chez 33,1% des patientes. Nous avons noté un courant granulaire conjonctival dans 41,7%, des lésions du segment postérieur chez 32,3% des patientes. Ces résultats ont été discutés parrapport à la littérature, et nous notons plus de cas d'atteinte rétinienne. Nous n'avons pas trouvé de lien statistiquement significatif entre la tension artérielle à l'admission et le stade de la rétinopathie hypertensive. Les complications oculaires de la pré-éclampsie sévère sont très fréquentes et souvent ignorées. Les atteintes rétiniennes sont fréquentes mais de bon pronostic.Keywords: Pré-éclampsie, éclampsie, manifestations oculaires, Burkina Fas

Sharing experiences and dilemmas of conducting focus group discussions on HIV and tuberculosis in resource-poor settings

Focus group discussions (FGD) are gaining in popularity in research on HIV and tuberculosis (TB) internationally as researchers seek to understand the experiences, needs and perspectives of people living with TB and/or HIV as well as their carers within the community and health sector. Conducting FGDs in resource-poor settings with vulnerable participants who are living with diseases that are frequently stigmatised poses multiple challenges. Our approach in this discussion paper is to follow the research cycle to present the practical experience of research teams using FGDs in TB and HIV in resource-poor contexts in Africa and Asia in order to contribute to effective practice. The approach highlights dilemmas and shares effective practice for negotiating initial discussions with different communities, constructing sampling frames and samples, choosing a facilitator, encouraging discussion, ethics, translation, pitfalls and dissemination. We demonstrate the techniques and adaptations needed to ensure that FGDs provide rich, high-quality and policy-relevant data on the voices and perspectives of people living with HIV and TB, community groups and health workers within the challenges of resource-poor settings. In applying theory to develop good practice in FGDs across the research cycle, a critical and reflexive approach is needed

Developing a Patient Centred Approach to TB treatment in Burkina Faso: Implications for poverty and equity

info:eu-repo/semantics/publishe

Barriers to Linkage to Care for Hepatitis B Virus Infection: A Qualitative Analysis in Burkina Faso, West Africa

International audienceHepatitis B virus (HBV) infection is a critical global health problem. The World Health Organization (WHO) has recently developed a global elimination strategy for HBV infection. Increasing access to screening, liver assessment, and antiviral treatment are crucial steps in achieving this goal. Little is known, however, about obstacles to linkage to care in low-and middle-income countries. Using a grounded theory approach, this qualitative study sought to characterize the diagnostic itineraries of people with chronic HBV infection in Burkina Faso, a west African country with high HBV prevalence, to identify barriers to linkage from screening to specialist care with hepatic assessment (alanine transaminase and hepatitis B e antigen or HBV DNA). We conducted 80 semistructured interviews with chronically infected people, their families, medical personnel, and traditional practitioners, and participant observation of HBV diagnostic announcements and consultations. Of 30 individuals diagnosed with chronic viral hepatitis, 18 inadvertently discovered their status through blood screening and 12 actively sought diagnosis for their symptoms. Only a quarter (8/30) were linked to care. Barriers included: 1) patients' ability to pay for testing and treatment; 2) a formal health system lacking trained personnel, diagnostic infrastructures, and other resources; 3) patients' familial and social networks that discouraged access to testing and HBV knowledge; 4) a well-developed demand for and provisioning of traditional medicine for hepatitis; and 5) a weak global politics around HBV. More training for medical personnel would improve linkage to care in sub-Saharan Africa. Developing effective communications between medical workers and patients should be a major priority in this elimination strategy

Profils des enfants de zero a trois ans examines sous anesthesie generale dans le service d’ophtalmologie du Centre Hospitalier Universitaire Yalgado Ouedraogo: Profiles of children from zero to three years old examined under general anesthesia in the ophthalmology department of the Yalgado Ouedraogo University Hospital Center

Introduction : Les jeunes enfants ont des besoins en soins oculaires souvent plus urgents que ceux des adultes. Les maladies oculaires des enfants de 0-3 ans peuvent engager le pronostic visuel et/ou vital. Le but de notre était de décrire les profils des patients de 0-3 ans examinés sous anesthésie générale dans le service d’ophtalmologie du CHU-Yalgado OuédraogoPatients et méthode : étude prospective du 1er Janvier au 31 Octobre 2019. Tous les enfants de 0-3 ans examinés sous anesthésie générale ont été inclus. Les variables étudiées ont été l’âge, le sexe, la provenance, la durée de la symptomatologie, le motif de consultation, les signes cliniques et le diagnostic retenu.Résultats : cent huit (108) patients ont été examinés. La moyenne de l’âge était de 15,62±11,41 mois ; le sex ratio était de 1,4. Les enfants dont les parents résidaient à Ouagadougou représentaient 57,41 %. La leucocorie était le motif de consultation le plus fréquemment retrouvé avec 41,67%. Seuls 25,93% des cas ont été pris en charge dans le 1er mois de la découverte de la symptomatologie. Le rétinoblastome, le glaucome congénital et la cataracte congénitale étaient les pathologies les plus fréquemment rencontrées avec respectivement 31,48 %, 25,93% et 25,93 %.Conclusion : plus de 80% des enfants de 0 à 3 ans examinés sous anesthésie générale constituaient des urgences fonctionnelles et/ou vitales. Il serait nécessaire d’en informer les parents et les autorités sanitaires afin de favoriser la prise en charge rapide de ces patients.ABSTRACTIntroduction: Young children have eye care needs that are often more urgent than those of adults. Eye diseases in children 0-3 years old can have a visual and / or vital prognosis. The aim of this study was to describe the profile of patients aged 0-3 years under general anesthesia in the ophthalmology department of CHU-Yalgado OuedraogoPatients and method: prospective study from January 1st to October 31, 2019. All children aged 0-3 years examined under general anesthesia were included. The variables studied were age, sex, origin, duration of symptomatology, reason for consultation, clinical signs and diagnosis.Results: One hundred and eight (108) patients were examined. The mean age was 15.62 ± 11.41 months; the sex ratio was 1.4. Children whose parents lived in Ouagadougou accounted for 57.41%. Leucocoria was the most common reason for consultation with 41.67%. Only 25.93% of cases were treated in the first month of symptom discovery. Retinoblastoma, congenital glaucoma and congenital cataract were the most common pathologies with 31.48%, 25.93% and 25.93%, respectively.Conclusion: more than 80% of children aged 0 to 3 years examined under general anesthesia constituted functional and / or vital emergencies. It would be necessary to inform the parents and the health authorities to promote the rapid care of these patients

Impact of Improving Community-Based Access to Malaria Diagnosis and Treatment on Household Costs

Background. Community health workers (CHWs) were trained in Burkina Faso, Nigeria, and Uganda to diagnose febrile children using malaria rapid diagnostic tests, and treat positive malaria cases with artemisinin-based combination therapy (ACT) and those who could not take oral medicines with rectal artesunate. We quantified the impact of this intervention on private household costs for childhood febrile illness. Methods. Households with recent febrile illness in a young child in previous 2 weeks were selected randomly before and during the intervention and data obtained on household costs for the illness episode. Household costs included consultation fees, registration costs, user fees, diagnosis, bed, drugs, food, and transport costs. Private household costs per episode before and during the intervention were compared. The intervention's impact on household costs per episode was calculated and projected to districtwide impacts on household costs. Results. Use of CHWs increased from 35% of illness episodes before the intervention to 50% during the intervention (P < .0001), and total household costs per episode decreased significantly in each country: from US Dollars (USD) $4.36 to USD$1.54 in Burkina Faso, from USD $3.90 to USD$2.04 in Nigeria, and from USD $4.46 to USD$1.42 in Uganda (all P < .0001). There was no difference in the time used by the child's caregiver to care for a sick child (59% before intervention vs 51% during intervention spent ≤2 days). Using the most recent population figures for each study district, we estimate that the intervention could save households a total of USD $29 965, USD$254 268, and USD $303 467, respectively, in the study districts in Burkina Faso, Nigeria, and Uganda. Conclusions. Improving access to malaria diagnostics and treatments in malaria-endemic areas substantially reduces private household costs. The key challenge is to develop and strengthen community human resources to deliver the intervention, and ensure adequate supplies of commodities and supervision. We demonstrate feasibility and benefit to populations living in difficult circumstances. Clinical Trials Registration. ISRCTN13858170