Pesticide residues in commonly consumed food from five localities of Burkina Faso: occurrence and health risk assessment.

Monitoring data for pesticides are generally scarce in many countries of the world, especially in developing countries. In Burkina Faso, there are few scientific data on the occurrence and concentrations of pesticide residues in staple foods found in local markets. Using QuEChERS extraction method and gas chromatography-mass spectrometry, samples of commonly eaten foods from five localities of Burkina Faso were evaluated by targeting more than 40 pesticides. It appears that 58.1% of all the collected samples exhibited at least one or more pesticide residues. Among those, 36.5% of the samples had at least one pesticide with a concentration above the maximum residue level (MRL) value. Unfortunately, no MRL data was available for dried fish which is a widely consumed food in this part of Africa. Simazine was found in tomatoes, pyrethroids in cereals, while dried fish contained most of the pesticides detected. The assessment of long-term health risks revealed that dieldrin quantified in dried fish showed more than 250% of acceptable daily intake which was then labelled as unacceptable high risk. For hazardous foods, more sampling should be carried out for a better assessment of the health risks involved.

[Overview of visual impairment at the Yalgado Ouédraogo University Medical Center: Study of 501 cases]. / Les profils de la déficience visuelle au centre hospitalier universitaire Yalgado Ouédraogo : à propos de 501 cas.

OBJECTIVE: To determine the main causes of visual impairment according to age in patients admitted to the ophthalmology department. MATERIALS AND METHODS: This was a retrospective study of 501 cases of visual impairment. Included were patients of both sexes whose best-corrected visual acuity in the better eye was strictly less than 5/10. The parameters studied were age, gender, place of residence, corrected visual acuity in the better eye, and diagnosis. The data were entered and processed with the Epi info 7.2 software. RESULTS: Subjects over 50 were the most prevalent (48.5%). In patients over 50 years of age, cataracts (54.32%) were the leading cause of visual impairment, followed by glaucoma (24.69%) and non-glaucomatous optic neuropathy (26.19%). Trauma (17.62%) was frequently found in patients aged 16 to 50 years. Tropical endemic limbo-conjunctivitis (25.00%) was the leading cause of visual impairment in subjects aged 5 to 15 years. CONCLUSION: This study confirms the results of the literature, which have shown that cataracts are the leading cause of visual impairment in developing countries. A major effort to raise awareness, provide information and therapeutic care would reduce the incidence of visual impairment.

In vivo Antimalarial, Antioxidant Activities and Safety of Carapa procera DC. (Meliaceae).

Background and Objectives: Carapa procera is a popular herb used by traditional healers in the western part of Burkina Faso. In a previous study, Carapa procera showed interesting antiplasmodial activity in vitro against P. falciparum. The present study aimed to evaluate its in vivo potential against malaria parasites and its safety in mice. Materials and Methods: The antimalarial activity of the ethanolic extract was evaluated on Plasmodium berghei Anka in the Naval Medical Research Institute (NMRI) mice using the Peters 4-day suppressive test. The acute toxicity was performed according to the Lorke method and sub-acute toxicity following the Seewaboon method. The polyphenols and flavonoids were determined by colorimetric methods. The antioxidant activity of the extract was evaluated in vitro by Ferric Reducing Antioxidant Power (FRAPP) and 2,2-diphenyl-1-picrylhydrazyl (DPPH) methods. Results: Carapa procera had a good antiplasmodial activity at a dose of 250 mg kg¹ b.wt. Phytochemical screening revealed the presence of polyphenols and flavonoids in the extracts. Soxhlet ethanolic extracts had the highest content in polyphenols and flavonoids. The antioxidant activity of Soxhlet ethanolic extracts was better than macerated extract by DPPH method and FRAP method. Besides, no mortality in mice was recorded with the soxhlet ethanolic extract. No toxic signs were observed in animals in the sub-acute toxicity test. Conclusion: Carapa procera soxhlet ethanolic stem bark extract had a good in vivo antimalarial activity against Plasmodium berghei infection in mice and the extract was relatively safe when administered orally in mice.

[Preliminary selective laser trabeculoplasty (SLT) intraocular pressure results in glaucoma patients in Burkina Faso]. / Résultats tonométriques préliminaires de la trabéculoplastie sélective au laser (SLT) chez les glaucomateux au Burkina Faso.

INTRODUCTION: Glaucoma is the leading cause of irreversible blindness in the world. The purpose of our study was to evaluate the tonometric results of SLT treatment in patients with glaucoma. MATERIALS AND METHODS: This was a prospective study of patients with glaucoma who were seen from October 1, 2017 to July 31, 2018. All patients underwent SLT of the inferior 180°. Intraocular pressure (IOP) was measured before and then at 1, 15, 30, 60, 90 and 120days after treatment. RESULTS: We studied 35 eyes of 31 patients. The mean age was 59.3 (±8.4years), range 43-77years. The mean IOP prior to SLT was 20.1mmHg (±7mmHg). One day after the laser, this decreased to 17.6mmHg (±8.4), for a percentage of drop of 12.4%. At 30days, it was 15.3mmHg (±5.4mmHg), i.e. a 23.9% decrease. After 60 and 90days, there was a drop of 13.9% and 15.4%, respectively. At 120days, 43.3% of treated eyes had a decrease of at least 20%. The main complication was increased IOP in 14.2% of cases. CONCLUSION: SLT reduces IOP and the number of glaucoma medications in patients. It appears to be a viable alternative in our countries. These results should be confirmed with a larger cohort and longer follow-up.

Prevalence of COPD among women and relation with cooking fuel choice in Ouagadougou, Burkina Faso.

BACKGROUND: According to the WHO, chronic obstructive pulmonary disease (COPD) will become the third leading cause of death by 2030. In sub-Saharan Africa, the burden of the disease is unknown. We assessed the prevalence and the factors associated with COPD and chronic bronchitis among women in charge of household cooking.METHODS: A cross-sectional population survey was conducted. We randomly selected women aged ≥18 years in charge of cooking in their household. COPD was defined as post-bronchodilator FEV1/FVC (forced expiratory volume in 1 sec/forced vital capacity) ratio of <0.70; chronic bronchitis was defined as cough with sputum of at least 3 months in the year for at least 2 consecutive years.RESULTS: Of the 1705 women interviewed, 835 were selected to perform spirometry and 564 provided an acceptable test result. The prevalence of COPD was 1.1% and that of chronic bronchitis was 1.2%. COPD prevalence was higher among women using biomass, women aged >40 years, those had been cooking or had been exposed to toxic gases for more than 30 years. After adjustment, only biomass fuel use and exposure to toxic products were found to be associated with COPD.CONCLUSION: Urgent action is need to accelerate the transition to the other sources of energy.

Spreading of SARS-CoV-2 in West Africa and assessment of risk factors.

Although the African continent is, for the moment, less impacted than the rest of the world, it still faces the risk of a spread of COVID-19. In this study, we have conducted a systematic review of the information available in the literature in order to provide an overview of the epidemiological and clinical features of COVID-19 pandemic in West Africa and of the impact of risk factors such as comorbidities, climatic conditions and demography on the pandemic. Burkina Faso is used as a case study to better describe the situation in West Africa. The epidemiological situation of COVID-19 in West Africa is marked by a continuous increase in the numbers of confirmed cases. This geographic area had on 29 July 2020, 131 049 confirmed cases by polymerase chain reaction, 88 305 recoveries and 2102 deaths. Several factors may influence the SARS-CoV-2 circulation in Africa: (i) comorbidities: diabetes mellitus and high blood pressure could lead to an increase in the number of severe cases of SARS-CoV-2; (ii) climatic factors: the high temperatures could be a factor contributing to slow the spread of the virus and (iii) demography: the West Africa population is very young and this could be a factor limiting the occurrence of severe forms of SARS-CoV-2 infection. Although the spread of the SARS-CoV-2 epidemic in West Africa is relatively slow compared to European countries, vigilance must remain. Difficulties in access to diagnostic tests, lack of hospital equipment, but also the large number of people working in the informal sector (such as trading, businesses, transport and restoration) makes it difficult to apply preventive measures, namely physical distancing and containment.

[Wholesale distribution and delivery of plant-based medicinal products through the pharmaceutical system of Burkina Faso]. / Distribution en gros et délivrance des médicaments à base de plantes à travers le circuit pharmaceutique du Burkina Faso.

OBJECTIVE: In order to improve the contribution of medicines from traditional pharmacopoeia to health care, African countries like Burkina Faso have adopted for several years, policies and regulations organizing their distribution. This study aims to analyze the situation of the wholesale and retail sale of herbal medicines imported by the official pharmaceutical facilities. METHOD: This is a retrospective study involving all 18 drug wholesalers and 115 pharmacies in the city of Ouagadougou (Burkina Faso). It consisted of a collection of sales data of herbal medicines from 2013 to 2016 and interviews of the pharmacists responsible for the facilities surveyed. RESULTS: All the pharmacies surveyed obtain their supplies from national wholesalers, but eleven of them do so directly from manufacturers or non-wholesalers. Only 40% (44/111) of herbal medicines distributed by wholesalers and pharmacies had valid marketing authorizations. Also, although the average growth rates of annual sales by wholesalers and private pharmacies, respectively 23.67% and 11.94%, are significant, the turnover generated from their sale remains low. CONCLUSION: Supporting local producers with appropriate funding and adequate promotion of herbal medicines is still needed to boost the share of the national herbal medicines market.

Meningitis trends in Niger 2008-2015: a secondary data analysis.

INTRODUCTION: Niger, located in the meningitis belt, faces recurrent epidemics of magnitudes that vary with the year. The objective of this study was to describe the trends in meningitis and identify the profile of the microbes implicated in meningitis epidemics in Niger. METHODS: We conducted a descriptive study (a secondary analysis) of meningitis data from 2008 through 2015. The study population comprised patients with suspected and confirmed meningitis. We conducted an exhaustive sampling of all suspected and confirmed meningitis cases reported in Niger from 2008 to 2015. RESULTS: A total of 6167 (40.6 %) confirmed cases of meningitis were identified. Among them, 5,507 (89.3 %) were attributable to Neisseria meningitidis, 593 (9.6 %) to Streptococcus pneumoniae, and 66 (1.1 %) to Haemophilus influenzae respectively. Among the Neisseria meningitidis cases, 2,984 (54.2 %) were caused by serogroup A, 1,333 (24.2 %) by serogroup W, 1,165 (21.1 %) by serogroup C, 23 (0.4 %) by serogroup X, and 2 (0.03 %) by the serogroup B. CONCLUSION: This study enabled us to describe meningitis trends and identify the profile of the bacteria implicated in its epidemics in Niger. We observed the emergence of Neisseria meningitidis C and recommend vaccination against this serogroup.

[What do we know about diabetic retinopathy at the Sourô Sanou university medical center in Bobo-Dioulasso (CHUSS)?] / Que savons-nous de la rétinopathie diabétique au centre hospitalier universitaire Sourô Sanou de Bobo-Dioulasso (CHUSS) ?

INTRODUCTION: Ocular damage is one of the numerous complications of diabetes. Proliferative diabetic retinopathy can result in blindness. The purpose of our work was to study the aspects of diabetic retinopathy on fundus examination in diabetic patients in Bobo-Dioulasso in a hospital environment. METHODS: This is a descriptive, cross-sectional, prospective study from March 1st to August 31st 2014 of diabetic patients in the Sourô Sanou university hospital. We used the Francophone Diabetes Society's classification. RESULTS: We included 246 patients (487 eyes). The frequency of diabetic retinopathy (DR) was 47.1%, and the frequency of diabetic maculopathy 8.9%. Proliferative DR and severe Non-Proliferative DR represented 3.3% of eyes, and blindness occurred in 3%. Among diabetics with DR, the mean age was 55.75 years (standard deviation 11.04 years); the median duration of diabetes was 36 months, and 99.1% of the diabetic patients were categorized as type 2. There was a statistically significant association between diabetic retinopathy and duration of diabetes progression, history of neuropathy, presence of proteinuria on 24hour urines, hypercreatininemia, and also between triglyceride levels and diabetic maculopathy. CONCLUSION: Diabetic retinopathy affects almost half of diabetic patients at the Sourô Sanou university hospital. An earlier, multidisciplinary management approach might prevent this.

Distance to care, care seeking and child mortality in rural Burkina Faso: findings from a population-based cross-sectional survey.

OBJECTIVE: Although distance has been identified as an important barrier to care, evidence for an effect of distance to care on child mortality is inconsistent. We investigated the association of distance to care with self-reported care seeking behaviours, neonatal and post-neonatal under-five child mortality in rural areas of Burkina Faso. METHODS: We performed a cross-sectional survey in 14 rural areas from November 2014 to March 2015. About 100 000 women were interviewed on their pregnancy history and about 5000 mothers were interviewed on their care seeking behaviours. Euclidean distances to the closest facility were calculated. Mixed-effects logistic and Poisson regressions were used respectively to compute odds ratios for care seeking behaviours and rate ratios for child mortality during the 5 years prior to the survey. RESULTS: Thirty per cent of the children lived more than 7 km from a facility. After controlling for confounding factors, there was a strong evidence of a decreasing trend in care seeking with increasing distance to care (P ≤ 0.005). There was evidence for an increasing trend in early neonatal mortality with increasing distance to care (P = 0.028), but not for late neonatal mortality (P = 0.479) and post-neonatal under-five child mortality (P = 0.488). In their first week of life, neonates living 7 km or more from a facility had an 18% higher mortality rate than neonates living within 2 km of a facility (RR = 1.18; 95%CI 1.00, 1.39; P = 0.056). In the late neonatal period, despite the lack of evidence for an association of mortality with distance, it is noteworthy that rate ratios were consistent with a trend and similar to or larger than estimates in early neonatal mortality. In this period, neonates living 7 km or more from a facility had an 18% higher mortality rate than neonates living within 2 km of a facility (RR = 1.18; 95%CI 0.92, 1.52; P = 0.202). Thus, the lack of evidence may reflect lower power due to fewer deaths rather than a weaker association. CONCLUSION: While better geographic access to care is strongly associated with increased care seeking in rural Burkina Faso, the impact on child mortality appears to be marginal. This suggests that, in addition to improving access to services, attention needs to be paid to quality of those services.

Facteurs associés à la qualité de vie de patients souffrant du diabète de type 2 au Burkina Faso

Le diabète est une maladie responsable de complications qui aggravent le risque de mortalité chez les malades. au Burkina Faso, très peu de données existent sur la qualité de vie des patients souffrant du diabète de type 2. l'objectif de l'étude est de decrire la qualité de vie des patients diabétiques de type 2 dans les deux principales villes du pays. il s'agit d'une étude transversale descriptive qui a inclus des patients de Ouagadougou et Bobo-dioulasso souffrant de diabète de type 2 et suivis par un spécialiste dans les hôpitaux publiques et les cliniques privées. au total cent 100 (patients) ont été inclus dans l'étude. les informations sociodémographiques et cliniques ont été collectées à partir de questionnaires adminitrés en vis-à-vis par des enquêteurs formés. la perception de la qualité de vie a été mesurée sur une échelle de 10 (10/10 = vit parfaitement avec sa maladie ; 0/10 = ne vit pas du tout parfaitement avec sa maladie). le patient était considéré comme mécontent de sa qualité de vie si le score était < 5. une analyse descriptive pour explorer l'échantillon a été réalisée. ensuite, une analyse factorielle des correspondances multiples a été effectuée pour analyser la relation entre les caractéristiques des patients et la qualité de vie perçue. dans l'échantillon, il y avait 52 % (52) d'hommes et 61 % (61) des patients avaient plus de 50 ans. la plupart des patients étaient mariés, chefs de ménage, et avaient un travail. au total, 39 % (39) des patients ne vivaient pas du tout parfaitement avec leur maladie. les facteurs qui contribuent à la première dimension (65,2 % de l'inertie) appelée « répercussions de la maladie » étaient celle décrivant l'impact du diabète sur la vie professionnelle (12,2 %), économique (11,2 %), sociale (9,4 %) et familiale (3,8 %) du patient. les facteurs qui contribuent à la deuxième dimension (27,37 % de l'inertie) appelée « complications de la maladie » étaient les complications cardiovasculaires (16,6 %), nerveuses (12,5 %, rénales (11,2 %), et oculaires (9,2 %), et le fait d'avoir une durée de la maladie d'au moins 5 ans (7,5 %). l'étude a montré que le diabète de type 2, a non seulement des répercussions sur la vie professionnelle, économique, sociale et familiale, mais aussi des repercussions en termes de complications cliniques qui impactent négativement sur la qualité de vie des malades. une stratégie de promotion de santé centrée sur la sensibilisation de l'entourage des malades et l'accessibilité aux soins permettraient d'améliorer la santé des patients souffrant de diabète de type 2

[Point of view of older adults on the potentially inappropriate medications prescribing in primary care facilities in Bobo-Dioulasso, Burkina Faso]. / Regard des personnes âgées sur la prescription des médicaments potentiellement inappropriés dans le premier niveau de soins à Bobo-Dioulasso, Burkina Faso.

BACKGROUND: Little is known about the organization of primary care facilities in sub-Saharan Africa that might lead to potentially inappropriate prescribing. The aim of this study was to analyze the factors that could lead to potentially inappropriate prescribing in primary care facilities in Bobo-Dioulasso (Burkina Faso), taking into consideration the patient's perspective. METHODS: A cross-sectional qualitative study was conducted in primary care facilities from November 2013 to February 2014. People aged 60 years or more with at least one chronic disease were included. Individual interviews were conducted. An analysis of the thematic content of the interviews was conducted. RESULTS: Our results showed that the patient referral system was insufficient. We also found many different prescribers for older people seeking care and poor communication between prescribers and patients. This caused some consequences such as the absence of review of drugs consumed before a new prescription, a lack of exchange on medication changes and repeated treatment change during hospitalization. Most of the persons who prescribed potentially inappropriate medications were nurses. CONCLUSION: The poor communication between prescribers and patients is a challenge for the prevention of prescribing potentially inappropriate medications. Teamwork is an important feature of the organizational care system, strengthening it could be a way to improve rational prescription.

Are healthcare workers at higher risk of HIV infection than the general population in Burkina Faso?

In order to assess the HIV prevalence in healthcare workers (HCWs) in Burkina Faso, we conducted a national survey in 97 health facilities from urban and rural areas. Of 1570 HCWs who agreed to participate, 1013 (64·5%) provided a urine sample for HIV testing. The crude prevalence of HIV in HCWs was 3·5% (95% CI 2·3-4·6). HIV prevalence was 0·7% in students and trainees, 3·8% in nurses and midwives, 4·5% in administrative workers, and 4·6% in laboratory workers. After age and area standardization, men from the Demographic Health Survey (DHS) had a similar HIV prevalence (2·3%, 95% CI 1·4-2·9) as male HCWs (2·5%, 95% CI 1·1-4·0), while female HCWs were more infected (4·5%, 95% CI 2·5-6·0) than women from the DHS (2·1%, 95% CI 1·3-2·4). A voluntary counselling and testing (VCT) programme should be specifically implemented and adapted for female HCWs.

24-Month adherence, tolerance and efficacy of once-a-day antiretroviral therapy with didanosine, lamivudine, and efavirenz in African HIV-1 infected children: ANRS 12103/12167.

BACKGROUND: There is no data on long-term benefit of once-a-day antiretroviral therapy (ART) with combination of DDI, 3TC and EFV to allow its use in future therapeutic strategies. OBJECTIVES: To assess 24-month immuno-virological, adherence, tolerance, and effectiveness of a once-a-day ART with DDI, 3TC and EFV. METHODS: A phase 2 open trial including 51 children aged from 30 months to 15 years, monitored a once-a-day regimen for 24 months from 2006 to 2008 in the Departement de Pediatrie du CHUSS, at Bobo-Dioulasso in Burkina Faso. We tested immunological and virological response, adherence, tolerance and resistance of the treatment. RESULTS: Children with CD4 >25% at 24 months were 67.4% (33/49) CI 95% [54%, 80%]. The proportion of children with viral plasma RNA <300 cp / ml at 24 months of treatment was 81.6 % (40/49) CI [68.0% 91.2%]. Good adherence was obtained with more than 88% adherence > 95% over the 24 months. Drugs were well tolerated. CONCLUSIONS: Given the limited number of antiretroviral drugs available in Africa and the inadequacy of laboratory monitoring in support program, once-a-day treatment and especially the DDI-based combination strategies could be an attractive operational option.

[Determinants of low birth weight among newborns to HIV-infected mothers not eligible for antiretroviral treatment in Africa]. / Déterminants du faible poids de naissance chez des enfants nés de mères séropositives pour le VIH, non éligibles au traitement antirétroviral, en Afrique.

BACKGROUND: Low birth weight (LBW) increases the risk of infant death, but little is known about its rate and determinants among babies born to HIV-infected mothers in sub-Saharan Africa. METHODS: This study was conducted in South Africa, Burkina Faso, Uganda and Zambia, during the recruitment process of the PROMISE-PEP (ANRS 12174) clinical trial. The study sample included 1196 subjects screened between August 2009 and December 2011, respectively 254 in South Africa, 221 in Burkina Faso, 197 in Uganda and 524 in Zambia, all ineligible for antiretroviral therapy. Data were collected during ANRS12174 clinical trial antenatal and postnatal screening visits, and during an inclusion visit for completion of an electronic case report form (eCRF). RESULTS: The mean (±SD) age of mothers was 27±5years and their mean CD4 count was 576±195cells/µL. Most mothers lived in a couple (78.7%), had no employment (72.3%) and had a good level of education (74% had gone to school). Male newborns predominated (51.7%). The mean birth weight was 3043g±435g, and 7.8% ([95%CI: 6.3%-9.3%]) of newborns weighed less than 2500g. In univariate analyses, being married or cohabiting, body mass index, WHO HIV disease stage II, female newborn and low gestational age were associated with risk of LBW. In multivariate regression model, low gestational age (aOR=3.74, P<0.0001) and female newborn (aOR=1.63, P=0.04) were significantly associated with LBW. CONCLUSION: The risk factors for LBW found in HIV-infected women ineligible for antiretroviral therapy were the same as in the general population. There was no evidence of additional risk factors associated with HIV infection.

Combining rapid diagnostic tests and dried blood spot assays for point-of-care testing of human immunodeficiency virus, hepatitis B and hepatitis C infections in Burkina Faso, West Africa.

People screened for human immunodeficiency virus (HIV) using rapid diagnostic tests (RDTs) in Africa remain generally unaware of their status for hepatitis B (HBV) and hepatitis C (HCV) infections. We evaluated a two-step screening strategy in Burkina Faso, using both HIV RDTs and Dried Blood Spot (DBS) assays to confirm an HIV-positive test, and to test for HBV and HCV infections. HIV counselling and point-of-care testing were performed at a voluntary counselling and testing centre with HBV, HCV status and HIV confirmation using DBS specimens, being assessed at a central laboratory. Serological testing on plasma was used as the reference standard assay to control for the performance of DBS assays. Nineteen out of 218 participants included in the study were positive for HIV using RDTs. A fourth-generation HIV ELISA and immunoblot assays on DBS confirmed HIV status. Twenty-four out of 25 participants infected with HBV were found positive for hepatitis B surface antigen (HBsAg) using DBS. One sample with a low HBsAg concentration on plasma was not detected on DBS. Five participants tested positive for HCV antibodies were confirmed positive with an immunoblot assay using DBS specimens. Laboratory results were communicated within 7 days to participants with no loss to follow up of participants between the first and second post-test counselling sessions. In conclusion, DBS collection during HIV point-of-care testing enables screening and confirmation of HBV, HCV and HIV infections. Diagnosis using DBS may assist with implementation of national programmes for HBV, HCV and HIV screening and clinical care in middle- to low-income countries.

Characterization of HIV-1 genotypes and antiretroviral drug-resistance mutations among patients in Burkina Faso.

The purposes of this study were: (1) to describe the genetic variability of HIV strains found in Burkina Faso, (2) to characterize non-B HIV strains mutation profiles selected by ARVs and (3) to detect possible resistances induced by ARV drugs. From 30 October 2002 to 20 November 2003, 132 HIV 1-positive patients taking Highly Active Antiretroviral Therapy (HAART) for more than one year in Bobo-Dioulasso and Ouagadougou were included. T-CD4+ lymphocytes count was done using Dynabeads technique while genotypic test and ARV-resistance tests were conducted using Pol sequencing that codes for reverse transcriptase reverse, integrase and protease. Due to undetectable viremia, 86 samples out of 132 could not be characterized. Whereas in the 46 others that had a viral load exceeding 1000 copies mL(-1), the following HIV-1 subtypes were identified: CRF06 (54,55%); CRF02(38,63%); CRF01 (4,55%) and subtype A (2,27%). In addition, several mutations related to PI, NRTI and NNRTI resistance were isolated in 27 samples. This study found a huge genetic HIV-1 polymorphism in Burkina Faso. The level of acquired resistance to ARV after one year of treatment amounted 20.4%. These results clearly show that there is imperative need to set up an ARV resistance surveillance network in Burkina Faso to guide treatment strategies and follow the extension of the phenomenon in the country.

[Eales disease: a case report in Burkina Faso]. / Maladie de Eales : à propos d'un cas au Burkina Faso.

The authors report the first case of Eales disease described in Burkina Faso. A 21-year-old man presented myodesopsia with acute visual acuity decrease in the right eye at 1/50, vitreous haemorrhage, and retinal phlebitis of the large trunks. In the left eye, visual acuity was 10/10 P2, with phlebitis associated with retinal haemorrhages, vascular occlusion, and retinal ischaemia. Laboratory investigations found a positive TST at 20mm but the Koch bacillus was not isolated. The patient received treatment for tuberculosis, corticosteroids, retinal argon laser photocoagulation, and vitrectomy in the right eye. The clinical, immunopathological, and therapeutic aspects of Eales disease are discussed.

A prospective study on neonatal mortality and its predictors in a rural area in Burkina Faso: can MDG-4 be met by 2015?

OBJECTIVE: To measure the neonatal mortality rate (NMR) and investigate its predictors in a rural area of Burkina Faso. STUDY DESIGN: A cohort of infants born in 24 villages in Banfora region was followed until the children were 6 months old. We estimated the risk of neonatal death and used logistic regression to identify its predictors. RESULT: Among 864 live births followed to day 28, there were 40 neonatal deaths, a NMR of 46.3 per 1000 live births (95% confidence intervals (CI): 22 to 70). Multivariable regression identified twin birth (OR=11.5, 95% CI: 4.5 to 29.8), having a nulliparous mother (odds ratio (OR)=4.3, 95% CI: 1.5 to 12.1), and birth into a polygynous household (OR=2.1, 95% CI: 1.0 to 4.7) as main predictors of neonatal death. CONCLUSION: The burden of neonatal mortality in rural Burkina Faso is very high and the observed NMRs in a predominantly rural country suggest that it is unlikely Burkina will meet fourth Millennium Development Goal (MDG-4) by 2015.