Sahel terrorist crisis and development priorities: case of financial allocations for the control of non-communicable diseases in Burkina Faso.

In Africa, nearly 46% of all mortality will be attributed to non-communicable diseases (NCDs) by 2030. While the cost of inaction far exceeds the cost of action against NCDs, global funding for the prevention and control of NCDs is minimal. The objective of this was to explore the Ministry of Health budget allocations for NCDs from 2010 to 2020 as well as the effect of the terrorism crisis on these allocations. The methodology was based on the budget tracking tool developed by the Scaling Up Nutrition Movement. Twenty-nine budget lines related to the prevention and/or control of NCDs have been identified. About 29.9 million USD were allocated to the fight against NCDs with an absorption rate of more than 98%.There is an upward trend of allocated budget characterized by an exponential increase from the development of the national integrated strategic plan for the fight against NCDs (2016-2020). In 2017, an increase of 184% compared to 2016 was observed. However, the efforts were challenged by the emergence of the terrorist threat which triggered in January 2016, leading to a drastic reduction in allocations for NCDs in favor likely of defense and security priorities as well as addressing the needs of internally displaced persons. A trend analysis suggests that the NCDs budget significantly decrease as the country global terrorist index increase. Further analysis is needed to better understand the implication on NCD incidence, and identify advocacy opportunities for mitigating the negative impact of the terrorist treat on NCDs and other development issues.

An overview of governance of noncommunicable diseases (NCDs) in West African countries.

Noncommunicable diseases (NCDs) account for over 50% of total premature mortality in most low- and middle-income countries (LMICs). However, responses to the fight against NCDs are yet to be efficient in most of these countries. There is little published data on how this response is structured from a governance perspective in the context of global health systems. This study explored from existing research, the state of the governance in the fight against NCDs in the ECOWAS region. It consists of a review of articles published in peer-reviewed journals between 2010 and 2020 on ECOWAS countries. Of three hundred thirty-three (333) articles initially identified, eight (8) publications were included in these studies. There is a serious lack of information on the governance of NCDs in French-speaking countries such as Burkina Faso where no article has been identified. Of the 8 studies meeting the inclusion criteria, none has addressed the coherence of policies and programs. Seven (7) publications provided information on the component national NCDs policies, strategies and action plans, four (4) studies on the component of actors, interventions and the multisectoral coordination mechanism, five (5) on the issue of budget allocations and financing of NCD prevention and control interventions. Political commitment and government leadership has been discussed in three (3) publications. While some studies have provided information on the components of governance, it is important to remember that most of the studies were literature reviews and not empirical studies, which does not allow a better understanding of the situation of governance in each country. Designing an empirical study to answer some questions related to the governance of NCDs in the selected countries is necessary.

Physicochemical, potential nutritional, antioxidant and health properties of sesame seed oil: a review.

Sesame (Sesanum indicum L.) is one of the primary annual oilseeds grown in Africa and Asia. Sesame seed oil (SSO) is of great economic and human nutrition interest worldwide. Due to its composition in phytochemical antioxidants and profile in unsaturated fatty acids, sesame is used as a biological source of essential fatty acids. It contains bioactive compounds such as lignans (sesamin, sesamol, sesamolin), tocopherols and phytosterols. The oleic/linoleic fatty acids ratio of sesame makes it important for human health. SSO has bioactive compounds that can help prevent certain cardiovascular, metabolized and coronary diseases. The ω-3 and ω-6 fatty acids in SSO are precursors to eicosanoids that regulate the immune system and inflammatory functions. The essential fatty acids contained in this oil are essential for cell construction and highly recommended during the first trimester of pregnancy. The consumption of SSO allows both a decrease in the LDL-cholesterol complex and an increase in the HDL-cholesterol complex. It regulates blood sugar and may have favorable effects on people with liver cancer and those developing fatty liver disease. In this review, the nutritional value, antioxidant properties, and health benefits of SSO have been compiled to provide collective information of nutritional and medical interest.

Production and sensory evaluation of composite breads based on wheat and whole millet or sorghum in the presence of Weissella confusa A16 exopolysaccharides.

The aim of the study was to evaluate the acceptability of composite breads based on local cereal (millet and sorghum) formulations. Bread preparations based on 50% wheat flour and 50% local cereal flour were made in the presence of exopolysaccharide (Eps) production stimulated by a strain of Weissella confusa A16 in the fermented dough. Seven formulations were done in two baking sets and were submitted to sensory evaluations which consisted of tests on sensory profile, hedonic analysis and ranking. Results showed that the presence of Eps improved the acceptability of breads made with local cereal flours. The white color of the crumb of breads made with 100% wheat flour was the most appreciated by consumers. The less local flour is used in the bread preparation, the better the bread is appreciated. Nevertheless, formulations containing whole grains were the least appreciated, partly because of the hardness of the breads. Interestingly, more than 50% of consumers found the taste pleasant for breads made with 50% millet flour.

Non-Sensory Perception and Sensory Appeal of Zamnè, PseudoZamnè, Traditionally Cooked Senegalia erythrocalyx Seeds, and Tempeh According to Burkinabe Consumers.

The lack of adequate knowledge of the culinary and sensory properties of most indigenous and wild foods hampers their promotion in human diets and the market. In the present study, 80 Burkinabe volunteers evaluated the sensory appeal and attributes of three selected Senegalia seed species (Zamnè, pseudoZamnè or Kumatiya, and S. erythrocalyx) and their food formulae (traditionally cooked, harvested as green and fresh legumes, and fermented as tempeh) using the nine-point hedonic scale and check-all-that-apply questionnaire. They found that the traditionally cooked Zamnè, pseudoZamnè or Kumatiya, and derived tempeh had good sensory appeal (scoring between 5 and 7) and subtle alkaline and nutty tastes. However, an appreciable number (32%) of the participants were unaccustomed to tempeh and gave very low scores (2.5-3.4) for all the tempeh products. In contrast, the traditionally cooked seeds of Senegalia erythrocalyx and the green and fresh Zamnè evoked bitter and sour off-tastes, respectively, and were not much appreciated (scoring 4). The present study provides unprecedented insight into consumers' non-sensory perceptions and the culinary and sensory properties of Senegalia seed foods, which will be essential for their valorization, branding, and marketing.

Mung Bean (Vigna radiata (L.) R. Wilczek) from Burkina Faso Used as Antidiabetic, Antioxidant and Antimicrobial Agent.

Chronic non-communicable diseases are becoming more and more recurrent and require the addition of functional foods in our eating habits. Legumes due to their composition in biomolecules could meet this need. Much used in Chinese medicine, the mung bean arouses interest in Burkina Faso. The objective of this study is to perform phytochemical profiling and to evaluate certain biological properties of the mung bean in its natural or germinated state. Qualitative phytochemical screening was carried out by precipitation and differential staining tests. The antimicrobial activity was tested on in vitro growth by the agar medium diffusion method. DPPH and FRAP methods were used to assess antioxidant activity. The antidiabetic activity of hydroethanolic extracts was evaluated on rats rendered diabetic by streptozotocin, with metformin as a reference molecule. Phytochemistry has revealed the presence of phenolic compounds and derivatives in the mung bean, whether in its natural state (MBN) or in its germinated state (MBG). Only the MBG exhibits antimicrobial activity on 70% of the strains used. It appears that the MBG has a reducing power of the DPPH radical with an IC50 of 28 mg/mL compared to the same extract of the MBN, which had an IC50 of 32.5 mg/mL with a difference (p < 0.05) between the extracts. MBN extracts at a dose of 300 milligrams per kilogram of body weight (mg/kg.bw) showed a reduction (p < 0.0001) in glycaemia and kept the body weight of the animals constant throughout the treatment. In addition, the MBN regulated the level of total cholesterol, tryglicerides of LDL, ASAT, ALAT, urea and creatine. These results show that the mung bean grown in Burkina Faso is a health food, which, integrated into dietary habits, could contribute to the prevention of chronic diseases.

[Particularities of psycho-physiological aspects of sleeping disorders among women performing hospitals night work (Senegal)]. / Particularites des aspects psycho-physiologiques des troubles du sommeil chez les femmes effectuant des gardes de nuit en milieu hospitalier (Senegal).

OBJECTIVE: Todescribe the different psycho-physiological repercussions of night work among female health professionals subject to numerous socio-cultural constraints. MATERIAL AND METHODS: This was a cross-sectional and descriptive study including female professionals performing night work, conducted between July 1 and July 30, 2018 at the Kolda Regional Hospital Center.The study was carried out using anonymous questionnaires. The data collected was entered and analyzed with Microsoft Excel version 2013. RESULTS: A total of 41 women participated in the study. The average age was 30.9 years old. The average night work was 5.9 years. 51.2% of the workers felt comfortable with this type of schedule, compared to 48.8% feeling disrupted. 73.1% preferred daytime work. 36.5% wanted to stop this type of schedule. Several impacts of night work were identified.Physiologically, poor sleep quality (36.6%), insufficient sleep duration (36.6%), menstrual disorders (29.2%) were noted. On the psychological level, stress (48.8%), temperamental disorders (17.5%), anxiety and depression (10.7%) were found. CONCLUSION: A regular medical and psychological follow-up should be necessary for these professionals.

BUT: Il consistait à décrireles différentes répercussions psycho-physiologiques du travail de nuit, chez desprofessionnelles de santé sujettes à de nombreuses contraintes socioculturelles. MATÉRIEL ET MÉTHODES: Il s'agissait d'une étude transversale et descriptive incluant des professionnels de santé féminins, menée entre le 1er juillet et le 30 juillet 2018 au Centre Hospitalier Régional de Kolda. L'étude a été réalisée à l'aide de questionnaires anonymes.Les données recueillies ont été saisies et analysées avec Microsoft Excel version 2013. RÉSULTATS: Au total, 41 femmes avaient participé à l'étude. L'âge moyen était de 30,9 ans. La moyenne d'ancienneté dans le travail de nuit était de 5,9 ans. Les travailleuses se sentant à l'aiseavec ce type d'horaire représentaient 51,2% contre, 48,8% se sentant perturbées. La majorité (73,1%) préférait le travail de jour et 36,5% souhaitaient arrêter le travail de nuit. Plusieurs répercussions du travail de nuit étaient recensées. Sur le plan physiologique, une mauvaise qualité du sommeil (36,6%), une insuffisance de la durée du sommeil (36,6%), des troubles menstruels (29,2%) ont été notés. Sur le plan psychologique, le stress (48,8%), les troubles caractériels (17,5%), l'anxiété et la dépression (10,7%) étaient retrouvés. CONCLUSION: Un suivi médico-psychologique régulier serait nécessaire pour ces professionnelles.

Facteurs imputables aux services de santé limitant la pratique de l´allaitement exclusif dans la région du Centre au Burkina Faso: une étude transversale / Factors attributable to health services limiting the practice of exclusive breastfeeding in the Center Region of Burkina Faso: a cross-study

Introduction: l´organisation mondiale de la santé affirme que l´allaitement revêt une importance fondamentale pour la survie et le développement de l´enfant. Le but de la présente étude a été d´apprécier le niveau de connaissance et les attitudes du personnel soignant dans la promotion de l´allaitement exclusif afin d´identifier les facteurs limitants qui sont imputables aux services de santé. Méthodes: il s´est agi d´une étude transversale réalisée de juillet à novembre 2021 auprès de 74 agents de santé du district sanitaire de Boulmiougou. La collecte de données a été basée sur l´observation directe et l´administration d´un questionnaire. Le niveau de connaissance et les performances ont été évalués par le calcul des moyennes et le score de satisfaction a été fixée à au moins 80%. Résultats: il ressort de cette étude que les sages-femmes et les maïeuticiens représentaient 48,65% et que la majorité 78,37% des personnes interviewées avaient plus de cinq ans d´ancienneté. Pour l´opérationnalité des services, un score de satisfaction global de 21,25% a été retrouvé par rapport à l´existence de directives et de documentations sur l´allaitement. En matière de connaissance, le score de performance le plus élevé (62,06%) a été obtenu par une sage-femme et le plus bas (27,58%) obtenu par une accoucheuse auxiliaire. Conclusion: l´étude a permis de mettre en exergue la situation catastrophique dans la promotion de l´allaitement exclusif d´où il parait urgent de revoir la politique sanitaire en la matière pour redynamiser les activités afin de réduire la mortalité néonatale et infantile.

Introduction: the World Health Organization states that breastfeeding is of fundamental importance for child survival and development. The purpose of this study was to assess the level of knowledge and attitudes of health care personnel in the promotion of exclusive breastfeeding in order to identify the limiting factors that are attributable to health services. Methods: this was a cross-sectional study carried out from July to November 2021 among 74 health workers in the Boulmiougou health district. Data collection was based on direct observation and the administration of a questionnaire. The level of knowledge and performance were assessed by calculating averages and the satisfaction score was set at at least 80%. Results: it appears from this study that midwives and midwives represented 48.65% and that the majority 78.37% of those interviewed had more than five years of seniority. For the operationality of the services, an overall satisfaction score of 21.25% was found in relation to the existence of guidelines and documentation on breastfeeding. In terms of knowledge, the highest performance score (62.06%) was obtained by a midwife and the lowest (27.58%) obtained by an auxiliary midwife. Conclusion: the study made it possible to highlight the catastrophic situation in the promotion of exclusive breastfeeding from which it seems urgent to review the health policy in this area to revitalize activities in order to reduce neonatal and infant mortality.

Heterozygous HTRA1 nonsense or frameshift mutations are pathogenic.

Heterozygous missense HTRA1 mutations have been associated with an autosomal dominant cerebral small vessel disease (CSVD) whereas the pathogenicity of heterozygous HTRA1 stop codon variants is unclear. We performed a targeted high throughput sequencing of all known CSVD genes, including HTRA1, in 3853 unrelated consecutive CSVD patients referred for molecular diagnosis. The frequency of heterozygous HTRA1 mutations leading to a premature stop codon in this patient cohort was compared with their frequency in large control databases. An analysis of HTRA1 mRNA was performed in several stop codon carrier patients. Clinical and neuroimaging features were characterized in all probands. Twenty unrelated patients carrying a heterozygous HTRA1 variant leading to a premature stop codon were identified. A highly significant difference was observed when comparing our patient cohort with control databases: gnomAD v3.1.1 [P = 3.12 × 10-17, odds ratio (OR) = 21.9], TOPMed freeze 5 (P = 7.6 × 10-18, OR = 27.1) and 1000 Genomes (P = 1.5 × 10-5). Messenger RNA analysis performed in eight patients showed a degradation of the mutated allele strongly suggesting a haploinsufficiency. Clinical and neuroimaging features are similar to those previously reported in heterozygous missense mutation carriers, except for penetrance, which seems lower. Altogether, our findings strongly suggest that heterozygous HTRA1 stop codons are pathogenic through a haploinsufficiency mechanism. Future work will help to estimate their penetrance, an important information for genetic counselling.

Traditional African Dishes Prepared From Local Biofortified Varieties of Pearl Millet: Acceptability and Potential Contribution to Iron and Zinc Intakes of Burkinabe Young Children.

Biofortification is among the food-based strategies, recently implemented and still in development, to fight micronutrient deficiencies. Three cereal-based traditional dishes of Sub-Saharan Africa (tô paste, pancakes, and gruel) prepared from one local (Gampela), or two biofortified (GB 8735 and Tabi) varieties of millet were assessed for their (i) acceptability by local consumers, (ii) iron and zinc absorption predicted by phytate-to-mineral molar ratios and (iii) contribution to the iron and zinc requirements of young children. Tasters preferred the color, texture, and taste of dishes prepared with the local variety, whether or not the grains were decorticated. Hedonic and preference tests showed no significant difference between the two biofortified varieties, but the cooks reported different behaviors during processing. Biofortified millet contained up to two times more iron than the local variety, reaching 6.5 mg iron/100 g dry matter. Iron and zinc contents remained higher in biofortified varieties even after decortication. Iron content in the dishes was highly variable, depending on iron loss and potential contamination during processing. The phytate-to-mineral molar ratios of all dishes indicated low iron absorption, independent of the millet variety, but improved zinc absorption in dishes prepared with biofortified varieties. The contribution of a dish prepared with one of the two biofortified millet varieties to the recommended iron and zinc intakes for 6-11-month-old children was estimated to be about 5 and 7%, respectively, compared to 2 and 4% for the same dish prepared with local millet. For 12-23-month-old children, the contribution to the recommended intakes was estimated to be about 14 and 12% with biofortified millet, respectively, and about 6 and 7% with local millet. The use of biofortified millet varieties could be complementary to food diversification strategies to increase iron and zinc intakes. As in Ouagadougou, cereals are eaten in different forms by young children several times per day, iron and zinc intakes could be improved in the long term by using the biofortified varieties of pearl millet.

Susac syndrome: about two cases.

Susac syndrome is an autoimmune endothelopathy that affects precapillary arterioles of the brain, retina and inner ear. We report for the first time observations of two patients with Susac syndrome in Senegal.

Half of rifampicin-resistant Mycobacterium tuberculosis complex isolated from tuberculosis patients in Sub-Saharan Africa have concomitant resistance to pyrazinamide.

BACKGROUND: Besides inclusion in 1st line regimens against tuberculosis (TB), pyrazinamide (PZA) is used in 2nd line anti-TB regimens, including in the short regimen for multidrug-resistant TB (MDR-TB) patients. Guidelines and expert opinions are contradictory about inclusion of PZA in case of resistance. Moreover, drug susceptibility testing (DST) for PZA is not often applied in routine testing, and the prevalence of resistance is unknown in several regions, including in most African countries. METHODS: Six hundred and twenty-three culture isolates from rifampicin-resistant (RR) patients were collected in twelve Sub-Saharan African countries. Among those isolates, 71% were from patients included in the study on the Union short-course regimen for MDR-TB in Benin, Burkina Faso, Burundi, Cameroon, Central Africa Republic, the Democratic Republic of the Congo, Ivory Coast, Niger, and Rwanda PZA resistance, and the rest (29%) were consecutive isolates systematically stored from 2014-2015 in Mali, Rwanda, Senegal, and Togo. Besides national guidelines, the isolates were tested for PZA resistance through pncA gene sequencing. RESULTS: Over half of these RR-TB isolates (54%) showed a mutation in the pncA gene, with a significant heterogeneity between countries. Isolates with fluoroquinolone resistance (but not with injectable resistance or XDR) were more likely to have concurrent PZA resistance. The pattern of mutations in the pncA gene was quite diverse, although some isolates with an identical pattern of mutations in pncA and other drug-related genes were isolated from the same reference center, suggesting possible transmission of these strains. CONCLUSION: Similar to findings in other regions, more than half of the patients having RR-TB in West and Central Africa present concomitant resistance to PZA. Further investigations are needed to understand the relation between resistance to PZA and resistance to fluoroquinolones, and whether continued use of PZA in the face of PZA resistance provides clinical benefit to the patients.

[Prevalence of smoking among 741 High school students from Dakar. Carbon monoxide measurement]. / Prevalence du tabagisme parmi 741 Lycéens de Dakar : Intérêt de la mesure du monoxide de carbone.

BACKGROUND: Tobacco consumption is a net increase in our areas. In Senegal, as in other African countries, sponsorship of cultural and sporting events in schools promote tobacco use among schoolchildren. Our objective was to assess the prevalence of tobacco in the French School of Jean Mermoz of Dakar by a survey completed by a measurement of carbon monoxide (CO) in expired air. METHODS: seven hundred forty-one students (n = 402 girls and n = 339 boys), aged 11 to 18 years of French and African cultures, participated in the study. A questionnaire with several items of smoking has been distributed to them . Two weeks after the collection of questionnaires, the CO measuring for all students was conducted. RESULTS: The prevalence of smoking in High School was 23.1% and smoking was found more in boys according to the questionnaire and piCO+TM with 13.7% and 7.1% respectively. It affected over the upper age class or equal to fifteen years. The most mentioned reason for the initiation of smoking (45.4% of smokers) was curiosity with a need to be free, followed by the influence of the environment famial (44.4%) and friendly (20.5%). The measurement of carbon monoxide showed that 12.4% of our subjects had a smoking profile with 8% light smoking, 1% moderate smoking, and severe smoking was 3% of our students. A significant difference (p = 0.0021) between the two prevalences was found. CONCLUSION: The carbon monoxide intoxication by tobacco use is responsible for microcirculatory accidents such as tissue hypoxia, whereas smoking affects young students, in which the phenomenon is more precocious. Thus it is urgent to establish a policy of tobacco control in schools.

Shifts in Mycobacterial Populations and Emerging Drug-Resistance in West and Central Africa.

In this study, we retrospectively analysed a total of 605 clinical isolates from six West or Central African countries (Benin, Cameroon, Central African Republic, Guinea-Conakry, Niger and Senegal). Besides spoligotyping to assign isolates to ancient and modern mycobacterial lineages, we conducted phenotypic drug-susceptibility-testing for each isolate for the four first-line drugs. We showed that phylogenetically modern Mycobacterium tuberculosis strains are more likely associated with drug resistance than ancient strains and predict that the currently ongoing replacement of the endemic ancient by a modern mycobacterial population in West/Central Africa might result in increased drug resistance in the sub-region.

Effectiveness of a strategy to improve adherence to tuberculosis treatment in a resource-poor setting: a cluster randomized controlled trial.

CONTEXT: Poor adherence to treatment remains a major obstacle to efficient tuberculosis (TB) control in developing countries. Innovative strategies to improve access and adherence to treatment are needed. OBJECTIVES: To assess the effectiveness of a contextualized intervention strategy aimed at improving patients' adherence to treatment and to evaluate its impact on TB control in a resource-poor country in Africa with prevalent TB infection. DESIGN, SETTING, AND PATIENTS: A cluster randomized controlled trial, conducted between June 2003 and January 2005, at 16 government district health centers in Senegal. Patients older than 15 years with newly diagnosed sputum smear-positive pulmonary TB were randomly assigned to the intervention or control group. INTERVENTION: The intervention strategy included reinforced counseling through improved communication between health personnel and patients, decentralization of treatment, choice of directly observed therapy (DOT) supporter by the patient, and reinforcement of supervision activities. In the control group, the usual TB control program procedures remained unchanged. MAIN OUTCOME MEASURE: Proportion of patients successfully completing the 8-month course of treatment and the proportion of patients defaulting from treatment. RESULTS: A total of 1522 patients were recruited into the study. Treatment was successful for 682 (88%) of 778 patients recruited in the intervention group, and for 563 (76%) of 744 patients recruited in the control group (adjusted risk ratio [RR], 1.18; 95% confidence interval [CI], 1.03-1.34). The proportion of patients defaulting was reduced in the intervention group to 5.5% (n = 43) compared with 16.8% (n = 125) in the control group (adjusted RR, 0.43; 95% CI, 0.21-0.89). CONCLUSION: The intervention package based on improved patients counseling and communication, decentralization of treatment, patient choice of DOT supporter, and reinforcement of supervision activities led to improvement in patient outcomes compared with the usual TB control procedures. This approach may be generalized in the context of TB control programs in resource-poor countries. TRIAL REGISTRATION: clinicaltrials.gov Identifier: NCT00412009.