ABSTRACT
BACKGROUND: Burundi is cited among countries where malaria remains endemic. Notably, malaria is highly endemic in Imbo region, a lowland lying astride Lake Tanganyika. Among key malaria riposte interventions includes the promotion of Long-Lasting Insecticidal Nets (LLINs), but its incidence rate has not reduced. In this paper, we present the distribution of malaria species in 2 settings within Imbo region by accounting for the seasonal variations and the mostly infected populations. METHODS: The study was conducted from 2 Health Care Centres of Murambi and Rugombo in Cibitoke District, Northern Burundi. Blood samples were collected on blood slides and the samples were used to confirm the presence of malaria parasites by microscopy. RESULTS: The study observed an average malaria parasite prevalence of 32.5% across the selected site. Majority of patients 459(95.2%) were infected by P. falciparum while 8(1.7%) patients were infected by P. malariae. Patients from Murambi were more infected than those from Rugombo. P. falciparum was the most highly prevalent specie in the 2 localities. High prevalence was observed in children aged between 2 and 5 years. Among older participants P. falciparum still predominated and mixed infections were rather the least prevalent. CONCLUSION: This study showed that P. falciparum and P. malariae are the most parasites involved in malaria morbidity in North Imbo region. The transmission of P. falciparum was observed year-round. Patients in Murambi are most exposed to malaria infections than those in Rugombo. Further research at large scale including entomological studies is required to better understand the relationship between Entomological Inoculation Rates (EIR) and malaria transmission levels in this setting.
ABSTRACT
BACKGROUND: Prevention of mother-to-child transmission (PMTCT) programmes aim to both eliminate vertical transmission of HIV and optimise the health and survival of infants born with HIV. Therefore, early infant diagnosis (EID) of HIV infection via DNA polymerase chain reaction (PCR) testing is a key component of PMTCT programming. We assessed the effectiveness of EID and PMTCT interventions at health-care facilities in Bujumbura, Burundi. METHODS: This was a prospective analytical study of infants born to HIV-positive mothers on antiretroviral therapy (ART), who were followed from December 2016 to March 2017 at 3 centres providing PMTCT services in Bujumbura. Babies enrolled in this study received once-daily nevirapine from birth through to 6 weeks of life, after which HIV DNA PCR testing was conducted. RESULTS: Of 122 HIV-exposed infants, 60 were boys and 62 were girls. The mother-to-child transmission rate at 6 weeks of life was 0.9%. Eighty-three (68%) of the women had commenced ART before pregnancy and 39 (32%) during pregnancy. The mean CD4 lymphocyte count was 653±308 cells/µl. Ninety-two (75.4%) of the pregnancies were planned, and 98 (80%) of the births were via spontaneous vaginal delivery. After birth, 111 (91.0%) infants were exclusively breastfed, and 11 (9.0%) infants received exclusive replacement feeding. CONCLUSION: There was a low rate of transmission of HIV from women taking ART to children who were given nevirapine for the first 6 weeks of life. Infants of HIV-positive women can live healthy lives free from HIV infection if their mothers participate in PMTCT programmes.
ABSTRACT
BACKGROUND: Increasing resistance to antimicrobials is a worldwide problem. The aim of our study was to determine the pathogens and antimicrobial susceptibility of bacteria causing urinary tract infection (UTI) in children. METHODS: This is a prospective cohort study conducted over a 10-month period with 101 children hospitalised at Kamenge University Hospital for acute UTI. The infections were confirmed by Kass urinalysis criteria, and culture and susceptibility antibiotic tests were performed for isolated microbial agents. RESULTS: Frequency of UTI in the overall population of children hospitalised at Kamange University Hospital was 8.4%. Of the 101 children with UTIs, 87 (86.1%) were under the age of 24 months. Diagnosis of pyelonephritis (82%) was the most common, followed by cystitis (18%). Escherichia coli (82%) was the most frequent pathogen causing UTI. We found E coli and Klebsiella pneumonia to be resistant to aminopenicillins (100%), cotrimoxazole (98.2%, 100%), Augmentin (amoxicillin/clavulanic acid) (70.5%, 80%), cefotaxime (45.8%, 28.6%), cefuroxime (36.8 to 45.5%, 50%), fluoroquinolones (33.3 to 53.6%, 28.6 to 50%), gentamicin (27.5%, 20%), and nitrofurantoin (9.3%, 50%). CONCLUSION: E coli is the main causal agent of UTI in childhood with a high resistance to antibiotics. Appropriate antibiotics for empiric therapy should be based on local circulating bacterial strains and resistance profiles.