Surgical treatment of trochanteric fractures: An Ivorian experience

Background: Trochanteric fractures have become a major focus of orthopaedic interest. Surgical management is the best option for treating such fractures. Objective: To present our experience with the surgical treatment of trochanteric fractures with special attention to short-term results. Design: A retrospective study performed between 1993 and 2002. Setting: Department of orthopaedics surgery, Yopougon teaching hospital, Abidjan, Côte d'Ivoire. Patients and methods: There were 48 men and 17 women with a mean age of 44 years at the moment of the injury. Road traffic accident was the main cause of fractures accounting for 42 cases. Mean preoperative delay was 22 days. Surgical implants used were the Judet screw plate and Küntscher nail. Results: Postoperative death occurred in three cases. Fracture healing was achieved in 57 patients at an average of four months. Malunion and displacement into varus was noticed in 11.7% of patients. Infection occurred in seven patients, wound hematoma in eight and decubital ulcer in five. Conclusions: Trochanteric fractures in our environment are caused by severe trauma. These injuries could be managed surgically with simple methods that are readily available with immediate satisfactory outcome. Keywords: trochanteric fractures, surgical care Judet screw plate, Küntscher nail, complications Nigerian Journal of Surgical Research Vol. 7(1&2) 2005: 187–19

Community perception regarding childhood vaccinations and its implications for effectiveness: a qualitative study in rural Burkina Faso

Background: Vaccination has contributed to major reductions in global morbidity and mortality, but there remain significant coverage gaps. Better knowledge on the interplay between population and health systems regarding provision of vaccination information and regarding health staff organization during the immunization sessions appears to be important for improvements of vaccination effectiveness. Methods: The study was conducted in the Nouna Health and Demographic Surveillance System (HDSS) area, rural Burkina Faso, from March to April 2014. We employed a combination of in-depth interviews (n = 29) and focus group discussions (n = 4) including children’s mothers, health workers, godmothers, community health workers and traditional healers. A thematic analysis was performed. All material was transcribed, translated and analyzed using the software ATLAS.ti4.2. Results: There was better social mobilization in the rural areas as compared to the urban area. Most mothers know the Expanded Program of Immunization (EPI) target diseases, and the importance to immunize their children. However, the great majority of informants reported that mothers don’t know the vaccination schedule. There is awareness that some children are incompletely vaccinated. Mentioned reasons for that were migration, mothers being busy with their work, the practice of not opening vaccine vials unless a critical number of children are present, poor interaction between women and health workers during immunization sessions, potential adverse events associated with vaccination, geographic inaccessibility during rainy season, and lack of information. Conclusions: Well organized vaccination programs are a key factor to improve child health and there is a clear need to consider community perceptions on program performance. In Burkina Faso, a number of factors have been identified which need attention by the EPI managers for further improvement of program effectiveness

Attitudes towards female genital cutting among adolescents in rural Burkina Faso: A multilevel analysis Female genital cutting in Burkina Faso

Objective: Despite decades of abandonment efforts, female genital cutting (FGC) prevalence rates in Burkina Faso remain high. We present updated prevalence data from rural adolescents and examine factors associated with FGC receipt and attitudes, testing predictions of social convention and modernisation theory regarding the abandonment process. Methods: We interviewed 1644 adolescents aged 12–20 years from 10 villages and one sector of Nouna town in the Nouna Health and Demographic Surveillance site in late 2017. Response‐weighted prevalence for self‐reported FGC receipt, beliefs about religious requirements, and attitudes about abandonment were calculated. We used bivariate regression and two‐level hierarchical models to test whether social convention or modernisation theory‐related factors predicted current FGC attitudes. Results: 43% of women in our sample reported having undergone FGC; 74% of women and 76% of men believed FGC should be abandoned. The strongest predictors of FGC receipt were religion, ethnicity, the village’s FGC rate and mother’s education. The strongest predictors of FGC abandonment attitudes were religion, ethnicity, belief that FGC is religiously required, and own FGC status. Males’ attitudes were less determined by community factors than females’; females’ attitudes were more strongly influenced by factors linked to modernization, such as maternal education and household wealth. Conclusions: FGC continues to be common in rural and small‐town Burkina Faso, and our analysis suggests that social conventions play an important role in its continuation. However, modernisation‐related factors were stronger predictors of abandonment attitudes than of FGC status, particularly in adolescent women. The changes these relationships suggest may benefit the next generation of girls

Long-term effect of Mali phosphate rock on the grain yield of interspecifics and saltiva rice cultivars on acid soil in a humid forest zone of Côte d’Ivoire

To generate knowledge of upland rice intensification in West Africa, the grain yields of four interspecific cultivars (V2 = WAB450-1 B-P-38-HB; V3 = WAB450-11-1-P-40-HB; V4 = WAB450-11-1-P-40-1-H; and V5 = WAB450-24-3-2-P-18-HB) were compared with that of a soil acidity tolerant sativa (WAB 56-104 = V1) on acid soil at Man in the humid forest zone in Côte d’Ivoire during five cropping seasons (1998, 1999, 2000, 2001 and 2002). Nitrogen and potassium were annually applied at 100 and 50 kg ha-1 respectively. Mali phosphate rock from Tilemsi was applied once in 1998 at 0, 150, 300 and 450 kg P ha-1 in a randomized complete block design with three replications. The results revealed a grain yield ranging from 0.5 t ha-1 to 2.6 t ha-1 with highest productivity of interspecific cultivars V3 and V4 even at 0 kg P ha-1 compared to acid tolerant saltiva (V1). Annual optimum rates of P application were determined at 31.5 and 45 kg P ha-1 respectively for V3 and V4. Applying Mali PR at 31.5 and 45 kg P ha-1 respectively for V3 and V4 was recommended for upland rice intensification in the humid forest zone of Côte d’Ivoire.Keywords: Mali phosphate rock, rice, Côte d’Ivoire, interspecific, acid soil

‘If he sees it with his own eyes, he will understand’: how gender informed the content and delivery of a maternal nutrition intervention in Burkina Faso

A growing body of literature urges policymakers, practitioners and scientists to consider gender in the design and evaluation of health interventions. We report findings from formative research to develop and refine an mHealth maternal nutrition intervention in Nouna, Burkina Faso, one of the world's most resource-poor settings. Gender was not an initial research focus, but emerged as highly salient during data collection, and thus guided lines of inquiry as the study progressed. We collected data in two stages, first using focus group discussions (FGD; n = 8) and later using FGDs (n = 2), interviews (n = 30) and observations of intervention delivery (n = 30). Respondents included pregnant women, breastfeeding mothers and Close-to-Community (CTC) providers, who execute preventative and curative tasks at the community level. We applied Morgan et al.'s gender framework to examine intervention content (what a gender-sensitive nutrition programme should entail) and delivery (how a gender-sensitive programme should be administered). Mothers emphasized that although they are often the focus of nutrition interventions, they are not empowered to make nutrition-based decisions that incur costs. They do, however, wield some control over nutrition-related tasks such as farming and cooking. Mothers described how difficult it is to consider only one's own children during meal preparation (which is communal), and all respondents described how nutrition-related requests can spark marital strife. Many respondents agreed that involving men in nutrition interventions is vital, despite men's perceived disinterest. CTC providers and others described how social norms and gender roles underpin perceptions of CTC providers and dictate with whom they can speak within homes. Mothers often prefer female CTC providers, but these health workers require spousal permission to work and need to balance professional and domestic demands. We recommend involving male partners in maternal nutrition interventions and engaging and supporting a broader cadre of female CTC providers in Burkina Faso

Comparative studies of drying methods on the seed quality of interspecific NERICA rice varieties (Oryza glaberrima x Oryza sativa) and their parents

Seed moisture content (MC) is a key component that determines storability of germplasm conserved in seed genebanks. The purpose of this research was to compare the efficiency of sun-, shade-, silica geland conventional room drying in terms of rice seed MC and viability using seeds of two interspecific progenies (NERICA 1 and NERICA 3) and their parents Oryza glaberrima and O. sativa varietiesharvested 15 days before, at and 15 days after mass maturity. Sun drying most significantly reduced MC (4-5%) and was comparable with silica gel drying regardless of the variety tested and the maturity stageat harvest. Likewise, sun drying gave the best germination percentages followed by silica gel. Shade and room drying did not significantly lower MC and led to poor germination, especially when rice washarvested prematurely. Except for the sativa variety, harvesting prematurely resulted in no germination. In contrast, the initial germination percentages in all tested varieties improved as rice was harvested at or after mass maturity rather than 15 days earlier. Though comparable to sun drying, silica gel may not be readily available and affordable for resource-limited seed storage facilities. In this case sun drying was found an effective and affordable method for short-term storage, especially farm-saved seeds

A double-masked placebo-controlled trial of azithromycin to prevent child mortality in Burkina Faso, West Africa: Community Health with Azithromycin Trial (CHAT) study protocol.

BACKGROUND:Biannual, mass azithromycin distribution has previously been shown to reduce all-cause child mortality in sub-Saharan Africa. Subgroup analysis suggested that the strongest effects were in the youngest children, leading to the hypothesis that targeting younger age groups might be an effective strategy to prevent mortality. We present the methods of two randomized controlled trials designed to evaluate mass and targeted azithromycin distribution for the prevention of child mortality in Burkina Faso, West Africa. METHODS/DESIGN:The Child Health with Azithromycin Treatment (CHAT) study consists of two nested, randomized controlled trials. In the first, communities are randomized in a 1:1 fashion to biannual, mass azithromycin distribution or placebo. The primary outcome is under-5 all-cause mortality measured at the community level. In the second, children attending primary healthcare facilities during the first 5-12 weeks of life for a healthy child visit (e.g., for vaccination) are randomized in a 1:1 fashion to a single orally administered dose of azithromycin or placebo. The primary outcome is all-cause mortality measured at 6 months of age. The trial commenced enrollment in August 2019. DISCUSSION:This study is expected to provide evidence on two health systems delivery approaches (mass and targeted treatment) for azithromycin to prevent all-cause child mortality. The results will inform global and national policies related to azithromycin for the prevention of child mortality. TRIAL REGISTRATION:ClinicalTrials.gov, ID: NCT03676764. Registered on 19 September 2018; prospectively registered pre results

Lack of antigenic diversification of major outer membrane proteins during clonal waves of Neisseria meningitidis serogroup A colonization and disease

In particular in the ‘meningitis belt' of sub-Saharan Africa, epidemic meningococcal meningitis is a severe public health problem. In the past decades, serogroup A lineages have been the dominant etiologic agents, but also other serogroups have caused outbreaks. A comprehensive vaccine based on subcapsular outer membrane proteins (OMPs) is not available. Here, we have investigated whether meningococcal populations overcome herd immunity by changing antigenic properties of their OMPs. Meningococcal isolates were collected in the context of longitudinal studies in Ghana between 2002 and 2008 and in Burkina Faso between 2006 and 2007. Serogroup A strains isolated during two clonal waves of colonization and disease showed no diversification in the genes encoding their PorA, PorB, and FetA proteins. However, we detected occasional allelic exchange of opa genes, as well as wide variation in the number of intragenic tandem repeats, showing that phase variation of Opa protein expression is a frequent event. Altogether we observed a remarkable antigenic stability of the PorA, PorB and FetA proteins over years. Our results indicate that while herd immunity may be responsible for the disappearance of meningococcal clones over time, it is not a strong driving force for antigenic diversification of the major OMPs analyzed her

Impairment in Activities of Daily Living and unmet need for care among older adults: A population-based study from Burkina Faso

OBJECTIVES: The importance of impairment in performing Activities of Daily Living (ADL) is likely to increase in sub-Saharan Africa since few care options for affected people exist. This study investigated the prevalence of ADL impairment, the extent to which care-need was met and described characteristics of people with ADL impairment and unmet need in Burkina Faso. METHODS: This study used data from the CRSN Heidelberg Aging Study, a population-based study among 3,026 adults aged over 40 years conducted in rural Burkina Faso. Information on six basic ADL items was sought, with a follow-up question asking whether care-needs were not met, partially met or met. Bivariable correlations and multivariable logistic regression were used to determine sociodemographic and health characteristics associated with ADL impairment and unmet need. RESULTS: ADL impairment of any kind was reported by 1,202 (39.7%) respondents and was associated with older age (Adjusted Odds Ratio: 1.05 [95% CI: 1.04-1.06]), being a woman (1.33 [1.06-1.60]) and reporting depressive symptoms (1.90 [1.65-2.18]). Among those with ADL impairment, 67.8% had at least one unmet need. Severe ADL impairment was found in 202 (6.7%) respondents, who reported lower prevalence of unmet need (43.1%). Severe ADL impairment was associated with depressive symptoms (2.55 [2.11-3.07]) to a stronger degree than any ADL impairment. DISCUSSION: Prevalence of ADL impairment and unmet need was high in this setting. Variation in impairment across the population highlighted key groups for future interventions. Unmet need for care was highest in middle-aged adults, indicating a gap in care provision

Process‐based atmosphere-hydrology-malaria modeling: performance for spatio‐temporal malaria transmission dynamics in Sub‐Saharan Africa

With the goal of eradication by 2030, Malaria poses a significant health threat, profoundly influenced by meteorological and hydrological conditions. In support of malaria vector control efforts, we present a high-resolution, coupled physically-based modeling approach integrating WRF-Hydro and VECTRI. This model approach accurately captures topographic details at the scale of larvae habitats in the Nouna Health and Demographic Surveillance Systems in Sub-Saharan Africa. Our study demonstrates the proficiency of the high-resolution hydrometeorological model, WRF-Hydro, in replicating observed climate characteristics. Comparisons with in-situ local weather data reveal root mean square errors between 0.6 and 0.87 mm/day for rainfall and correlations ranging from 0.79 to 0.87 for temperatures. Additionally, WRF-Hydro's surface hydrology reproduces the seasonal and intraseasonal variability of the ponded water fraction with 96% accuracy, validated against Sentinel-1 data at a 100-m resolution. The VECTRI model demonstrates sensitivity to surface hydrology representation, particularly when comparing conceptual and detailed physical process models, for variables such as larvae density, mosquito abundance, and EIR. The model's ability to replicate the seasonality of malaria transmission aligns well with available cohort malaria data suggesting its potential for predicting the impacts of climate change on mosquito abundance and transmission intensity in endemic tropical and subtropical zones. This integrated approach opens avenues for enhanced understanding and proactive management of malaria