Antiretroviral (ARV) Therapy in Resource Poor Countries: What do we Need in Real Life?

Significant progresses have been made in the last 5 years towards the ultimate goal to provide universal access to care for all HIV/AIDS patients needing antiretroviral treatment in resource-poor countries. However, many barriers are still to be overcome, including (●) cost of care for the individual, (●) stigma, (●) lack of qualified human resources and infrastructure, especially in the rural setting, (●) rescue drugs for failing patients and (●) pediatric formulations. Priority actions to be promoted if the fight against HIV/AIDS is to be successful include: (i) promoting access to care in the rural areas, (ii) strengthening of basic health infrastructures, (iii) waiving of users’ fee to get ARV, (iv) a larger variety of drugs, with particular regard to fixed dose combination third line drugs and pediatric formulations, (v) local quality training and (vi) high quality basic and translational research. While the universal access to HIV care is crucial in developing countries, a strong emphasis on prevention should be maintained along

Epidemiology of Syphilis in regional blood transfusion centres in Burkina Faso, West Africa

Introduction: Syphilis remains a major public health problem in  sub-Saharan Africa, including Burkina Faso. However, few published data are available on the prevalence of syphilis in the population. This study had two main objectives: to determine the seroprevalence of syphilis in acohort of 37,210 first time blood donors and to study socio-demographic factors associated with the risk of infection by Treponema pallidum.Methods: Antibodies to Treponema pallidum were screened by using  Reagin Rapid Test (RPR) and confirmed by treponema pallidum  haemagglutination test (TPHA). Results: The overall seroprevalence of syphilis was 1.5% among first time blood donors and was significantly different between centers (p <0.001). The infection was significantly higher in men than women among blood  donors in Ouagadougou and Fada N´gourma (P = 0.001 and P = 0.034). The overall seroprevalence of syphilis among blood donors was not  associated with either age group or HIV status. In contrast, a significantly high seroprevalence of syphilis was observed in blood donors with HBsAg (P = 0.014) and anti-HCV (P = 0.007) positive.Conclusion: Our report shows a low seroprevalence of syphilis in the  representative sample of the population of Burkina Faso. The  seroprevalence of syphilis remains unequally distributed between urban and rural areas and was not associated with HIV infection

First detection of bla TEM, SHV and CTX-M among Gram negative bacilli exhibiting extended spectrum β- lactamase phenotype isolated at University Hospital Center, Yalgado Ouedraogo, Ouagadougou, Burkina Faso

Resistance to a wide variety of common antimicrobials is observed among clinical strains designed as extended spectrum β-lactmase (ESBL)  producers. They produce enzymatic protein which inactivates efficiently oxyimino cephalosporin and constitutes a serious global health concern that has complicated treatment strategies. Many studies report high prevalence of ESBL producers among Gram negative bacilli. The aim of this work was to identify the presence of TEM, SHV and CTX-M families in thesestrains which were initially screened by phenotypic method. Gram negative bacilli resisting third or four generation cephalosporin were isolated during anti-biogram study. The presence of ESBL positivity was detected using the double disk synergy test. Minimal inhibitory concentrations (MICs) of ceftriazon for any strain were determined using E-test manufacturing protocol. Polymerase chain reaction (PCR) analysis for β-lactamase (bla) genes of TEM, SHV and CTX-M family was carried out using designed primers in 171 ESBL isolates producers. Among 259 Gram negative bacilli collected, 171 (66, 02%) exhibited ESBL producers’ profile. Urine samples constitute major source of ESBL producers. The highest prevalence of ESBL was observed in Escherichia coli (75, 50%). Among ESBL isolates producers, gene prevalence of bla-CTX-M (65, 49%) was highest, followed by bla-TEM (25, 73%) and bla-SHV (18, 71%) in the present study. The frequency of ESBL producing strains among clinical isolates has been steadily increased. Continual drug resistance surveillance and molecular characteristics of ESBL isolates are necessary to guide the appropriate and judicious antibiotic use.Key words: Extended spectrum β-lactamase (ESBL), double disk synergy test, blaTEM, blaSHV, blaCTX-M, PCR

Antioxidant and antibacterial activities of polyphenols from ethnomedicinal plants of Burkina Faso

Polyphenols from four medicinal plants of Burkina Faso, Combretum micranthum, Khaya senegalensis, Pterocarpus erinaceus and Sida acuta, were screened for their antioxidant and antimicrobial activities against pathogenic bacteria. The medicinal plants displayed different polyphenols contents and antioxidant activities. The bark of P. erinaceus had the highest antioxidant activity. Some microorganisms were susceptible to polyphenol extracts with minimal bactericidal concentration values between 20 and 2000 mg/ml while other microorganisms appeared to be resistant to the extracts. Microbicide and microbiostatic activities of the extracts were dependent on the type of strains. Results suggest that these plants are not only interesting sources for antimicrobial activities but also potential sources of phenolic antioxidants

Sida acuta Burm. f.: a medicinal plant with numerous potencies

Sida acuta is shrub belonging to Malvaceae family. The plant is widely distributed in the subtropical regions where it is found in bushes, in farms and around habitations. Surveys conducted in indigenous places revealed that the plant had many traditional usages that varied from one region to another. The most cited illnesses are fever, headache and infections diseases. Indeed, many laboratory screening have been conducted to show the scientific rationale behind these usages and many compounds havebeen isolated from the plant. In the present review we listed the plant usages in folk medicine in some regions where the plant grows and we discussed on the confirmed in vitro activities after laboratoryscreenings. The review ended with the pharmacological properties of several compounds isolated from S. acuta principally alkaloids

Microbiological and kinetic detection of gram negative bacilli producing extended-spectrum- β-lactamases (esbl) in emergencies and reanimation units of university hospital center, Yalgadoouedraogo, Burkina Faso

Background: Epidemiology of extended-Spectrum- β-lactamases has become worldwide, and our aim was to establish the prevalence of isolates producer in university hospital center Yalgado OUEDRAOGO particularly in reanimation and emergencies units.Material and methods: Prospective study was drive during July 2009 to march 2012 in order to collect strains resisting to third generation of cephalosporin during diagnosis analysis of biological specimens. Susceptibility of bacteria to antimicrobial agents was evaluated by disc diffusion method. Production of extended-spectrum β-lactamases has been investigated by double disc diffusion and kinetic methods.Results: 259 isolates which resisted at least to one of third generation of cephalosporins were collected. Among them 188 (72, 58 %) were positive to synergy test by a double disc diffusion method. The MICs of ceftriaxone determined by E-test were under than 50kg/ml, 100kg/ml et 256kg/ml for respect 81,57°/° ; 55,26°/° et 39,74°/° of isolates. Hydrolyze of β-lactam ring by bacterial extract followed at spectrophotometer showed speeds running at 0 to 0,090UAb.mn-1 for both isolates. Extract of 171 bacterial strains positives to synergy test had hydrolyzed at least one of oxy-iminocephalosporins and were identified as producing extended- spectrum β-lactamases. Spices reported by this study were 99 Escherichia coli (57,89%) ; 28 Klebsisella pneumonia (16,37%) ; 15 Enterobactersp (8,77%) ; 19 Pseudomonas aeruginosa (11,11%) ; 4 Citrobactersp (2,33%) 2 Acinetobactersp (1,16%), 3 Proteus mirabilis (1,75%) and 1 Salmonella typhi (0,05%).Conclusion: This study showed that bacterial resistances by extended- spectrum β-lactamases are a reality in University Hospital center YalgadoOuedraogo. It calls about antibiotics prescription and hospital hygiene in order to reduce emergence and propagation of new resisting bacterial.Keywords: microbial and kinetic analysis, Gram negative bacilli, extended-Spectrum- β-lactamase, emergencies, reanimatio

Antibacterial activity of alkaloids from Sida acuta

Sida acuta is a shrub indigenous to pantropical regions. The plant is widely used for its various pharmacological properties. Among compounds of pharmacological interest occurring in the plant, are indoloquinoline alkaloids. The aim of the present study was to investigate the antimicrobial activity ofalkaloids of S. acuta from Burkina Faso. The alkaloids had a good antimicrobial activity against the test microorganisms. In the agar-well diffusion assay, highest inhibition zone diameters were recorded with Gram-positive bacteria. The broth microdilution assay gave minimal inhibitory concentration values ranging from 16 to 400 ìg/ml and minimal bactericidal concentration values ranging from 80 to up to 400 ìg/ml. The gas chromatography-mass spectrometry analysis of the same alkaloids led to the identification of cryptolepine and quindoline as the major components

Diagnostic moléculaire d’helicobacter pylori par PCR chez les patients en consultation gastroentérologique au Centre Médical Saint Camille de Ouagadougou

Introduction: L'infection par Helicobacter pylori constitue un problème de santé publique notamment dans les pays en développement. Elle entraine une gastrite pouvant évoluer vers des formes sévères d'ulcération et de transformation maligne. La présenté étude avait pour objectif de diagnostiquer H. pylori par des techniques sérologique et moléculaire au Burkina Faso. Méthodes: L'étude prospective a été conduite de mars à juin 2012 sur 70 patients venus en consultation dans le service de gastroentérologie au Centre Médical Saint Camille. Le diagnostic de H. pylori a été réalisé par le test ELISA Immunocomb (ORGENICS Ltd, Yavne, Israël) et la PCR sur des biopsies gastriques prélevées sur les patients. Résultats: Les pathologies gastroduodénales étaient plus fréquentes chez les patients de plus de 45 ans. Les prévalences de H. pylori étaient respectivement de 88,57% et de 91,43% par sérologie Immunocomb et par PCR. La différence entre les deux techniques n'était pas significative (P = 0,573). La performance de la PCR a été comparée à celle de la technique Immunocomb. Les résultats montrent une sensibilité et une spécificité de 92,2% et 50,0% pour la technique Immunocomb. Conclusion: Le diagnostic de H. pylori par PCR est plus spécifique que le test sérologique Immunocomb et devrait être introduit dans le diagnostic de routine de cette bactérie pathogène au Burkina Faso

Genetic diversity of Sclerocarya birrea subspecies birrea populations in Burkina Faso detected by RAPDs

Sclerocarya birrea, multipurpose plant is characteristic of the Sahel-Sudanian savanna and is widespread in West Africa. Although this species has a high socio-economic importance, its genetic organization was not well characterized in Burkina Faso. In this study, the intra and interpopulation genetic diversity of S. birrea was determined by random amplified polymorphic deoxyribonucleic acid (RAPD) markers. We found a high average of intra population genetic diversity (He = 0.20) among S. birrea populations. The species populations were also characterized by their low genetic differentiation (Gst = 0.24), indicating a significant exchange of genes flow between populations. The whole population was clustered into four groups without reference of site and climatic zone. The Mantel test suggested that genetic distances between populations were not correlated to geographic distances. Our results strongly suggest that the structure and the level of this species’ genetics diversity may be due to its mode of dissemination involving ruminants.Key words: Genetic, variation, Sclerocarya birrea subspecies birrea, populations, RAPDs markers, Burkina Faso

HCV and HIV co-infection in pregnant women attending St. Camille Medical Centre in Ouagadougou (Burkina Faso

Five hundred and forty-seven pregnant women with less than 32 weeks of amenorrhoea, attending an antenatal clinic of St. Camille Medical Centre (SCMC) of Ouagadougou were enrolled for a hepatitis C virus (HCV) and HIV co-infection study. Fifty-eight (10.6%) were HIV positive and 18 (3.3%) were anti-HCV positive. Only seven pregnant women (i.e., 1.3%) had a documented HIV and HCV co-infection. HCV-RNA was found in 5 out of 18 (27.8%) patients, who had anti-HCV antibodies. The genotype analysis of these five patients showed that two were of 1b whereas three were of 2a genotype. Mother-to-infant transmission of the same HCV genotype (2a) was documented in only one case. High 1b prevalence has been reported in other parts of Africa, while 2a is the prevalent genotype (60%) in Burkina Faso. This genotype has a higher response rate to treatment. Serum transaminases were normal, also in presence of HCV-RNA. The higher than expected rate of co-infection in Burkina Faso seems to demonstrate a correlation between these two infections, which could influence the evolution of HIV and HCV diseases