Impact of an integrated nutrition intervention on nutrient intakes, morbidity and growth of rural Burkinabe preschool children

Iron deficiency and undernutrition often co-exist among children and the prevalence in sub-Saharan African is high. In Burkina Faso, 92% of children under the age of five years were anaemic and 39% were stunted in 2003 according to Demographics and health survey. Risk factors include inadequate dietary intakes and infections that often occur concomitantly. Orphans and vulnerable children who are already atincreased risk for poor psycho-emotional development due to their social status are particularly susceptible to malnutrition. Therefore, there is a challenge to develop effective interventions that address the multiple risk factors of nutritional deficiencies in these children. An integrated nutrition intervention including dietary modification and changes in hygiene practices was implemented targeting a group of preschoolorphans and vulnerable children living in group foster homes. The amount of iron-rich foods particularly goat meat and condiments as well as citrus fruits were increased in the diet. The hygiene component of the intervention focused on handwashing, eating in individual plates, food storage and stool disposal. All members of the foster homesat large benefitted from the activities of the intervention; however, measurements and impact evaluation focused on preschool children (12 - 72 months). Energy and nutrient intakes, anthropometric indices and morbidity including diarrhoea, fever, vomiting and respiratory infections were assessed at baseline and after 18 weeks. Mean bioavailable iron intake was increased from 0.4 to 0.9 mg/d. The intervention resulted in a decrease in the prevalence of inadequate intakes for energy, proteins and most micronutrients. The intervention increased the meat-fish-poultry contribution to energy and iron intakes from 1.6 to 3.5% and from 5.2 to 7.9%, respectively. There was also a decrease in the incidence of infection (from 73 to 9%, p<0.01) and overall orbidity (from 39 to 15%, p<0.05) most likely due to deworming and improvementsin hygiene behaviours. Contrary to baseline, helminths such as Hymelolepis nana,Strongylo�des stercoralis and Necator americanus that often cause blood loss were rarely found at the end of the intervention. The overall changes resulted in improvements in height-for-age z-score (-1.63 to -1.27, p<0.01) and weight-for-age zscore (-1.22 to -1.06, p<0.05). In conclusion, an intervention that targets bioavailableiron and hygiene behaviours improved child growth, iron status and overall morbidity in areas of high incidence of infection

Prevalence of HIV, HBV and Chlamydia infections in Cameroonian University context: case of the University of Dschang, in the Western Region

Introduction: In sub-Saharan Africa HIV infection remains largely epidemic, whereas HBV infection is highly endemic (>8%). In Cameroon, HIV prevalence is 4.3%. Concerning HBV and chlamydia infections, their prevalence are both ≥10%. Young adults, including university students, are the population groups mostly affected. Epidemiological data on these infections, among university students could be helpful to implement specific prevention strategies. Methods: A descriptive study was performed in May 2013 among 624 students from the University of Dschang, Cameroon. Participants were screened for HIV, HBV and Chlamydia infections. Data was collected by a standard questionnaire and analyzed by Epi Info. Results: Average age of participants was 23.3 years (σ = 3.2) with female predominance (58.7%). Prevalence of HIV, HBV and Chlamydia infection was 1.1% (7/624), 2.8% (5/176) and 2.0% (2/100) respectively. 83.2% of participants were sexually active. Concerning sexual risk behaviors, participants reported having multi partners (14.8%), using condom occasionally (58.6%) or never (5.0%). 100%, 62.6% and 52.2% reported to be aware on HIV, HBV and Chlamydia infections respectively. In addition, only 5.5% and 21.3% of the participants were aware of their HBV and Chlamydia status respectively, versus 64.4% for HIV. The excessive cost of HBV and Chlamydia tests has been identified as the major barrier to testing (87.6%). Conclusion: Among college Cameroonian students the prevalence of HIV, HBV and Chlamydia infections seems to be relatively low if compared to general population. However, having multiple sexual partners in addition to non-systematic use of condoms during sexual intercourse represents risk behaviors among students. Awareness campaigns and screening facilitation on HBV and chlamydia infections need to be strengthened

Past, Present and Future Perspectives on Groundnut Breeding in Burkina Faso

Groundnut (Arachis hypogaea L.) is a major food and cash crop in Burkina Faso. Due to the growing demand for raw oilseeds, there is an increasing interest in groundnut production from traditional rain-fed areas to irrigated environments. However, despite implementation of many initiatives in the past to increase groundnut productivity and production, the groundnut industry still struggles to prosper due to the fact of several constraints including minimal development research and fluctuating markets. Yield penalty due to the presence of drought and biotic stresses continue to be a major drawback for groundnut production. This review traces progress in the groundnut breeding that started in Burkina Faso before the country’s political independence in 1960 through to present times. Up to the 1980s, groundnut improvement was led by international research institutions such as IRHO (Institute of Oils and Oleaginous Research) and ICRISAT (International Crops Research Institute for the Semi-Arid Tropics). However, international breeding initiatives were not su�cient to establish a robust domestic groundnut breeding programme. This review also provides essential information about opportunities and challenges for groundnut research in Burkina Faso, emphasising the need for institutional attention to genetic improvement of the crop

Polymerase Chain Reaction (PCR) provides a superior tool for the diagnosis of Pneumococcal Infection in Burkina Faso

Purpose of study: The aim of this study was to determine the value of real-time Polymerase Chain Reaction (rt-PCR) in the routine surveillance of pneumococcal meningitis in Burkina Faso, compared to standard methods of culture, Gram stain and latex agglutination assay.Materiel and methods: A total of 385 specimens of cerebrospinal fluid were analyzed by the three standard bacteriological methods (Gram stain, latex agglutination assay, and culture) and real-time Polymerase Chain Reaction.Results: Of 385 specimens analyzed by these methods, 204 S. pneumoniae were detected by one or more  methods. Gram stain detected 36.4% (140/385) Gram positive encapsulated diplococci; 37.7% (145/385) and 20.8% (80/385) of the specimens were positive for pneumococci by latex agglutination assay and culture. These specimens were tested with rt-PCR, which confirmed 51.2% (197/385) S. pneumoniae positive. The sensitivity and specificity of culture were 54.4% and 31.5%, respectively, and the sensitivity and specificity of rt-PCR were 96.6% and 100%, respectively. These results showed that rt-PCR was more sensitive than Gram stain (p=0.0235), latex agglutination assay (p=0.0442)and culture (p=0.0006).The culture is the gold standard method; however, the result showed that rt-PCR had specificity and was as specific as Gram stain (p=0.3405) and latex agglutination assay (p=0.7745).Conclusion: rt-PCR was highly sensitive and specific. It could be used as a complementary diagnostic tool to  mprove case confirmation of bacterial meningitis. However,its high cost, the qualification of the technical staff and infrastructures required for its implementation, constitute obstacles to its widened use in countries with limited resources.Keywords: Streptococcus pneumoniae, meningitis, rt-PCR, standard bacteriological methods Objectif: Le but de cette étude était de déterminer la place de la rt-PCR dans la surveillance de routine deméningitespneumococciquesau Burkina Faso et la comparée avec les méthodes de la bactériologie classique: Culture, coloration de Gram et l’agglutination au latex.Matériel etméthodes: Au total, 385 échantillons deliquides céphalorachidiens (LCR)étaient analysés par les trois méthodes de la bactériologie classique (coloration de Gram, agglutination au latex, culture) et la PCR en temps réel.RESULTATS: Parmi 385 échantillons analysés, 204 cas de Streptococcuspneumoniae étaient détectés par une ou plusieurs méthodes. La coloration de Gram adétecté 36,4% (140/385) diplocoques encapsulés à Gram positif (DGP); 37,7% (145/385) et 20,8% (80/385) d’échantillons étaient positifs aux pneumocoques par l’agglutination au latex et la culture. Ces échantillons étaient aussi testés par rt-PCR qui a confirmé 51,2% (197/385) cas positifs de S. pneumoniae. La sensibilité et la spécificité de la culture étaient respectivement de 54,4% et 31,5%, et la sensibilité et la spécificité de rt-PCR étaient respectivement de 96,6% et 100%. Ces résultats ont montré que la rt-PCR était plus sensible que la coloration de Gram (p=0,0235), l’agglutination au latex (p=0,0442) et la  culture(p=0,0006).La culture est une méthode de référence; cependant, le résultat a montré que rt-PCR était plus sensibleet aussi spécifique que la coloration de Gram ((p=0,3405)et l’agglutination au latex (p=0,7745).Conclusion : :rt-PCR était plus sensible et plus spécifique. Elle pourrait être utilisée comme un outil de diagnosticcomplémentaire pour améliorer les cas de confirmation de méningites bactériennes. Cependant, ces coûts de réalisation, la qualification de techniciens et les matériels pour son application constituent des obstacles pour sa vulgarisation dans les pays à ressources limités.Keywords: Streptococcus pneumoniae, méningites, rt-PCR, méthodes de la bactériologie classique Article in English

Quantifying individual variability in exposure risk to mosquito bites in the Cascades region, Burkina Faso

Background The Cascades region, Burkina Faso, has a high malaria burden despite reported high insecticide-treated mosquito net (ITN) use. Human and vector activities outside the hours when indoor interventions offer direct protection from infectious bites potentially increase exposure risk to bites from malaria-transmitting Anopheles mosquitoes. This work investigated the degree of variation in human behaviour both between individuals and through time (season) to quantify how it impacts exposure to malaria vectors. Methods Patterns in human overnight activity (18:00–06:00) to quantify time spent using an ITN across 7 successive nights in two rural communities, Niakore (N = 24 participants) and Toma (71 participants), were observed in the dry and rainy seasons, between 2017 and 2018. Hourly human landing Anopheles mosquito catches were conducted in Niakore specifically, and Cascades region generally, between 2016 and 2017. Data were statistically combined to estimate seasonal variation in time spent outdoors and Anopheles bites received per person per night (bpppn). Results Substantial variability in exposure to outdoor Anopheles bites was detected within and between communities across seasons. In October, when Anopheles densities are highest, an individual’s risk of Anopheles bites ranged from 2.2 to 52.2 bites per person per night (bpppn) within the same week with variable risk dependent on hours spent indoors. Comparably higher outdoor human activity was observed in April and July but, due to lower Anopheles densities estimated, bpppn were 0.2–4.7 and 0.5–32.0, respectively. Males and people aged over 21 years were predicted to receive more bites in both sentinel villages. Conclusion This work presents one of the first clear descriptions of the degree of heterogeneity in time spent outdoors between people and across the year. Appreciation of sociodemographic, cultural and entomological activities will help refine approaches to vector control

Risk factors associated with HIV prevalence in pregnant women in Burkina Faso, from 2006 to 2014

Purpose of the study: To determine the socio-demographic factors influencing the dynamics of HIV prevalence among pregnant women in Burkina Faso.Material and methods: A total of 66,597 pregnant women from the 13 health regions of Burkina Faso were included in this study conducted between 2006 and 2014. Venous blood samples were collected and analyzed for the detection of HIV antibodies according to WHO / UNAIDS strategy II, using the mixed test Vironostika HIV Uniform II Plus O (Bio-Mérieux) and the test discriminating ImmunoCombII HIV-1 & 2 BiSpot (Orgenics). Samples with discordant results between the two tests, as well as those positive to HIV-2 or HIV-1 + 2, were retested with HIV BLOT 2.2 (MP Diagnostics). Sociodemographic data collected from the participants were correlated with their HIV status to determine key risk factors influencing HIV infection prevalence in Burkina Faso.Results: Sociodemographic data showed that the study population consisted mainly of married women (91.2%) at their first pregnancy (27.1%) with a large majority of them being housewives (86.2%) who did not attend any form of schooling (69.4%). About 88.4% had stayed longer than a year in the health region where they initially participated in the study and 55.8% were between 20 and 29 years of age. Overall HIV prevalence significantly dropped from 2.7 % in 2006 to 1.3% in 2014. However HIV seroprevalence in this study has varied significantly according to socio-demographic characteristics including marital status, parity, occupation, education, age group and the length of stay in the women's health community (p <0.0001). Factors sustaining HIV transmission included the status of being unmarried (OR=1.67 [1.42-1.97]), primigest (OR=1.64 [1.41-1.89]), having other occupations except being student (OR = 1.68 [1.20-2.33]), aged between 20-49 years (OR=3.14 [2.51-3.93]) and the duration of stay less than a year in their locality (OR=5.33 [4.61-10.16]) and these factors were identified as main risk factors associated with HIV prevalence.Conclusion: Burkina Faso remains among the countries with concentrated epidemics despite a significant reduction in the prevalence observed in this study. The inclusion of identified risk factors in the national HIV program could improve the quality of the response to the epidemic.Keywords: HIV-Pregnant Women-Risk Factors-Burkina Fas

Characterising the intensity of insecticide resistance: A novel framework for analysis of intensity bioassay data

Insecticide resistance is a growing problem that risks harming the progress made by vector control tools in reducing the malaria burden globally. New methods for quantifying the extent of resistance in wild populations are urgently needed to guide deployment of interventions to improve disease control. Intensity bioassays measure mosquito mortality at a range of insecticide doses and characterise phenotypic resistance in regions where resistance is already detected. These data are increasingly being collected but tend to exhibit high measurement error and there is a lack of formal guidelines on how they should be analysed or compared. This paper introduces a novel Bayesian framework for analysing intensity bioassay data, which uses a flexible statistical model able to capture a wide variety of relationships between mortality and insecticide dose. By accounting for background mortality of mosquitoes, our approach minimises the impact of this source of measurement noise resulting in more precise quantification of resistance. It outputs a range of metrics for describing the intensity and variability in resistance within the sample and quantifies the level of measurement error in the assay. The functionality is illustrated with data from laboratory-reared mosquitoes to show how the lethal dose varies within and between different strains. The framework can also be used to formally test hypotheses by explicitly considering the high heterogeneity seen in these types of data in field samples. Here we show that the intensity of resistance (as measured by the median lethal dose (LC50) of insecticide) increases over 7 years in mosquitoes from one village in Burkina Faso but remains constant in another. This work showcases the benefits of statistically rigorous analysis of insecticide bioassay data and highlights the additional information available from this and other dose-response data