Prospective cohort of COVID-19 patients requiring hospital admission in Douala, Cameroon.

OBJECTIVES: To report characteristics and outcome of COVID-19 patients who required hospital admission in sub-Saharan Africa clinics with no access to invasive mechanical ventilation. METHODS: Between April and June 2021, documented COVID-19 patients with SaO2 < 95% who were admitted in two clinics in Douala (Cameroon) were invited to participate. Data were prospectively collected using a standardized questionnaire. RESULTS: We included 67 patients: 39 males (58%), median age 62 years [50-70]. Comorbidities included hypertension (n = 38, 57%), obesity (n = 26, 38%), and diabetes (n = 16, 24%). No patient reported COVID-19 vaccination. On admission, 35 patients (52%) required O2 > 6 L/min. CT scan demonstrated extended lesions (>50%) in 50/61 cases (82%). Most patients received dexamethasone (n = 64, 96%), heparin (n = 64, 96%), chloroquine/azithromycin (n = 59, 88%), and broad-spectrum antibiotics (n = 59, 88%). Sixteen patients died (24%), after a median of 11.5 days [7.5-15.5] post-admission. CONCLUSIONS: Despite the lack of invasive mechanical ventilation, 76% of COVID-19 patients survived.

Extended red blood cell antigens and phenotypes in Burkina Faso: potential issues to design local population-sourced red blood cell reagent panels.

To date, 43 blood group systems with 349 red blood cell (RBC) antigens have been recognized. The study of their distribution is useful for blood services to improve their supply strategies for providing blood of rare phenotypes, but also to design indigenous RBC panels for alloantibody screening and identification. In Burkina Faso, the distribution of extended blood group antigens is not known. This study aimed to investigate the extended profiles of blood group antigens and phenotypes of this population and to raise limitations and potential strategies for the design of local RBC panels. We conducted a cross-sectional study that included group O blood donors. Extended phenotyping for antigens in the Rh, Kell, Kidd, Duffy, Lewis, MNS, and P1PK systems was performed using the conventional serologic tube technique. The prevalence of each antigen and phenotype combination was determined. A total of 763 blood donors were included. The majority were positive for D, c, e, and k and negative for Fya and Fyb. The prevalence of K, Fya, Fyb, and Cw was less than 5 percent. The most frequent Rh phenotype was Dce, and the most common probable haplotype was R0R0 (69.5%). For the other blood group systems, the K-k+ (99.4%), M+N+S+s- (43.4%), and Fy(a-b-) (98.8%) phenotypes were the most frequent. Antigenic polymorphism of blood group systems by ethnicity and geography argues for the design and evaluation of population-sourced RBC panels to meet specific antibody profiles. However, some of the specificities identified in our study, such as the rarity of double-dose antigen profiles for certain antigens and the cost of antigen phenotyping tests, are major challenges to overcome.

Feasibility and performance of in-house red blood cell reagents to detect unexpected antibodies in immunized patients in Burkina Faso.

In sub-Saharan Africa, antibody detection tests remain inaccessible because of the high cost and limited shelf life of red blood cell (RBC) reagents. This study aimed at investigating the feasibility and performance of locally prepared RBC reagents for antibody detection in Burkina Faso. We conducted an experimental study comparing commercial RBC panels and a local panel prepared from phenotyped blood donors in Ouagadougou, Burkina Faso. Antibody detection testing was performed by the indirect antiglobulin test using a gel card filtration column in a low-ionic-strength solution. Judgment criteria were the concordance rate and the kappa agreement coefficient of results generated by the two panels. A total of 302 blood donors were phenotyped for the major antigens of the RH, KEL, MNS, FY, JK, LE, and P1PK blood group systems. From this pool of donors, we designed an RBC detection panel that was used to screen for unexpected antibodies in 1096 plasma samples from 832 patients with a history of transfusion and 264 recently delivered or pregnant women with no history of blood transfusion. A positive antibody detection test was observed in 8.1 percent of the samples using the local panel versus 6.4 percent with the commercial panels. A total of 23 samples were negative with the commercial panels and positive with the local panel, while the findings were reversed for four samples. The concordance rate was 97.5 percent, and the kappa agreement coefficient was 0.815. Our results suggest that the development of local RBC panels can be an alternative to commercial panels in countries with limited resources. It could also be a cost-effective intervention, mainly for children under 5 years of age, women of childbearing age, and pregnant women, all of whom are most at risk for malaria and sickle cell disease complications. Blood services could develop and implement appropriate strategies to make phenotyped donor pools available for the design of suitable RBC panels.

[Prevalence of Chronic Complications of Sickle Cell Disease at the Bobo-Dioulasso Teaching Hospital, Burkina Faso]. / Prévalence des complications chroniques de la drépanocytose au CHU de Bobo-Dioulasso, Burkina Faso.

This is a descriptive cross-sectional unicentric study, with a prospective collection of data on the frequency of chronic complications of sickle cell disease in patients monitored at Souro Sanou University Hospital in Bobo-Dioulasso in the department of medicine conducted from April 1, 2017 to July 31, 2018. Patients with confirmed adult sickle cell disease, at least 16 years of age, who had given oral consent, was seen at least twice in the inter-critical period during the study, and who had performed a biological and / or radiological screening for chronic complications. Out of 144 sickle cell patients seen, 79 met our inclusion criteria. The mean age of the patients was 28.8 ± 10.3 years with extremes of 16 and 63 years. Females predominated in 68% of cases (N = 54). Sickle cells were of SC phenotype in 68% of cases, SS in 24%, Sß + in 5% of cases and Sß0 in 3% of cases. The overall prevalence of complications was 54% (43/79), 68% (13/19) in SS individuals and 50% in SC individuals (27/54). The observed chronic complications were ocular, bony, renal, cardiac, cutaneous respectively in 19%, 13%, 6.3%, 5% and 4% of cases, biliary and neurological in 3% each, ENT and pulmonary in 1.3% each. The mean age of patients with at least one chronic complication was 30.9 ± 10.4 years; it was 32.1 ± 10.3 years old in the SC and 25.3 ± 7.8 years old in the SS. Complications were unique in 72%, double in 23% and triple in 5%. The prevalence of chronic complications of sickle cell disease is high in patients with major sickle cell syndrome. Systematic screening and evaluation of organ damage are required to interrupt or delay their evolution.

Il s'est agi d'une étude transversale descriptive unicentrique à collecte prospective des données de la fréquence des complications chroniques de la drépanocytose chez les patients suivis au CHU Sourô-Sanou (CHUSS) de Bobo-Dioulasso dans le département de médecine menée du 1er avril 2017 au 31 juillet 2018. Ont été inclus les patients ayant une drépanocytose majeure confirmée, âgés d'au moins 16 ans, ayant donné un consentement verbal, vus en période intercritique au moins deux fois au cours de l'étude, et ayant réalisé un bilan biologique et/ou radiologique de dépistage des complications chroniques. Sur 144 patients drépanocytaires vus en consultation hématologique, 79 répondaient à nos critères d'inclusion. L'âge moyen des patients était de 28,8 ± 10,3 ans avec des extrêmes de 16 et 63 ans. Le sexe féminin prédominait dans 68 % des cas (n = 54). Les drépanocytaires étaient de phénotype SC dans 68 % des cas, SS dans 24 %, Sß+ dans 5 % des cas et Sß0 dans 3 % des cas. La prévalence globale des complications était de 54 % (43/79). Elle était de 68 % (13/19) chez les drépanocytaires SS et de 50 % chez les drépanocytaires SC (27/54). Les complications chroniques observées étaient oculaires, osseuses, rénales, cardiaques, cutanées, respectivement dans 19, 13, 6,3, 5 et 4 % des cas, biliaires et neurologiques dans 3 % chacune, ORL et pulmonaires dans 1,3 % chacune. L'âge moyen des patients ayant présenté au moins une complication chronique était de 30,9 ± 10,4 ans ; il était de 32,1 ± 10,3 ans chez les SC et de 25,3 ± 8 ans chez les SS. Les complications étaient uniques dans 72 %, doubles dans 23 % et triples dans 5 %. La prévalence des complications chroniques de la drépanocytose est élevée chez les patients porteurs d'un syndrome drépanocytaire majeur au CHUSS. Le dépistage systématique et l'évaluation des dommages aux organes s'imposent pour interrompre ou retarder leur évolution.

[Role of quality control for improvement of blood components in the Regional Blood Centre of Ouagadougou in Burkina Faso, 2014]. / Apports du contrôle qualité produits finis dans l'amélioration de la qualité des produits sanguins labiles au Centre régional de transfusion sanguine de Ouagadougou (Burkina Faso), 2014.

OBJECTIVES: In Burkina Faso, blood components must comply with national standards. Then, all Transfusion services must implement a quality control process to ensure compliance. Our study aims to establish the main characteristics of blood components of the regional transfusion center of Ouagadougou, and evaluate the capability of this center to improve its manufacturing process. METHODS: We conducted from marsh to December 2014 a pre-post study, assessing blood components' characteristics before and after the implementation of a six months' improvement plan. The assessed parameters were: volume, hematocrit (Ht) and hemoglobin (Hb) levels in RBCs; volume and the number of platelets in PPCs; and volume and concentration of clotting factor VIII in fresh frozen plasma (FFP), respectively. Three hundred and twelve RBCs and 280 PCs were randomly selected for the first series of controls, and 215 RBCs, 54 PCs and 60 FFP were selected for the second series of controls. We compared the mean values of the components parameters and the overall non-compliance rates for each series. RESULTS: The average Hb level of RBCs was respectively 47.8±8.9g and 54.7±7.2g in the first and second series compare to a standard of≥40g. Non-compliance rates of Hb level decreased significantly from 17.6% to 1.4%. For PCs units, the mean number of platelets was 0.14±0.10×1011 and 0.30±0.15×1011 in the first and second period compare to a standard of 0.5×1011. Non-compliance rates for platelets number were high 97.1% and 72.2%. CONCLUSION: The study demonstrates that only RBCs complied with national standards. The study also demonstrates the capability of CRTSO to improve blood components' processing even if for PCs and FFP, NC rates remain high. QC must be maintained and expanded to the others regional blood centers of the country.

[Factors associated with the satisfaction of prescribers of blood products in Burkina Faso]. / Facteurs associés à la satisfaction des prescripteurs de produits sanguins labiles au Burkina Faso.

BACKGROUND: The National Blood Transfusion Centre, unique operator of blood transfusion in Burkina Faso is engaged into the quality process according to ISO 9001. Therefore, the assessment of customer satisfaction is a main part of its system. Our study conceives "customer satisfaction" as dependant to the perceived service quality based on SERVQUAL model. OBJECTIVES: To identify factors associated with the satisfaction of blood products prescribers in order to help decision-makers for continuous improvement of services. MATERIAL AND METHODS: We conducted a cross-sectional survey among prescribers of blood components in Ouagadougou, between February 27 and April 30, 2015. We used an anonymous self-administered questionnaire, including 13 items associated to the 5 dimensions of SERVQUAL model. The different satisfaction gaps were calculated and linear regression was used to determine statistical associations with a significance level of 5%. RESULTS: The return rate was 94.5% about the 256 questionnaires distributed. A total of 30% of respondents were satisfied to very satisfied. The overall global gap of satisfaction was -5.74. The product delivery time, the efficacy and safety of blood products, the medical and clinical support, the pro-activity of the communication, the management of blood products reservation and the satisfaction of needs in blood products were the factors associated with the prescribers' satisfaction. CONCLUSION: This first study in blood transfusion services in our context was been useful to assess customer satisfaction and identify the main axes on which targeting priority actions in order to effectively use available resources.

[Pernicious anemia: diagnosis and course in Burkina Faso]. / Maladie de Biermer : aspects diagnostiques et évolutifs au Burkina Faso.

Pernicious anemia (also known as Biermer disease or anemia, Addison or Addisonian anemia, and Addison-Biermer anemia) is an autoimmune atrophic gastritis responsible for vitamin B12 malabsorption due to a deficiency of intrinsic factor. We report eight cases of pernicious anemia in Burkina Faso, collected over a 44-month period. The three criteria for diagnosis of pernicious anemia were: vitamin B12 deficiency, gastric disease (gastric histology) with presence of anti-intrinsic factor, and/or anti-gastric parietal cell antibodies in serum. All patients had anemia, with a mean hemoglobin level of 8.75 g/100 mL. The average mean corpuscular volume (MCV) was 122.1 fL the average mean corpuscular hemoglobin (MCH) 39.3 pg, the mean reticulocyte count 12.069 10(9)/L reticulocytes, and the mean rate of megaloblast marrow cells 17.2%. The serum vitamin B12 level ranged from 35 to 71 pmol/L. Antibodies against intrinsic factor were found in all eight patients. All ABO blood groups were present with a predominance (4 cases) of group O. Endoscopy found a normal fundic mucosa in three patients. Histology showed gastric atrophy and intestinal metaplasia for six patients (85.7%). Under B12 vitamin therapy, the course was favorable in all patients; seven patients also had 10 days of iron therapy. We recommend a gastric biopsy even in the absence of macroscopic gastric lesions on the upper gastrointestinal endoscopy.

[Rheumatologic diseases and haemoglobinopathies in Ouagadougou (Burkina Faso)]. / Pathologies rhumatologiques et hémoglobinopathies à Ouagadougou (Burkina Faso).

The purpose of this study is the prevalence of the rheumatologic complications in the sickle cell disease and the associations between haemoglobinopathies and rheumatologic affections. It is a retrospective study from 29 February 2006 to 28 March 2008 conducted in the Internal Department of the University Hospital Yalgado-Ouédraogo. All patients received in the period of study and having an electrophoresis of haemoglobin realized in alkaline pH were included. These patients came from hematologic consultation. Two hundred and seventy-seven patients out of 1451 were included: 142 patients (51.30%) had haemoglobinopathies, including 21 (7.60%) with composite sickle cell disease SC and 17 patients (6.13%) had aseptic necrosis of the femoral head including 7 with haemoglobin SC. The other rheumatologic affections did not have a semiological particularity related to the type of haemoglobin. The prevalence of patients who have haemoglobinopathies is important in rheumatologic practice. The sickle cell disease is strongly associated to osteonecrosis.

[Failure of first-line antiretroviral therapy in HIV-infected children in Ouagadougou, Burkina Faso]. / Echecs du traitement antirétroviral de première ligne chez les enfants infectés par le VIH à Ouagadougou (Burkina Faso).

Approximately one-fourth of the estimated 10,000 HIV-infected children in Burkina Faso are undergoing antiretroviral (ARV) therapy. At the Charles de Gaulle Pediatric Hospital Center in Ouagadougou, Burkina Faso, Support for ARV therapy began in July 2003 and a total of 250 children were undergoing treatment in late 2007. The purpose of this retrospective case-control study conducted over a period of 54 months from July 2003 to December 2007 was to investigate cases involving failure of first-line ARV therapy in particular with regard to cause. All patients (n = 32) showing poor virological, immunological, and/or clinical response to ARV therapy were considered as failures and thus included in the case group. The control group (n = 160) consisted of patients with good responses to treatment. Cases and controls were compared using the Chi-square test and odds ratio (OR) technique with a confidence interval at 95%. The failure rate was 12.8%. Failure was significantly correlated with low socioeconomic level (OR = 3), orphan status (OR = 4), age over 10 years (OR = 5), male gender (OR = 3), baseline viral load > or = 1,000,000 copies/mL (OR = 9), and poor compliance (OR = 37). Mortality in children who failed to respond to first-line ARV therapy was 25% due to the unavailability of a national second-line ARV therapy program. This study underlines the need for patient education to promote compliance and for creation of reference centers to prescribe ARV therapy to HIV-infected children including second-line ARV and genotyping.

[Hemoglobin sickle cell disease: experience of the Yalgado Ouedraogo University Hospital of Ouagadougou, Burkina Faso]. / Le syndrome drépanocytaire de type hémoglobine SC : expérience du CHU Yalgado Ouédraogo de Ouagadougou (Burkina Faso).

OBJECTIVES: To evaluate the clinical features of children with hemoglobin sickle cell disease (HbSC) and compare them to children with sickle cell anemia (HbSS). POPULATION AND METHODS: This was a descriptive and retrospective study. New patients with sickle cell disease who consulted at the Yalgado Ouédraogo University Hospital's Pediatric Center in Ouagadougou, Burkina Faso, between May 2005 and June 2006, were included. They were free of any major disease unrelated to sickle cell disease. Clinical and laboratory results reported for these children were based on their health book and medical records. RESULTS: Sixty-one children were included in the study, 38 and 23 children were positive for HbSC and HbSS, respectively; there was no significant difference between the 2 groups in terms of sex ratio or mean age at inclusion. Mean age at diagnosis was 5 years and 2 years for HbSC and HbSS children, respectively. The first clinical event appeared at a significantly later age for HbSC than HbSS children (4 years versus 2 years). Painful episodes were equivalent in mean number per year and mean length per episode between the 2 groups; the median hemoglobin (Hb) level at inclusion was significantly higher for HbSC than for HbSS children, i.e., 95 g/l versus 70 g/l. CONCLUSION: At the Yalgado Ouédraogo University Hospital Pediatric Center, children with HbSC disease presented clinical and biological features very similar to those with HbSS.

Neonatal haemoglobinopathy screening in Burkina Faso.

AIMS: To report our experience of neonatal screening for sickle cell disease in Ouagadougou (Burkina Faso) and to discuss the feasibility of neonatal screening in this country. METHODS: Between the years 2000 and 2004, there were about 2,341 births in five maternity services in Ouagadougou. These babies were screened for sickle cell disease in a universal screening pilot programme. In 2006, 53 babies born to selected couples were screened. The specimens were collected either by cord blood sampling or from a dried blood spot on filter paper. The screening was performed using an isoelectric focusing technique. RESULTS: In the first stage (2000-4), the incidence of sickle cell disease was 1:57. In the second stage, six of 53 babies of selected couples were found to have major haemoglobinopathies: one was homozygous for haemoglobin S and five were compound heterozygotes for haemoglobins S and C. CONCLUSIONS: The results suggest that a national screening programme should be implemented in Burkina Faso with effective newborn and subsequent follow-up, but a methodology needs to be developed.

[Sickle cell disease: an anonymous survey of physicians in Burkina Faso]. / Les syndromes drépanocytaires majeurs: une enquête anonyme auprès du corps médical au Burkina Faso.

The purpose of this survey was to evaluate the experience of physicians in Burkina Faso with haemoglobinopathy (particularly sickle cell disease). Survey findings showed that these pathologies were encountered in daily medical practice but that resources necessary to insure proper prevention, follow-up and treatment were insufficient. Practitioners expressed the need for better continuous medical education and for information campaigns to familiarize the public.

Neonatal screening and clinical care programmes for sickle cell disorders in sub-Saharan Africa: lessons from pilot studies.

OBJECTIVES: Despite the widespread use of neonatal screening programmes for sickle cell disease in Western regions, few studies have focused on the special healthcare needs in sub-Saharan African countries. The purpose of this review is to evaluate the need for a neonatal screening programme for sickle cell disease, and if justified, to propose a realistic healthcare programme for sickle cell newborns in those countries based on personal experiences in Kinshasa (Democratic Republic of the Congo) and Ouagadougou (Burkina Faso) as well as from a review of the literature. REVIEW: There are well-established criteria for the development of neonatal screening programmes for sickle cell disease in sub-Saharan African countries. In particular, in regions where incidence of the disease is 0.5 per 1000 or higher, a sickle cell screening programme can be proposed that includes the systematic screening of all newborns, or the targeted screening of those newborns who have a mother with a sickle cell or haemoglobin C trait. Screening should be preferentially organized using cord blood, with a simple, effective and affordable screening method such as isoelectric focusing. If necessary, confirmation of results should be performed using another cost-effective technique such as citrate agar electrophoresis at an acidic pH. There is also a need for a sickle cell disease clinical care programme which should include: infection prophylaxis with penicillin and malarial prophylaxis; family training to identify early severe or persistent symptoms and the gravity of malarial crises; the evaluation of nutritional status and adequate fluid intake; and the importance of regular medical visits. Improved knowledge of the diagnosis was found to reduce the need for unnecessary and unsafe blood transfusions. CONCLUSIONS: This paper provides an overview of practices employed in neonatal screening and clinical care programmes for sickle cell disease in sub-Saharan African countries. The development of these programmes is pivotal to improving the health care of those affected by haemoglobin disorders. However, such programmes require major economic and organizational resources, which must taken into account and balanced against other local health priorities.

Les syndromes drepanocytaires majeurs : une enquete anonyme aupres du corps medical au Burkina Faso

Cette etude evalue l'experience medicale vis-a-vis des hemoglobinopathies et en particulier des syndromes drepanocytaires au Burkina Faso. Un questionnaire a reponses a choix multiple et a reponses libres a ete utilise. L'etude montre que ces pathologies sont rencontrees dans la pratique quotidienne; mais que les moyens mis a disposition des medecins pour la prevention; le suivi et le traitement de celles-ci sont limites. Une amelioration dans la formation medicale continue et dans l'information du public ont ete souhaitees par les medecins interroges

[Iron deficiency anaemia: clinical presentation, biological diagnosis and management]. / Anémies ferriprives: signes d'appel, diagnostic et prise en charge.

The iron deficiency is the first cause of anaemia. In healthy young adult, anemia is well tolerated because of its progressive installation. The most common symptoms of anemia are pallor, fatigue and dyspnea. In biological exams, anemia is classically associated with microcytosis and hypochromia. The origins of microcytic anemia are iron deficiency, inflammatory aetiologies, thalassemia and sideroblastic anaemia. The iron-deficiency diagnosis includes two explorations: biological and clinical. The biological exploration is based on interpretation of serum biologics tests as blood iron, ferritin, transferrin with saturation, total iron-binding capacity and its soluble receptors. This interpretation is simple if it is not associated with clinical disorders influencing the internal iron cycle. The clinical exploration must always be followed by a careful assessment of the underlying cause as blood loss. The most common causes in women of reproductive age are gynaecologic. In men and menopausal women, the gastrointestinal tract bleeding is source of anemia. Therapeutic management of anemia is oral iron therapy. Etiological diagnostic of microcytosis is essential before iron therapy. If not, the treatment could be inefficient or it could mask or delay the etiological diagnostic.

[Lack of knowledge among blood donors in Burkina Faso (West Africa); potential obstacle to transfusion security]. / Faible niveau de connaissances des donneurs de sang au Burkina Faso; une entrave potentielle à la sécurité transfusionnelle.

BACKGROUND: The measures recommended to reduce TTD include clinical selection of donors, based on a standardized questionnaire which aims to find out antecedents and behaviours predicting transmitted diseases within donors. The effectiveness of this measure is well established in the industrialized countries where the level of education of the population may support a greater receptivity of donors about this procedure. What is happening in developing one? AIM: This study was carried out to assess knowledge attitude and behaviours among blood donors regarding blood and transfusion safety in Burkina Faso. METHODS: A cross sectional study was carried out in the blood bank of the teaching hospital of Ouagadougou. In addition to the routine questionnaire, 544 included blood donors were subjected to additional questions seeking to specify their behaviours, knowledge and attitude towards TTD diseases and screening. RESULTS: Donors were from 16 to 57 years of age (mean age : 28+/-7.9 years). The majority of donors were male (71.2%). Family donors represent 52% and first time donors 55%. About 30.8% were illiterate or of primary school level. A percentage of 14.4 donate to access HIV testing and 30.7% will donate blood immediately to check any contamination in case of exposure. There was no difference between donors having been informed about their HIV status in the past and the other donors regarding HIV, HBs Ag and VHC results. CONCLUSIONS: This study suggests that there is some great need for donors' education on transfusion safety. There is also need for staff training in donors' management.

[Haematological and biochemical outline of patients with sickle cell disease SS and SC in steady state in the National Hospital Center Yalgado Ouedraogo of Ouagadougou]. / Profil hematologique et biochimique des drepanocytaires ss et SC en phase stationnaire au Centre Hospitalier National Yalgado Ouedraogo de Ouagadougou.

Burkina Faso belongs to the sicklemic's belt of LEHMAN and is the epicenter of haemoglobin C. This is the reason of this study on the haematological and biochemical parameters of homozygotes SS and double heterozygotes SC in stationary stage. These parameters will be use for comparison during crisis and to evaluate the therapy efficiency. So 20 homozygotes and 20 double heterozygotes were studied. The blood film showed anaemia with an haemoglobin rate average of 7.8 g/dl for SS against 9.8 g/dl for SC (p < 0.001). An serum's iron elevated in 26.3% of the SS with an average of 23 micromoles /l against 36.8% with an average of 21.7 micromoles /l in the SC (p < 0.001). These results show the importance of SS anaemia's and biochemical's disorders in comparison to the SC.

[Vaccination status of children with sickle cell disease in Ouagadougou (Burkina Faso)]. / Evaluation du statut vaccinal de l'enfant drépanocytaire de la ville de Ouagadougou (Burkina Faso).

Because of the importance of preventive activities in fighting sickle cell disease, we sought to assess the vaccination status of children with this disease in Burkina-Faso. This cross-sectional study used a questionnaire to collect information from outpatients of the pediatric department of the Yalgado Ouédraogo hospital center and of Saint Camille medical center, also in Ouagadougou, from October 2005 through March 2006. The study included 122 children, 52.5% of whom had an SC phenotype. Coverage for vaccinations included in the WHO expanded vaccination programme was 97.5%. For other specific vaccines, coverage varied from 5.7% for the anti-Haemophilus influenzae vaccine to 65.8% for the 23 pneumococci included in pneumo23. The major reasons for non-vaccination were ignorance and the prohibitive cost of these vaccines for the families who knew about them. These results suggest the need for a national program against sickle cell disease, which should enable treatment centers to include in their preventive activities a specific vaccination program. Only in this way can we reduce the mortality rates among those younger than 5 years by 40% by 2015, the goal of the International Organization against sickle cell disease, to which Burkina-Faso belongs.