National action plan on antimicrobial resistance: An evaluation of implementation in the World Health Organization Africa region

In line with global instruments, within the last five years, two-thirds of all countries in the WHO Africa Region (WHO AFR) have developed a National Action Plan (NAP) on Antimicrobial Resistance (AMR). We sought to evaluate progress made across the countries implementing NAP for effective response to AMR. A semi-structured survey tool was administered to obtain information from national focal persons on the implementation of strategic elements of NAP on AMR. This was followed by a Lessons Learnt Workshop in June 2019 at Douala, Cameroon, where focal persons made presentations on the country's progress. Later, a desktop review of the LLW report and other key documents was conducted. Countries in WHO AFR that have set up a national surveillance system and are enrolled into the WHO global antimicrobial resistance surveillance system have progressively increased to 30 (of 47 countries), of which 15 are already submitting surveillance data. Of the 20 countries at the Lessons Learnt Workshop, 14 have infection prevention and control (IPC) policies and functional healthcare facility IPC programs, 15 participate in the commemoration of the annual world hand hygiene days. Although almost all countries surveyed have national standard treatment guidelines, only five have incorporated the WHO AWaRe classification into the national essential medicines list. Fourteen of 20 countries have established an active/functional national secretariat/coordinating center for AMR. Discernible progress is being made on the implementation of NAP in WHO AFR region. Gaps identified in the strategic elements of action plans need to be filled for effective AMR control.

Larvicidal Activity of Crude Extracts of Vernonia cinerea Less (Asteraceae) against the Larvae of Anopheles gambiae in Bobo Dioulasso, Burkina Faso

Aims: This study aims to evaluate the larvicidal activity of lyophilized methanolic extracts, hydro-methanolic extracts and aqueous extracts of Vernonia cinerea Less against the 3rd and 4th instars larvae of Anopheles gambiae. Place and Duration of Study: Pharmacognosy Laboratory, Department of Biomedical Sciences, Centre MURAZ /Research Institute for Health; Ministry of Health, Bobo-Dioulasso, between February 2017 and January 2018. Institut de Recherche en Sciences de la Santé/Direction Régionale de l’Ouest (IRSS) Bobo-Dioulasso, between March 2017 and January 2018. Methodology: The whole plant material was collected in Banfora, located at West of Burkina Faso. The 80% methanolic, 50/50% hydro-methanolic and aqueous extracts were obtained by using the classical natural product extraction method of the laboratory. Extracts were lyophilized and a series of concentrations of the extracts ranging from 0.001 – 100 mg/L were prepared. The larvicidal activity of lyophilized extracts has been tested against the 3rd and 4thAnopheles gambiae larvae. The larval mortality was evaluated after 24 hours and 48 hours of exposure. The percent of means of mortality was calculated. Lethal Concentration LC50 and LC90 values were determined. Results: In the laboratory, the results of methanolic extract at 100 mg/L achieved (100%) mortality against Anopheles gambiae after 24 hours of exposure.The same extract at 10 mg/L generated (95.85±1.26%) of mortality outside the laboratory. The 80% methanolic extract showed Lethal Concentration LC50 of 11.07 mg/L and Lethal Concentration LC90 of 81.38 mg/L (after 24 hours). The 50/50% hydro-methanolic extracts achieved Lethal Concentration LC50 of 22.27 mg/L against 3417.78 mg/L respectively inside and outside of the laboratory. Conclusion: The methanolic extract is the most effective in killing on the larvae compared to the other extracts tested. Vernonia cinerea Less possesses larvicidal activity against Anopheles gambiae larvae. It may be a possible source of mosquito vector control. This study provided promising finding for using crude extracts of Vernonia cinerea Less in controlling larvae of malaria vectors.

Enhancing the Role of Traditional Medicine in Health Systems: A Strategy for the African Region

In line with Resolution AFR/RC50/ R3 (Promoting the role of traditional medicine in health systems: A strategy for the African Region; 2000); Member States took steps between 2001 and 2012 to promote traditional medicine by developing national policies and regulatory frameworks and by implementing some priority interventions. By 2012; a total of 40 countries had national policies; 19 had strategic plans and there were 28 national research institutes that conducted research on traditional medicine products used for malaria; HIV/ AIDS; sickle-cell disease; diabetes and hypertension. In addition; seven countries included traditional medicine products into their national essential medicines lists (NEML) and nine adopted national frameworks for the protection of intellectual property rights and traditional medicine knowledge related to practices and products. Despite the progress made; countries continue to face challenges in implementing Resolution AFR/RC50/R3. This article introduces an updated strategy ( Regional Strategy on Promoting the Role of Traditional Medicine in Health Systems reproduced at the end of this article) that proposes key interventions to address these challenges and builds on the successful promotion of the positive aspects of traditional medicine in national health systems. The focus is on strengthening of stewardship and governance; the development and use of tools; the cultivation of medicinal plants and conservation of biological diversity; research and development; local production; the protection of intellectual property rights and traditional medicine knowledge; intersectoral coordination and capacity building

HIV-Infected Women of Burkina Faso: a Reservoir of Mycoplasma Infection

Introduction: The objective of this work was to assess the prevalence of bacterial vaginosis (BV) and genital mycoplasma colonization in 251 HIV-positive compared to 200 HIV-negative women at the Maternal and Child Health (MCH) service of Saint Camille Medical Center Ouagadougou (Burkina Faso). Methodology: After revealing the cervix with a speculum; we collected swabs of vaginal discharge for the detection of pathogenic bacteria. Results: Among HIV-positive and HIV-negative women; we identified respectively: Mycoplasma hominis (16.7versus 5.5); Ureaplasma urealyticum (16.3versus 0.0); co-infection M. hominis with U. urealyticum (13.14versus 0.0); Candida albicans (21.11versus 41.5); E. coli (9.96versus 4.0); and the presence of abundant vaginal discharge (27.5versus 5.0) respectively. The Nugent's score; utilized for the diagnosis of BV; was significantly higher in HIV-positive women (p 0.001) associated with poor vaginal hygiene practices (p 0.01) and no use of condoms (p 0.01). Enterobacter; Klebsiella pneumonia; Klebsiella oxitocica; Staphylococcus epidermidis and Staphylococcus aureus; Streptococcus agalactiae; Trichomonas vaginalis; and Gardnerella vaginalis were also isolated; but in a low prevalence ranging from 0to 5. Conclusion: These results demonstrate that the HIV-positive women of Burkina Faso are frequently affected by BV and represent a reservoir for mycoplasma infection. Since these germs can lead to sterility and premature delivery; it is important to develop a policy of screening

Towards the complete eradication of mother-to-child HIV/HBV coinfection at Saint Camille Medical Centre in Burkina Faso, Africa

The coinfection of HIV and hepatitis B virus (HBV) and their vertical transmission constitute a public health problem in sub-Saharan countries of Africa. The objectives of this research are: i) identify the pregnant women that are coinfected by HIV and HBV at Saint Camille Medical Centre; ii) use three antiretroviral drugs (zidovudine, nevirapine and lamivudine) to interrupt the vertical transmission of HIV and HBV from infected mothers; and iii) use the PCR technique to diagnose children who are vertically infected by these viruses in order to offer them an early medical assistance. At Saint Camille Medical Centre, 115 pregnant women, aged from 19 to 41 years, were diagnosed as HIV-positive and, among them, 14 coinfected with HBV. They had at least 32 weeks of amenorrhoea and all of them received the HAART, which contained lamivudine. Two to six months after childbirth, the babies underwent PCR diagnosis for HIV and HBV. The results revealed that, among these mothers, 64.4 percent were housewives, 36.5 percent were illiterates, and only 1.7 percent had a university degree. The rate of vertical transmission of HIV and HBV was 0.0 percent (0/115) and 21.4 percent (3/14), respectively. The 3 mothers who transmitted the HBV to their children had all HBsAg, HbeAg, and HBV DNA positive. An antiretroviral therapy that in addition to zidovudine and nevirapine includes lamivudine could, as in the present study, block or reduce the vertical transmission in HIV positive pregnant women who are coinfected with HBV.

L' introduction de plantes medicinales dans le traitement de l'infection a VIH : une approche reussie au Burkina Faso

La recherche et le developpement de medicaments traditionnels anti-VIH/SIDA est un processus complexe qui integre de nombreux defis. Ce processus comprend les evaluations precliniques et cliniques ainsi que la valorisation industrielle; avec la mise sur le marche de medicaments respectant des normes de qualite; d'innocuite et d'efficacite therapeutique. Si de nombreuses plantes africaines ont deja fait l'objet d'evaluations precliniques avec des resultats encourageants; les etudes cliniques comparatives sont encore insuffisantes. L'espoir est cependant permis; comme nous le montre l'experience du Burkina Faso; notamment a travers le developpement de deux medicaments qui ont franchi aujourd'hui avec succes l'etape d'essai clinique Phase II; et surtout l'identification des plantes medicinales pouvant avoir une interference negative avec les traitements antiretroviraux

Promotion de la medecine traditionnelle du Burkina Faso : essai de developpement d'un medicament antidrepanocytaire; le FACA

La recherche et le developpement de medicaments antidrepanocytaires est une priorite en Afrique; ou vivent la grande majorite des personnes souffrant de drepanocytoses. C'est dans ce sens que le FACA a ete developpe au Burkina Faso; a partir de la Medecine Traditionnelle et avec le soutien du bureau regional de l'OMS. Les proprietes antifalciformantes; anti-inflammatoires; antipyretiques et myorelaxantes ont ete evaluees. Il en est de meme de la toxicite. Les plantes composant le FACA; agissent en synergie contre les principaux symptomes de la crise drepanocytaire. Administre en evaluation clinique; le FACA est bien tolere et reduit de maniere significative; la frequence des crises. Apres son autorisation de mise sur le marche; le FACA fait maintenant l'objet d'une production industrielle