ABSTRACT
BACKGROUND: The AIRE operational project will evaluate the implementation of the routine Pulse Oximeter (PO) use in the integrated management of childhood illness (IMCI) strategy for children under-5 in primary health care centers (PHC) in West Africa. The introduction of PO should promote the accurate identification of hypoxemia (pulse blood oxygen saturation Sp02 < 90%) among all severe IMCI cases (respiratory and non-respiratory) to prompt their effective case management (oxygen, antibiotics and other required treatments) at hospital. We seek to understand how the routine use of PO integrated in IMCI outpatients works (or not), for whom, in what contexts and with what outcomes. METHODS: The AIRE project is being implemented from 03/2020 to 12/2022 in 202 PHCs in four West African countries (Burkina Faso, Guinea, Mali, Niger) including 16 research PHCs (four per country). The research protocol will assess three complementary components using mixed quantitative and qualitative methods: a) context based on repeated cross-sectional surveys: baseline and aggregated monthly data from all PHCs on infrastructure, staffing, accessibility, equipment, PO use, severe cases and care; b) the process across PHCs by assessing acceptability, fidelity, implementation challenges and realistic evaluation, and c) individual outcomes in the research PHCs: all children under-5 attending IMCI clinics, eligible for PO use will be included with parental consent in a cross-sectional study. Among them, severe IMCI cases will be followed in a prospective cohort to assess their health status at 14 days. We will analyze pathways, patterns of care, and costs of care. DISCUSSION: This research will identify challenges to the systematic implementation of PO in IMCI consultations, such as health workers practices, frequent turnover, quality of care, etc. Further research will be needed to fully address key questions such as the best time to introduce PO into the IMCI process, the best SpO2 threshold for deciding on hospital referral, and assessing the cost-effectiveness of PO use. The AIRE research will provide health policy makers in West Africa with sufficient evidence on the context, process and outcomes of using PO integrated into IMCI to promote scale-up in all PHCs. TRIAL REGISTRATION: Trial registration number: PACTR202206525204526 retrospectively registered on 06/15/2022.
Subject(s)
Delivery of Health Care, Integrated , Child , Humans , Cross-Sectional Studies , Prospective Studies , Burkina Faso , Oxygen , Primary Health CareABSTRACT
Cymbopogon giganteus is a medicinal plant from Burkina Faso whose leaves are used in many traditional recipes to treat several diseases. However, no scientific studies have been reported on the analysis of bioactive molecules of the plant. It is therefore for the first time that flavonoids are isolated from the leaves of the Burkina Faso species. The aim was to quantify, isolate and characterize the major flavonoids in methanol extracts of the plant leaves by spectrophotometry, chromatography and NMR respectively. Flavonoid content analysis showed values ranging from 134 to 270 µg QE/mg extract. HPTLC-MS identified six peaks corresponding to phenolic compounds. By a succession of chromatography on column and by chemical, physicochemical and physical methods, we could isolate and characterize three flavonoids: epicatechin, luteolin 8-C-glucosid and luteolin 6-C-glucosid which structures were characterized by NMR. This study has provided relevant results to contribute to the knowledge of bio-active molecules of the local flora of Burkina Faso for their consideration as an alternative to synthetic products in various fields.
