APOBEC3G variants and protection against HIV-1 infection in Burkina Faso

Studies on host factors, particularly the APOBEC3G gene, have previously found an association with AIDS progression in some populations and against some HIV-1 strains but not others. Our study had two main objectives: firstly, to screen a population from Burkina Faso for three variants of APOBEC3G previously described, and secondly to analyze the effect of these three variants and their haplotypes on HIV-1 infection with Circulating Recombinant Forms (CRFs) present in Burkina Faso. This case control study involved 708 seropositive and seronegative individuals. Genotyping was done by the TaqMan allelic discrimination method. Minor allele frequencies of rs6001417 (p<0.05), rs8177832 (P<0.05), and rs35228531 (P<0.001) were higher in seronegative subjects. The rs6001417 and rs8177832 SNPs were associated with HIV-1 infection in an additive model (P<0.01). Furthermore the SNP rs35228531 was also associated with HIV-1 infection in a dominant model (P<0.001). Odds ratio analysis of genotypes and alleles of the different APOBEC3G variants showed that there is a strong association between the minor genetic variants, genotype of the three SNPs, and HIV-1 status. Haplotype analysis demonstrated that rs6001417, rs8177832, and rs35228531 are in linkage disequilibrium. The haplotype GGT from the rs6001417, rs8177832 and rs35228531 respectively has a protective effect OR = 0.54 [0.43-0.68] with P<0.001. There was also associations between the haplotypes GGC OR = 1.6 [1.1;-2.3] P<0.05, and CGC OR = 5.21 [2.4-11.3] P<0.001, which increase the risk of infection by HIV-1 from almost two (2) to five (5) fold. This study demonstrates an association of rs6001417, rs8177832, and rs35228531 of APOBEC3G with HIV-1 infection in a population from Burkina Faso

Birth preparedness and complication readiness (BPCR) among pregnant women in hard-to-reach areas in Bangladesh:BPCR in hard-to-reach areas of Bangladesh

Birth preparedness and complication readiness aims to reduce delays in care seeking, promote skilled birth attendance, and facility deliveries. Little is known about birth preparedness practices among populations living in hard-to-reach areas in Bangladesh.To describe levels of birth preparedness and complication readiness among recently delivered women, identify determinants of being better prepared for birth, and assess the impact of greater birth preparedness on maternal and neonatal health practices.A cross-sectional survey with 2,897 recently delivered women was undertaken in 2012 as part of an evaluation trial done in five hard-to-reach districts in rural Bangladesh. Mothers were considered well prepared for birth if they adopted two or more of the four birth preparedness components. Descriptive statistics and multivariable logistic regression were used for analysis.Less than a quarter (24.5%) of women were considered well prepared for birth. Predictors of being well-prepared included: husband's education (OR = 1.3; CI: 1.1-1.7), district of residence, exposure to media in the form of reading a newspaper (OR = 2.2; CI: 1.2-3.9), receiving home visit by a health worker during pregnancy (OR = 1.5; CI: 1.2-1.8), and receiving at least 3 antenatal care visits from a qualified provider (OR = 1.4; CI: 1.0-1.9). Well-prepared women were more likely to deliver at a health facility (OR = 2.4; CI: 1.9-3.1), use a skilled birth attendant (OR = 2.4, CI: 1.9-3.1), practice clean cord care (OR = 1.3, CI: 1.0-1.5), receive post-natal care from a trained provider within two days of birth for themselves (OR = 2.6, CI: 2.0-3.2) or their newborn (OR = 2.6, CI: 2.1-3.3), and seek care for delivery complications (OR = 1.8, CI: 1.3-2.6).Greater emphasis on BPCR interventions tailored for hard to reach areas is needed to improve skilled birth attendance, care seeking for complications and essential newborn care and facilitate reductions in maternal and neonatal mortality in low performing districts in Bangladesh

Birth preparedness and complication readiness among the women beneficiaries of selected rural primary health centers of Dakshina Kannada district, Karnataka, India.

INTRODUCTION: Birth preparedness and complication readiness (BPCR) is a strategy to promote timely use of skilled maternal and neonatal care during childbirth. According to World Health Organization, BPCR should be a key component of focused antenatal care. Dakshina Kannada, a coastal district of Karnataka state, is categorized as a high-performing district (institutional delivery rate >25%) under the National Rural Health Mission. However, a substantial proportion of women in the district experience complications during pregnancy (58.3%), childbirth (45.7%), and postnatal (17.4%) period. There is a paucity of data on BPCR practice and the factors associated with it in the district. Exploring this would be of great use in the evidence-based fine-tuning of ongoing maternal and child health interventions. OBJECTIVE: To assess BPCR practice and the factors associated with it among the beneficiaries of two rural Primary Health Centers (PHCs) of Dakshina Kannada district, Karnataka, India. METHODS: A facility-based cross-sectional study was conducted among 217 pregnant (>28 weeks of gestation) and recently delivered (in the last 6 months) women in two randomly selected PHCs from June -September 2013. Exit interviews were conducted using a pre-designed semi-structured interview schedule. Information regarding socio-demographic profile, obstetric variables, and knowledge of key danger signs was collected. BPCR included information on five key components: identified the place of delivery, saved money to pay for expenses, mode of transport identified, identified a birth companion, and arranged a blood donor if the need arises. In this study, a woman who recalled at least two key danger signs in each of the three phases, i.e., pregnancy, childbirth, and postpartum (total six) was considered as knowledgeable on key danger signs. Optimal BPCR practice was defined as following at least three out of five key components of BPCR. OUTCOME MEASURES: Proportion, Odds ratio, and adjusted Odds ratio (adj OR) for optimal BPCR practice. RESULTS: A total of 184 women completed the exit interview (mean age: 26.9±3.9 years). Optimal BPCR practice was observed in 79.3% (95% CI: 73.5-85.2%) of the women. Multivariate logistic regression revealed that age >26 years (adj OR = 2.97; 95%CI: 1.15-7.7), economic status of above poverty line (adj OR = 4.3; 95%CI: 1.12-16.5), awareness of minimum two key danger signs in each of the three phases, i.e., pregnancy, childbirth, and postpartum (adj OR = 3.98; 95%CI: 1.4-11.1), preference to private health sector for antenatal care/delivery (adj OR = 2.9; 95%CI: 1.1-8.01), and woman's discussion about the BPCR with her family members (adj OR = 3.4; 95%CI: 1.1-10.4) as the significant factors associated with optimal BPCR practice. CONCLUSION: In this study population, BPCR practice was better than other studies reported from India. Healthcare workers at the grassroots should be encouraged to involve women's family members while explaining BPCR and key danger signs with a special emphasis on young (<26 years) and economically poor women. Ensuring a reinforcing discussion between woman and her family members may further enhance the BPCR practice

Professions and the social order: some lessons from Burkina Faso?

The study of professions has been dominated by Anglo-American models, with their focus on a small group of legally-licensed occupations. The field has recently shifted, mainly through studies of European experience, to a wider examination of the social management of expert workers. Very little has been written about developments in Africa and their implications for the way in which we might think about professions. This paper presents a case study of the role and practices of the medical profession in Burkina Faso, which has a relatively open market for the supply of healing services and limited regulation of the suppliers, whether physicians or traditional practitioners. The study returns to classic questions about the extent to which practice is shaped by the nature of occupational niches within the division of labour or to the development of a distinctive moral character among the workers within that niche

Productivity, family planning and reproductive health in Burkina Faso 2013-2014

(1)Quantitative data from a prospective cohort study of 839 pregnant and/or postpartum women who were between seven months gestation and three months postpartum at recruitment. Participants were interviewed three times over a nine month period. The cohort is a population-representative sample of parturient women in the commune of Bobo-Dioulasso, Burkina Faso. Data were collected relating to socio-demographic characteristics; household assets; reproductive history; women’s work and occupation including both income-generating and non-income generating activities; birth and postpartum preparedness; characteristics of the index delivery; contraceptive history and current use; fertility preferences; health-related functioning (ability to carry out usual daily activities); haemoglobin level; mental health measured through the K10 scale; time use diary; household food security scale. (2) qualitative data (transcripts of 56 in-depth interviews and 3 focus group discussions) from a nested cohort of women recruited from within PopDev, and their husband/partners. Key themes discussed in these qualitative data are women’s work, use of family planning, and the factors that facilitated or were challenging during their return to work during the postpartum period. Interviews with policy makers and key stakeholders also conducted Our previous ESRC-funded research in Burkina Faso showed the adverse effects of serious illnesses during pregnancy and the high costs of care on women's lives. The aim of this new project is to gain a detailed understanding of how the arrival of a new baby affects women’s productivity and how family planning and other reproductive health services can help women returning to good health and work. This multi-disciplinary project includes three sub-studies. Sub-study A is a secondary analysis of cross-sectional survey data collected in Burkina Faso from 2001-2006. Sub-study B is a cohort study of women identified in the community during pregnancy and the first trimester after childbirth. Over a period of nine months, women will be interviewed three times about their health, preparations they made for childbirth and the period after childbirth, changes in paid work (or education) and domestic work, fertility intention and contraceptive needs. Interviewers will measure women's blood pressure and whether they have anaemia. In sub-study C, qualitative methods will document how women and their family make decisions on work, childbirth and family planning. Sub-study C will re-interview a sub-sample of cohort women, observe some of them in their daily activities, and interview men, policy makers as well as health care providers

Residual risk of HIV, HCV, and HBV transmission by blood transfusion between 2015 and 2017 at the Regional Blood Transfusion Center of Ouagadougou, Burkina Faso

Arzouma Paul Yooda,1&ndash;3 Salam Sawadogo,3 Serge Th&eacute;ophile Soubeiga,1,2 Dorcas Obiri-Yeboah,4 Koumpingnin Nebie,3 Abdoul Karim Ouattara,1,2 Birama Diarra,1,2 Abibou Simpore,3 Yetema Dieudonn&eacute; Yonli,3 Abdoul-Guaniyi Sawadogo,3 Bia Emile Drabo,3 Seimbou Zalla,3 Anita Pierrette Siriti&eacute;,3 Rodrigue Sosth&egrave;ne Nana,3 Honorine Dahourou,3 Jacques Simpore1,2 1Laboratory of Molecular Biology and Genetics (LaBioGene), Training and Research Unit in Life and Earth Sciences, University Ouaga I Professor Joseph Ki-Zerbo, Ouagadougou, Burkina Faso; 2Pietro Annigoni Biomolecular Research Center (CERBA), Ouagadougou, Burkina Faso; 3National Blood Transfusion Center (NBTC), Ouagadougou, Burkina Faso; 4Department of Microbiology and Immunology, School of Medical Sciences, University of Cape Coast, Ghana Introduction: In sub-Saharan Africa, the high endemicity of blood-borne infections is a serious threat to transfusion safety. In order to improve transfusion safety, Burkina Faso has undertaken in recent years a reorganization of its blood-transfusion system through the creation of a National Blood Transfusion Center, which is the only blood operator in the whole country. This study aimed to estimate the residual risk of transmission of HIV, hepatitis B virus (HBV), and hepatitis C virus (HCV) by blood transfusion at the Regional Blood Transfusion Center (RBTC) of Ouagadougou.Methods: This was a retrospective study conducted at the RBTC of Ouagadougou between 2015 and 2017. Prevalence of infectious markers was calculated for first-time donors and incidence rates calculated for repeat donors who had made at least two donations of blood over the study period. Residual risks were estimated for the three viruses (HIV, HBV, and HCV) by multiplying the incidence rate per 100,000 person-years by the respective durations of serological windows.Results: Between 2015 and 2017, of a total of 84,299 blood donors, 68,391 (81.13%) were first-time donors compared to 15,908 (18.87%) repeat donors. The seroprevalence of HBV (8.56%) was twice that of HCV (4.40%) and fourfold that of HIV (1.80%). Incidence rates were 1,215, 2,601, and 1,599 per 100,000 donations for HIV, HCV, and HBV, respectively. In contrast, the estimated residual risk for HCV (1 in 213 donations) was double that of HBV (1 in 408 donations) and four times that of HIV (1 in 1,366).Conclusion: The residual risk of transmission of these viruses by blood transfusion remains high in repeat donors. An effective donor-retention and education policy could help to reduce this residual risk. Keywords: infectious diseases, prevalence, incidence, residual transfusion ris