Comparing the use and content of antenatal care in adolescent and older first-time mothers in 13 countries of west Africa: a cross-sectional analysis of Demographic and Health Surveys

Background West Africa has the highest proportion of married adolescents, and the highest adolescent childbirth rate and maternal death rate in sub-Saharan Africa. However, few studies have focused on the type and quality of health care accessed by pregnant young women in countries in this subregion. Methods We obtained data from Demographic and Health Surveys done between 2010 and 2014, to compare the use, timing, source, and components of antenatal care between adolescent and older first-time mothers in 13 west African countries. The sample included primiparous women who were aged 15–49 years with a livebirth in the 5-year survey recall period, and women were assigned to one of three groups on the basis of age at the time of childbirth: adolescent (10–19 years), young adults (20–24 years), or adults (25 years or older). We calculated the percentage of women who: attended at least one antenatal care visit, completed at least one visit during the first trimester of pregnancy, attended four or more appointments in antenatal care, and received four components of antenatal care (blood pressure measurement, urine tests, blood tests, and information on complications), as well as the sector where the women received care. We primarily report the comparison between adolescents and young adults. Findings In 2016, we acquired data from the Demographic Health Surveys from 13 west African countries between 2010 and 2014 on primiparous women. The study sample was 19 211 women, of whom 10 025 (52%) were adolescents, 6099 (32%) were young adults, and 3087 (16%) were adults. Overall, 17 386 (91%) of 19 211 first-time mothers made use of antenatal care facilities on at least one occasion. 3597 (41%) of 8741 adolescents compared with 8202 (47%) of all 17 386 women began the use of antenatal care during the first trimester. Across west Africa, 5430 (62%) of 8741 adolescents had four or more antenatal care visits compared with 4067 (71%) of 5717 young adults and 2358 (81%) of 2928 adults. Of those who had four or more visits to antenatal care, 2779 (51%) of 5430 adolescents received all the antenatal care components examined compared with 2488 (61%) of 4067 young adults and 1600 (68%) of 2358 adults. Although most women received antenatal care in the public sector, in nine of the 13 countries, the proportion of women that used the private sector was higher in older mothers. Interpretation Although a large percentage of west African adolescents use some antenatal care for their first birth, they seek care later, make fewer visits during pregnancy, and receive fewer components of care than older first-time mothers. Governments must ensure the pregnancy care accessed by adolescent mothers is of high quality and tailored to meet their needs

Screening of BRCA1 (c.5177_5180delGAAA rs80357867 and c.4986+6T>C rs80358086) and the BRCA2 (c.6445_6446delAT rs80359592) genes for breast cancer prevention in Burkina Faso

BACKGROUND: The objective of this study is to search for mutations in the BRCA1 (c.5177_5180delGAAA and c.4986+6T>C) and BRCA2 genes (c.6445_6446delAT) in a population of women diagnosed with breast cancer.METHODS: This is a case-control study that involved 140 participants, including 70 patients with histologically diagnosed breast cancer and 70 healthy women without breast cancer. Mutations in the BRCA1 (rs80357867, rs80358086) and BRCA2 (rs80359592) genes were tested by real-time PCR. The 95% confidence interval Odds Ratio (OR) was used to estimate the associations between specific genotypes and breast cancer.RESULTS: The study revealed that no mutations were detected for rs80359592. Similarly, no reference allele (TTTC/TTTC) of rs80357867 was found in this study. However, the homozygous double mutant (-/) genotype of this rs80357867 was observed in 11.43% and 1.43% of patients and controls respectively, while 88.57% of patients and 98.57% of controls had a heterozygous deletion (TTTC/-). Concerning rs80358086, 8.57% of the patients had a heterozygous mutation (A/G) with no significantly risk association with occurrence of breast cancer (OR = 6.46; 95% CI: 0.75-55.21; p = 0.11). In addition, this heterozygous mutation was significantly associated with a family history of breast cancer (OR=128; 95% CI: 9.46-1730.93) and breast cancer risk in nonmultiparous women (OR=6; 95% CI: 1-35.90; p= 0.05) but no association with overweight/obesity (OR=1.66; 95% CI: 0.18-15.35; p=1).CONCLUSION: This study shows high frequencies of heterozygous mutation of rs80357867 and rs80358086 from patients. In Burkina Faso, these results could help with early diagnosis of breast cancer in patients

Sombie I: Street-level workers’ criteria for identifying indigents to be exempted from user fees in Burkina Faso. Trop Med Int Health 2012, 17:782–791. doi:10.1186/1475-9276-13-31 Cite this article as: Ridde et al.: A community-based approach to indigent

Abstract objectives Universal healthcare coverage cannot be achieved in Africa as long as the indigent, the poorest, are unable to access healthcare systems. This study was carried out in Burkina Faso to obtain street-level workers' perspectives on what criteria should be used to select indigents to be exempted from user fees. methods Two group consensus techniques were used (Delphi and Concept Mapping). The participants were nurses (CM; n = 24), midwives (CM; n = 23) from a rural district and Social Action agents (CM; n = 31) and healthcare workers (Delphi n = 23) in training at two national schools. results Altogether, 446 criteria were proposed. The nurses put forward criteria related to being ill without support and being a victim of society. The midwives focused more on the disabled poor and those who were ill and unsupported. The healthcare workers in training mentioned disabled persons and the elderly with no family support. The Social Action agents spoke about vulnerability related to illness or disability and the fact of being excluded or being a disaster victim. conclusions These criteria proposed by street-level workers add to other studies conducted in Burkina Faso and should help the State to improve indigents' access to care

Analysis of the implementation of a community-based intervention to control dengue fever in Burkina Faso

Background A community-based dengue fever intervention was implemented in Burkina Faso in 2017. The results achieved vary from one area to another. The objective of this article is to analyze the implementation of this intervention, to better understand the process, and to explain the contextual elements of performance variations in implementation. Methodology The research was conducted in the former sector 22 of the city of Ouagadougou. We adapted the Consolidated Framework for Implementation Research (CFIR) to take into account the realities of the context and the intervention. The data collected from the participants directly involved in the implementation using three techniques: document consultation, individual interview, and focus group. Results Two dimensions of CFIR emerge from the results as having had a positive influence on the implementation: (i) the characteristics of the intervention and (ii) the processes of the intervention implementation. The majority of the CFIR constructions were considered to have had a positive effect on implementation. The quality and strength of the evidence received the highest score. The dimension of the external context had a negative influence on the implementation of the intervention. Conclusion The objective of the study was to analyze the influence of contextual elements on the implementation process of a community-based dengue fever intervention. We used the CFIR framework already used by many studies for implementation analysis. Although it was not possible to test this framework in its entirety, it is useful for the analysis of the implementation. Its use is simple and does not require any special skills from users. Usability is indeed an essential criterion for the relevance of using an analytical framework in implementation science

Prevalence and Antibiogram of Escherichia coli and Staphylococcus spp. Isolated from Cattle Milk Products Sold in Juja Sub-County, Kenya

Dairy ruminant milk provides a conducive environment for bacterial proliferation. In animals, these bacteria are exposed to antibiotics, whose overuse has led to increased cases of drug resistance. A cross-sectional study was conducted on milk and milk products vended in Juja Sub-County, Kenya to determine the prevalence of bacteria and antibiogram of Staphylococcus spp. and Escherichia coli. A total of 169 milk samples were obtained from various outlets in the study area. Milk samples were cultured and isolated bacteria were identified using standard bacteriological procedures. Various bacteria (15 species) were isolated in different proportions. Staphylococcus spp. and E. coli were isolated from 25.4% and 11.8% of the collected samples, respectively. The highest number of Staphylococcus spp. were isolated from raw milk (n = 34) while the highest number of E. coli where isolated from fermented milk (n = 15). Staphylococcus spp. and E. coli isolates were subjected to antimicrobial susceptibility tests using CLSI guidelines. The Staphylococcus spp. isolates were highly resistant to penicillin G (93%) but susceptible to norfloxacin (100%), gentamicin (90.6%), and chloramphenicol (86%). The E. coli isolates were highly resistant to cephalexin (85%) and ceftazidime (60%) but susceptible to chloramphenicol (100%), norfloxacin (95%), gentamicin (95%), azithromycin (95%) and cefepime (80%). Furthermore, 44.3% of Staphylococcus spp. and 50% of E. coli isolates had a Multiple Antibiotic Resistance (MAR) Index greater than 0.2. This implies that these bacteria were high-risk bacteria whose treatment with current antibiotics would be challenging. The high prevalence and multidrug resistance patterns shown by the Staphylococcus spp. and E. coli isolated from milk products in Juja Sub-county highlights the importance of proper handling and processing of milk from the farm to consumers. This will in turn reduce the possibility of zoonotic transfer of multidrug-resistant bacteria

Etude de l'insuffisance erectile dans une population d'hommes jeunes et sexuellement actifs au Burkina FasoStudy of erectile dysfuntion in a population of young and sexually active men in Burkina Faso

Objective: This study was carried out among a young population of working men to determine the prevalence of erectile dysfunction (ED) in our environment and to evaluate the patients' knowledge about and attitude towards this problem. Patients and Methods : This study was based on a survey carried out on male subjects aged 18 and above over a period of six months. The survey was done during an annual medical check-up of men working in local companies and some civil servants. Those who agreed to participate in the investigation (855 men), had to complete two questionnaires: the 5-item questionnaire of the International Index of Erectile Function (IIEF-5) evaluating the quality of erectile function and a questionnaire drawn up by our team with the aim of evaluating the participants' knowledge about and their attitude towards the problem of ED. The questionnaires were analyzed using the Epi info program. Results: The 855 subjects that took part in the investigation accounted for 80% of all men that had been asked to participate in the survey. The average age was 37,4 ± 9,1 years; more than two thirds of the participants (78%) were married and 69% were monogamous. The overall prevalence of ED was 47% and we noticed that it increased with age. Three risk factors were identified: age, arterial hypertension and hemorrhoidal disease. Age and arterial hypertension are classic risk factors for ED, while hemorrhoidal disease has so far not been considered as such. In our study, especially for the men interviewed, it has played an important role. 93,2% of the questioned subjects said that they would be ready to consult for ED, whereas in fact only 3,8% had taken medical advice.Conclusion: ED appears to be a real problem, also for younger men, in our environment. However the results of this study cannot be generalised and we are planning to undertake other studies based on the general population which will allow us to draw more valid conclusions and to better organize treatment of these patient. RsumObjectif: Notre tude avait pour objectif de dterminer la prvalence de l'insuffisance rectile (IE) dans notre environnement et d'valuer les connaissances et les attitudes des sujets qui en souffrent. Mthodologie: Il s'agissait d'une enqute transversale sur six mois concernant des sujets gs de 18 ans et plus du monde de travail, ralise au cours d'une visite annuelle des travailleurs des entreprises de la place et de quelques fonctionnaires. Les sujets ayant accept de participer l'enqute (855 hommes), avaient remplir deux questionnaires: la version 5 items de l'International Iindex of Erectile Function (IIEF5), qui value la fonction rectile et, un questionnaire labor par nous mme, dans le but d'valuer les connaissances et les attitudes des enquts, vis vis de l'IE. Les questionnaires ont ensuite t dpouills et analyss sur micro ordinateur l'aide du logiciel Epi info. Rsultats: Les 855 sujets qui ont particip l'enqute reprsentaient 80% de tous ceux qui ont t sollicits. L'ge moyen des enquts tait de 37,4 ± 9,1; plus des 2/3 (78%) taient maris et monogames dans 69%. La prvalence globale note tait de 47% et on a remarqu que celle-ci augmentait avec l'ge. Trois facteurs de risque ont t mis en exergue: l'ge, l'hypertension artrielle (HTA) et la maladie hmorrodaire. Si l'ge et l'HTA sont des facteurs de risque classiques, la maladie hmorrodaire l'est moins; par contre il a t beaucoup invoqu par de nombreux enquts. 93,2% des sujets interrogs seraient prts consulter pour IE, alors que seulement 3,8% l'avaient effectivement dj fait.Conclusion: L'insuffisance rectile s'est rvl comme un problme rel vcu dans notre environnement. Cependant nos rsultats ne peuvent pas tre gnraliss et nous envisageons d'autres tudes, en population gnrale, qui nous permettraient de tirer des enseignements et de mieux organiser la prise en charge de ces patients.African Journal of Urology Vol. 11(4) 2005: 310-31

Incontinence urinaire de la femme en milieu urbain au Burkina Faso: Enquête épidemiologique auprès de 759 femmes à Bobo Dioulasso

Objectifs : Déterminer la prévalence de l'incontinence urinaire, identifier les facteurs de risque et apprécier les retentissements de cette affection sur la vie des femmes. Patientes et méthodes : Etude prospective et transversale sur l'incontinence urinaire (UI) de la femme en milieu urbain au Burkina Faso. Il s'agit d'une enquête épidémiologique qui s'est déroulée de janvier 2003 à avril 2003 auprès de 759 femmes se rendant dans quelques formations sanitaires de la ville de Bobo-Dioulasso. Résultats : L'age moyen des femmes était de 29,8 ans, la gestité et la parité moyenne respectivement de 3 et 2,6. La majorité d'entre elles (63,6%) étaient des femmes au foyer dont 65,5% de mariées. La prévalence globale de l'IU était de 21,3% et l'incontinence urinaire d'effort (IUE) était le type dominant (54,6%). Concernant les facteurs de risque, seules la dystocie, les in-fections urinaires à répétition, la constipation chronique, l'épisiotomie et l'obésité restaient associés significativement à la survenue de l'IU, après une analyse multivariée utilisant le mode de régression logistique. Le retentissement de l'IU a été apprécié en terme de coût physique et surtout psychosocial ; le coût économique étant impossible à évaluer dans notre contexte. Conclusion : L'incontinence urinaire est fréquente dans notre région malgré le peu de cas vus dans les services de gynécologie et d'urologie. Une enquête de ce type réalisée en population générale et à l'échelle nationale permettrait de mieux apprécier l'amp-leur du problème et identifier les éléments nécessaires à une stratégie de prise en charge adéquate de cette pathologie. Female Urinary Incontinence in an Urban Area in Burkina Faso: Epidemiological Study of 759 Women in the City of Bobo-Dioulasso Objective: To evaluate the prevalence of urinary incontinence, identify its risk factors and describe its effects on the life of women affected by it in an urban area in Burkina Faso. Patients and Methods: This prospective study was carried out between January and April 2003 and was based on interviews with 759 female patients presenting to the Department of Urology, Sanou Souro Teaching Hospital, and five other medical centers in the city of Bobo-Dioulasso. By means of a questionnaire we collected information on socio-demographic patient characteristics, history of previous surgical or gynecological interventions, type of urine loss and the effects of urinary incontinence on the patients\' physical, psychological and economical condition. Results: The mean age of the patients was 29,8 years. The majority (63.6%) were housewives, 65.5% of them married. The overall prevalence of urinary incontinence was 21,3% with a predominance (54,6%) of stress urinary incontinence. Multivariate analysis of the risk factors (using the logistic regression model) showed that the following risk factors were significantly associated with urinary incontinence: dystocia, repeated urinary tract infections, chronic constipation, episiotomy and obesity. The physical and psycho-social effect of urinary incontinence on the patients is described. Conclusion: Urinary incontinence is frequently encountered in our environment although only few cases are seen in our gynecology and urology departments. A population-based investigation on a national scale will allow for a better judgment of the actual extent of the problem and will help to establish a strategy on how to better control it. African Journal of Urology Vol.11(1) 2005: 45-5

KNOWLEDGE, ATTITUDES AND PRACTICES OF TRADITIONAL PRACTITIONERS ABOUT JAUNDICE IN BOBO-DIOULASSO, BURKINA FASO

Knowledge, Attitudes and Practices of traditional practitioners about jaundice in Bobo-Dioulasso, Burkina Faso Introduction: Jaundice, according to popular knowledge cannot be treated in modern medicine and that’s why people consult traditional Practitioners. The objective of this paper was to study knowledge, attitudes and practices of traditional Practitioners (TP) about jaundice. Material and Methods: A descriptive cross sectional study was carried out from February 1st to April 30th inBobo-Dioulasso, Burkina. An individual questionnaire was used to collect about 100 TP members of two associations in the Bobo-Dioulasso. Results: The average age of participants was 48.51 (± 14) years old and sex ratio 1.9. Most of TP half (59%) were illiterate. The average number of practice was18.28 (± 11... 4) years old and the majority of TP (73%) were trained in Their family. Only few TP had (18%) the authorization of practice. Despite that all the TP knew jaundice, the level of knowledge of the causes was unsufficient in more than 91%. Only10% of TP named as hepatitis because 69% versus malaria. A good knowledge of jaundice causes was statistically associated to the alphabe-literacy (p = 0.003) but not to the anciennity of practice (p = 0. 5). The majority of machinery (86.5%) used herbal plants for the jaundice treatment.The most herbal plants cited by the TP were Cochlospermumtinctorium,Terminaliamacroptera,Commiphoraafricana,Anogeissusleiocarpus. Decoction was the most representation form used (74. 7%) and drinking is the most administration route (92. 7%). Some TP (9. 1%) think that the modern treatment was at risk of death in the presence of jaundice. The medical complementary exams were the main reason for TP to refer patients suffering from jaundice in modern medicine (48. 7%). Conclusion: this study shows an unsufficient knowledge of TP about jaundice notably its etiology. Herbal plants were the material the most used for the treatment of PD

The tip of the iceberg: evidence of seasonality in institutional maternal mortality and implications for health resources management in Burkina Faso.

AIMS: The aims of this study were to investigate seasonal patterns of institutional maternal deaths and complications, and to test for an association with malaria seasons, rainfall, and household income. METHODS: A systematic case review of hospital records in the Boucle du Mouhoun health region (Burkina Faso) was conducted over a 2-year period. A statistical smoothing procedure (T4253H) and Freedman's test were used to investigate seasonality and association with malaria, rainfall or household income variations. RESULTS: The data consistently showed the greatest rates of maternal deaths, eclampsia and haemorrhage cases during the dry season, which is the low malaria transmission season, and the period of the year when households have most money available and the lowest opportunity cost of travelling to seek medical attention, suggesting that financial and geographical barriers may be major underlying factors. CONCLUSIONS: The management both of health resources in hospital and of referral systems should accommodate cyclical variations in the presentation of maternal complications. Effective mechanisms are needed to help reduce the significant barriers to uptake faced by women and their families at particular times of the year

Tumeur d’Abrikossoff ou tumeur à cellules granuleuses à localisation buccale : à propos d’un cas au CHU Sourô SANOU de Bobo-Dioulasso

Les tumeurs à cellules granuleuses (TCG) sont des tumeurs rares de siège ubiquitaire avec une prédilection pour la région cervico-faciale. Dans la cavité buccale, elles siègent le plus souvent au niveau de la langue. Elles surviennent à tous les âges et sont le plus souvent bénignes. Elles sont caractérisées par la prolifération de grandes cellules à cytoplasme abondant, granuleux et éosinophile. L’immunohistochimie aide souvent au diagnostic. Les auteurs rapportent l’observation d’un enfant de 3 ans amené en consultation pour un nodule jugal droit évoluant depuis environ 2 ans. L’exérèse chirurgicale a été réalisée et l’examen histologique a montré des amas anastomosés de cellules de grandes tailles, arrondies ou ovalaire, à cytoplasme granuleux ou xanthélamisé, séparés par des cloisons de fibres collagènes et la présence de cellules géantes multinuclées. Le diagnostic de tumeur à cellules granuleuses a été retenu. Les suites opératoires étaient simples. Le contrôle à un an n’a pas objectivé de récidive. Mots clés : tumeur d’Abrikossoff, cavité orale, Bobo-Dioulasso.Granular cell tumors (GCT) are rare ubiquitous site tumors with a predilection for the head and neck localization. In the oral cavity tongue is the preferential localization. They occur at all ages and are most often benign. They are characterized by the proliferation of large cells with abundant, granular and eosinophilic cytoplasm. Immunohistochemistry often helps in diagnosis. The authors report the observation of a 3-year-old child consulting for a right jugal node evolving for about 2 years. Surgical excision was carried out and the histological examination showed anastomosed clusters of large cells, rounded or oval, with granular or xanthelamized cytoplasm, separated by fibro-collagenous partitions and the presence of giant multinucleated cells. The diagnosis of granular cell tumors was retained. The operating suites were simple. The one-year check did not show any recurrence. Key words: Abrikossoff’s tumor ; oral cavity ; Bobo-Dioulasso