Isolation and biocontrol of bacteriophages from wastewater in the city of Lomé, Togo: potential application as a novel source for antimicrobial therapy

Background: Bacteriophages offer one of the most promising solutions to the challenges of antimicrobial resistance in bacteria. The aim of this study is to investigate bacteriophages as a source of new antimicrobial therapy. Methodology: Waste water samples were randomly collected from 8 different locations in the city of Lomé for bacteriophage isolation. The phages were isolated using multi-resistant clinical isolates (Escherichia coli 1642 and Staphylococcus aureus 0868) as hosts by means of a spot test. The host range of the phages was determined also by a spot test using 8 other clinical bacterial isolates including two reference strains (E. coli ATCC 25922 and S. aureus ATCC 29213). The virulence of the phages and their effects on bacterial growth were assessed by in vitro experiments using E. coli 1642 BBec phage suspension. Results: Isolation of phages by the spot test was positive only with the host E. coli 1642. A reduced host range was observed with the other bacteria. The BBec phage suspension showed a titer of 1.6 x 107 PFU/ml. Virulence studies revealed a latency time of less than 10 minutes, a degree of absorption of 87% and a burst size of 63 PFU/cell. The effect of BBec phage suspension on E. coli 1642 showed an almost total reduction in the population of E. coli 1642 after 4 hours. Conclusion: This study provided scientific data showing the antibacterial effect of a phage suspension (BBec) on a multi-resistant clinical isolate of E. coli 1642. This phage could therefore be explored as a candidate for the development of new antibacterial therapies.

[Evaluation of the risk of obstructive sleep apnea in patients awaiting general anesthesia in Burkina Faso]. / Évaluation du risque du syndrome d'apnées hypopnées obstructives du sommeil chez des patients en attente d'une anesthésie générale au Burkina Faso.

INTRODUCTION: General anaesthesia and surgery increase morbidity and mortality in patients with obstructive sleep apnea hypopnea syndrome (OSAHS) who are not known to have OSAHS and therefore not treated before surgery. The objective of this study is to evaluate the risk of OSAHS using the STOP-BANG questionnaire (SBQ) in patients undergoing general anaesthesia in Burkina Faso. MATERIAL AND METHOD: This is a cross-sectional study concerning patients having received pre-anaesthetic consultation from 1st July 2020 to 30th June 2021. Risk of OSAHS is considered "medium to high" when the risk of obstructive sleep apnea is medium or high on SBQ. RESULTS: Our population consisted in 599 persons. A medium to high risk of OSAHS was found in 11.18%. The ASA score and the Mallampati scale were independently associated with moderate to high risk of OSAHS (P<0.001; P<0.001). ASA score of I and Mallampati class of I decreased the risk of OSAHS by 17 and 45% respectively (P=0.012; P=0.031). CONCLUSION: The risk of OSAHS in this population is comparable to that of the general population. Confirmation of OSAHS by ventilatory polygraphy or polysomnography would help to achieve further precision.

Knowledge, practices and beliefs of students regarding health effects of shisha use in Ouagadougou, Burkina Faso: A cross­sectional study.

Background: The tobacco epidemic is one of the biggest public health threats the world has ever faced. Shisha use has recently been gaining increased popularity in many developed and developing countries. Objectives: To determine the prevalence of shisha use among students in Ouagadougou, Burkina Faso, and associated knowledge, smoking practices and beliefs about health effects. Methods: A total of 443 students were selected for this cross-sectional study, using a stratified sampling method. Data on shisha use, knowledge about shisha, shisha smoking practices, and factors associated with use of shisha were collected via a questionnaire. The association between the independent variables and shisha use was assessed using a χ² test (p<0.05). Binary logistic regression analysis was used to determine variables that were independently associated with shisha smoking. Results: Of the 421 respondents, 162 (38.5%) indicated that they had smoked shisha; 14.0% were regular smokers. We found that 183 students (43.5%) had poor knowledge about the health effects of shisha. The main reasons for shisha smoking were being in the company of friends who were users (57.4%), the pleasant flavour and fragrance of shisha (25.9%), and fashion (22.2%). Ninety-nine shisha smokers (61.1%) also consumed alcohol. Factors associated with shisha smoking included age <20 years (p<0.001), gender (p=0.034), and educational level of the respondent's father (p=0.0001) and mother (p=0.0004). Conclusion: We found a relatively high prevalence of shisha smoking among the students, and that 43.5% of them had poor knowledge about its effects on health. Developing surveillance, intervention and regulatory/policy frameworks specific to shisha has become a public health priority. Study synopsis: What the study adds. The study provides additional data from resource-poor settings such as Burkia Faso, where there is an overall high prevalence of Sisha smoking, and also among students who are poorly informed about the health effects of smoking. Implications of the findings. The data informs advocacy and intervention strategies to combat smoking and decrease overall tobacco use in an African setting.

Onchocercoma of the scalp: A case report.

Onchocerciasis or river blindness is a parasitic disease caused by Onchocerca volvulus transmitted to humans by the byte of a black fly of the species Simulium. This pathology, which is a part of the Neglected tropical Disease (NTDs), has been resurgent for some years in certain regions of Burkina Faso. We report a case of onchocercoma with the aim of describing the anatomopathological aspects of this pathology. These were two (02) biopsy fragments from a scalp nodule in an 8-year-old boy, received in the pathology laboratory for examination. In this case study, we recall that onchocerciasis is manifested mainly by skin lesions, subcutaneous nodules and ocular lesions. Histologically, the skin lesions present as a dermatitis with adult worms in the superficial dermis within a predominantly eosinophilic inflammatory infiltrate. Nodules or onchocercomas, usually subcutaneous, consist of fibrous, inflammatory tissue with a predominance of eosinophils and adult worms including females containing microfilariae. Ocular lesions begin with punctate keratitis with a snowflake image. Sclerosis with opacification of the cornea progressively sets in, causing blindness.

Epididymal bilharzia simulating a testicular tumor: A case report.

Bilharzia or schistosomiasis is a parasitic disease due to infestation by a hematophagous trematode of the genus Schistosoma. It is the second most frequent parasitic endemic in the world after malaria. The most frequent tissue infections are intestinal and genitourinary. Testicular localizations of schistosoma are very rare. When lesions become chronic, they present as non-specific masses, bilharziomas, posing enormous problems of differential diagnosis with other benign and malignant pathologies, which impacts management. We report a case of epididymal schistosomiasis in a 37 years old patient simulating a malignant tumor. This case allowed us to review the diagnostic difficulties of this rare localization and the challenges of management.

[Availability and affordability of diagnosis and treatment for asthma and COPD in Ouagadougou, Burkina Faso]. / Disponibilité et accessibilité financière aux moyens diagnostiques et thérapeutiques de l'asthme et de la bronchopneumopathie chronique obstructive dans la ville de Ouagadougou, Burkina Faso.

INTRODUCTION: Chronic respiratory diseases, particularly asthma and Chronic Obstructive Pulmonary Disease (COPD), pose a significant threat to public health. This study aims to determine the accessibility and affordability of means of diagnosis and treatment. METHODS: This was a cross-sectional study covering the period from August to December 2021 in Ouagadougou, Burkina Faso. This study involved 107 health centers and 135 pharmacies. The World Health Organization/Health Action International definition was used as a benchmark for accessibility to medicines. RESULTS: Out of 107 health centers, 29 (27.1%) had a spirometer. The average cost of spirometry represented 19.88 days of salary for a patient paid at the minimum wage. The most widely available drugs were salbutamol in a pressurized metered dose inhaler (pMDI) (88.1%) and prednisone 20mg tablet (87.4%). No disease-modifying drug was available in public pharmacies. Affordable drugs were salbutamol 4mg tablet and aminophylline 100mg tablet. CONCLUSION: The means of diagnosis and treatment of asthma and COPD are insufficiently available, especially in the public sector, which is characterized by a nearly total absence of basic treatment.

Caustic oesophageal stricture treated by instrumental dilatation: A review of 6 years of practice at the pediatric university hospital charles de gaulle of Ouagadougou.

Background: Oesophageal stricture is one of the most important and redoubtable complications following caustic ingestions in children. Instrumental dilatation is usually considered the first line of treatment. Aims and Objectives: This study aims to evaluate the outcomes of caustic stenosis treatment when using Lerut dilatators. Materials and Methods: This is a descriptive retrospective study from May 2014 to April 2020. All children under 15 years hospitalised in our department for caustic oesophageal stricture and had a gastrostomy and oesophageal dilatation with insertion of an endless wire were included. Results: A total of 83 patients were included. The sex ratio was 2.2. The mean age was 4 years. The mean time from caustic ingestion to presentation was 90 days. Oesophageal stricture was mostly caused by caustic soda (n = 41) and potash (n = 15). We performed in total 469 dilatations and had only three oesophageal perforations. After a mean follow-up of 17 months, we had 60.2% good results (n = 50) and 7.2% (n = 6) failures. The mortality rate was 13.2% (n = 11). Conclusion: The results of the dilations by Lerut dilatators give encouraging results in our department. It is easy to perform and its complications remain rare. Mortality could be reduced by adequate nutritional support.

Knowledge, practices and beliefs of students regarding health effects of shisha use in Ouagadougou, Burkina Faso: A cross­sectional study

Background.The tobacco epidemic is one of the biggest public health threats the world has ever faced. Shisha use has recently been gaining increased popularity in many developed and developing countries.Objective. To determine the prevalence of shisha use among students in Ouagadougou, Burkina Faso, and associated knowledge, smoking practices and beliefs about health effects.Method. A total of 443 students were selected for this cross-sectional study, using a stratified sampling method. Data on shisha use, knowledge about shisha, shisha smoking practices, and factors associated with use of shisha were collected via a questionnaire. The association between the independent variables and shisha use was assessed using a χ2 test (p<0.05). Binary logistic regression analysis was used to determine variables that were independently associated with shisha smoking.Results.Of the 421 respondents, 162 (38.5%) indicated that they had smoked shisha; 14.0% were regular smokers. We found that 183 students (43.5%) had poor knowledge about the health effects of shisha. The main reasons for shisha smoking were being in the company of friends who were users (57.4%), the pleasant flavour and fragrance of shisha (25.9%), and fashion (22.2%). Ninety-nine shisha smokers (61.1%) also consumed alcohol. Factors associated with shisha smoking included age <20 years (p<0.001), gender (p=0.034), and educational level of the respondent's father (p=0.0001) and mother (p=0.0004).Conclusion. We found a relatively high prevalence of shisha smoking among the students, and that 43.5% of them had poor knowledge about its effects on health. Developing surveillance, intervention and regulatory/policy frameworks specific to shisha has become a public health priority.

[Diabetes mellitus and high blood pressure over risk in HIV-infected people followed at Souro Sanou University Hospital Day Hospital, Bobo-Dioulasso 2018]. / Sur-risque de diabète sucré et d'hypertension artérielle chez les personnes infectées par le VIH suivies à l'hôpital de jour du CHU Souro Sanou, Bobo-Dioulasso, Burkina Faso, 2018.

BACKGROUND: Non-communicable diseases (NCDs) represent the leading causes of death worldwide. HIV also increases the risk of developing NCDs including diabetes mellitus and hypertension. METHODS: A cross-sectional study, based on an analysis of the cohort database of the day hospital of the Souro Sanou teaching hospital in Bobo-Dioulasso (Burkina Faso). Diabetes mellitus was defined by the undergoing of anti-diabetic treatment or two successive measurements of fasting blood sugar above 7mmol/l and high blood pressure by the undergoing of antihypertensive treatment or two successive measurements of blood pressure above 140/90mmHg. Comparison of the frequency of diabetes and hypertension in the people living with HIV/AIDS (PLWHA) population on antiretroviral therapy (ART) with that of the general population of Burkina Faso was made by indirect standardization according to age and gender. RESULTS: A total of 4259 patients including 3148 women (73.9%) were included in this study. The median age of the patients was 45 years (IQR: 38-52); the median body mass index (BMI) was 19.6kg/m2 (IQR: 15.4 - 22.7) and 48.3% of patients had a BMI≥25kg/m2. The median CD4 count was 590 cells/mm3 (IQR: 417-785). The median ART duration was 8.2 years (IQR: 4.7-11.2). The majority of patients (82.9%) were on treatment combinations consisting in 2 INTI+1 NNRTI. Prevalence of hypertension was 39.8%; it was statistically higher in men than in women (45.8% versus 37.8%). Prevalence of hypertension was 87.0% higher in the PLWHA population than among same-sex and same-age subjects in the general population. Prevalence of diabetes mellitus was 7.3%. Diabetes mellitus was more common in men than in women (10.1% versus 6.3%; P<10-3). Prevalence of diabetes mellitus was 36.0% higher in the PLWHA population than among same-sex and same-age subjects in the general population. CONCLUSION: Prevalence of diabetes mellitus and hypertension was higher among PLHWA undergoing ART than in the general population. Care for the PLHWA population should more widely include NCD treatment.

[Factors associated with the occurrence of acute respiratory distress and death in patients with COVID-19 in Burkina Faso]. / Facteurs associés à la survenue de la détresse respiratoire aiguë et au décès chez des patients atteints de COVID-19 au Burkina Faso.

INTRODUCTION: The development of acute respiratory distress syndrome indicates a serious form of COVID-19. Although there have been several studies on the prognostic factors of its severe form, no such study has been conducted in Burkina Faso. METHODS: This was a retrospective cohort study conducted from March 9 to June 9, 2020 in Ouagadougou, Burkina Faso which involved 456 patients with COVID-19. RESULTS: Nearly a quarter of the patients (23.2%) had presented with acute respiratory distress and 44.3% of them died. Being over 65 years old (HR: 2.7; 95% CI: 1.5-5.1) and having hypertension (HR: 1.9; 95% CI: 1-3.5) were independently associated with the risk of mortality. However, after adjustment, only age over 65 years (HR: 2.3; 95% CI: 1.2-4.3) was a risk factor for death. The survival rate for patients over 65 was 38.5% at 7 days and 30.3% at 15 days. CONCLUSIONS: Acute respiratory distress leading to death is mainly found in older people with COVID-19. Close monitoring of these high-risk patients may reduce the risk of death.

[Central Post-Stroke Pain at the Tingandogo University Teaching Hospital of Ouagadougou (Burkina Faso): Frequency, Clinical Profile, Quality of Life of Patients and Associated Factors]. / La Douleur Centrale Post Accident Vasculaire Cérébral au Chu Tingandogo de Ouagadougou (Burkina Faso): Fréquence, Profil Clinique, Qualité de Vie des Patients et Facteurs Associés.

Objective: Few studies have been done on central post-stroke pain (CPSP) in Sub-Saharan Africa, while taking it into account would improve the quality of life of stroke survivors. The purpose of this study was to determine the prevalence of CPSP, to describe its clinical profile, to assess the quality of life of patients and to identify the factors associated with its occurrence, from a prospective hospital series in Ouagadougou, Burkina Faso. Methodology: It was a prospective, descriptive and analytical longitudinal follow-up study, conducted from January 2015 to March 2020, at the Tingandogo University Hospital, in Ouagadougou, Burkina Faso. The study involved all patients over the age of 16, consecutively hospitalized for stroke confirmed by CT and / or brain MRI, then reviewed every three months in outpatient Neurology, during at least 9 months after their stroke. The sociodemographic and clinical characteristics of the patients, the nature of the stroke, the existence of CPSP and, if applicable, its clinical characteristics, its treatment and its impact on the quality of life of the patients were recorded; a bivariate then multivariate analysis with logistic regression step by step, made it possible to search for the factors associated with the occurrence of CPSP. The significance threshold used was p < 0.05. Results: A total of 236 patients were collected, out of which 28 patients presented a CPSP (11.9%), after a mean duration of post-stroke follow-up of 12.9 months. Cerebral infarction, intracerebral hemorrhage and cerebral venous thrombosis accounted for 69.5%, 29.7% and 0.8% respectively. The mean age of patients with CPSP was 54.6 years, with a male predominance (53.6%). The mean time to onset for CPSP was 3.8 months after stroke. Pains such as burning (75%) and allodynia (67.8%) were the most common. The average CPSP intensity was 7.6 / 10 on the visual analog scale. Hypoaesthesia (96.4%) and paraesthesia (71.4%) were the signs or symptoms most commonly associated with CPSP. CPSP had a moderate to severe negative impact on usual work, general activity and mood of patients in 60.7%, 50% and 46.4% of patients, respectively. Amitriptyline (75%) and / or level II analgesics (60.7%,) were the most used molecules, and effective in 57% of cases. Only age ≤ 50 years was independently associated with the occurrence of CPSP (OR 2.86; p = 0.03). Conclusion: CPSP affects more than 1 in 10 stroke patients and moderately to severely affects the quality of life for most of these patients. Screening and adequate management of CPSP as part of multidisciplinary post-stroke follow-up will contribute to improve the quality of life of stroke patients and will facilitate their social and professional reintegration.

Prevalence of obstructive sleep apnoea in sleep consultations in Burkina Faso: Implications for monitoring.

BACKGROUND: Obstructive sleep apnoea syndrome (OSAS) is the most common respiratory disorder related to sleep. Its prevalence in developed countries varies from 3% to 28%. In several African countries, including Burkina Faso, this syndrome is still under-diagnosed and goes largely untreated. It is necessary to conduct studies in different contexts to determine the characteristics and develop the strategies for management of OSAS. OBJECTIVES: To determine the prevalence of OSAS in Burkina Faso. METHODS: This prospective study recruited 106 patients coming for consultation for sleep disorders at the Yalgado Ouedraogo University Hospital Center, who responded to a self-questionnaire and were diagnosed by respiratory polygraphy. RESULTS: A total of 77 patients (72.6%) had OSAS. The male to female ratio was 1.4:1 and the mean (standard deviation) age was 47.8 (12.8) years. The majority of the patients (53.8%) were obese. The main reason for consultation was snoring (84%), followed by hypopnea-apnoea reported (59.4%) and daytime sleepiness (45.3%). The most common comorbidity factor was hypertension (50%), followed by decreased libido (16%) and diabetes (13.2%). A continuous positive-pressure (CPAP) machine was prescribed to 51.25% of the patients, but only 22% were able to acquire it. CONCLUSION: The monitoring of OSAS is relatively new in Burkina Faso. This study showed the profile of patients with OSAS and difficulties in accessing continuous positive airway pressure (CPAP) devices for treatment.

[Repressive medical responsability: opinion of practitioners and users of the hospital, case of CHU Yalgado Ouédraogo in Burkina Faso]. / Responsabilite medicale repressive : avis des praticiens et des usagers de l'hopital, cas du CHU Yalgado Ouedraogo au Burkina Faso.

MATERIAL AND METHOD: A cross-sectional study on medical responsability for repressive purposes: the opinion of practitioners and users of the hospital, was carried out from 1 April to 30 June 2017 using an anonymous individual questionnaire 271 practitioners and users of CHU Yalgado Ouedraogo. RESULTS: The study population was young. The mean age of hospital users was 38.68 years, that of practitioners was 32.26 years. Hospital users think in 56.1% of cases (152) that a practitioner can be sued for punishment. Of these, criminal responsibility was the most cited by hospital users in 51%. Users who felt that they had been the victim of medical malpractice numbered 36 or 13.3%. None of these 36 users had filed a lawsuit complaint. Disciplinary responsibility was most cited by practitioners in 44% of cases. Practitioners who cited both criminal and disciplinary responsability were 65 or 24%. Practitioners who claim to have been the source of medical malpractice are 03 (1.1%).

MATÉRIEL ET MÉTHODE: Une étude transversale portant sur la responsabilité médicale à visée répressive, avis des praticiens et des usagers de l'hôpital, a été réalisée du 1er Avril au 30 Juin 2017 à l'aide d'un questionnaire individuel anonyme, auprès de 271 praticiens et usagers du CHU Yalgado Ouédraogo. RÉSULTATS: L'âge moyen des usagers de l'hôpital était de 38,68 ans, celui de praticiens était de 32,26 ans. Les usagers de l'hôpital pensent dans 56,1% des cas (152) qu'un praticien peut être poursuivi en justice pour être sanctionné. Parmi ces derniers, la responsabilité pénale était la plus citée par les usagers de l'hôpital dans 51%.Les usagers qui estimaient avoir été victime d'une faute médicale étaient au nombre de 36 soit 13,3%.Aucun de ces 36 usagers n'avait déposé une plainte pour poursuite judiciaire. La responsabilité disciplinaire était la plus citée par les praticiens dans 44% des cas. Les praticiens qui ont cité à la fois la responsabilité pénale et disciplinaire, étaient au nombre 65 soit 24%. Les praticiens qui déclarent avoir été à l'origine d'une faute médicale sont au nombre de 03 soit 1,1%.

Responsabilité médicale répréssive: avis des praticiens et des usagers de l'hôpital, cas du CHU Yalgado Ouedraogo au Burkina Faso

Matériel et méthode:Une étude transversale portant sur la responsabilité médicale à visée répressive, avis des praticiens et des usagers de l'hôpital, a été réalisée du 1er Avril au 30 Juin 2017 à l'aide d'un questionnaire individuel anonyme, auprès de 271 praticiens et usagers du CHU Yalgado Ouédraogo.Résultats: L'âge moyen des usagers de l'hôpital était de38,68 ans, celui de praticiens était de 32,26 ans.Les usagersde l'hôpital pensent dans 56,1% des cas (152) qu'un praticien peut être poursuivi en justice pour être sanctionné. Parmi ces derniers,la responsabilité pénale était la plus citée par les usagers de l'hôpital dans 51%.Les usagers qui estimaient avoir été victime d'une faute médicale étaient au nombre de 36 soit13,3%.Aucun de ces 36 usagers n'avait déposé une plainte pour poursuite judiciaire.La responsabilité disciplinaire était la plus citée par les praticiens dans 44% des cas.Les praticiens qui ont cité à la fois la responsabilité pénale et disciplinaire, étaient au nombre65soit 24%.Les praticiens qui déclarent avoir été à l'origine d'une faute médicale sont au nombre de03soit 1,1%

Position Statement on Atopic Dermatitis in Sub-Saharan Africa: current status and roadmap.

BACKGROUND: The first International Society of Atopic Dermatitis (ISAD) global meeting dedicated to atopic dermatitis (AD) in Sub-Saharan Africa (SSA) was held in Geneva, Switzerland in April 2019. A total of 30 participants were present at the meeting, including those from 17 SSA countries, representatives of the World Health Organization (WHO), the International Foundation for Dermatology (IFD) (a committee of the International League of Dermatological Societies, ILDS www.ilds.org), the Fondation pour la Dermatite Atopique, as well as specialists in telemedicine, artificial intelligence and therapeutic patient education (TPE). RESULTS: AD is one of the most prevalent chronic inflammatory skin diseases in SSA. Besides neglected tropical diseases (NTDs) with a dermatological presentation, AD requires closer attention from the WHO and national Departments of Health. CONCLUSIONS: A roadmap has been defined with top priorities such as access to essential medicines and devices for AD care, in particular emollients, better education of primary healthcare workers for adequate triage (e.g. better educational materials for skin diseases in pigmented skin generally and AD in particular, especially targeted to Africa), involvement of traditional healers and to a certain extent also patient education, bearing in mind the barriers to effective healthcare faced in SSA countries such as travel distances to health facilities, limited resources and the lack of dermatological expertise. In addition, several initiatives concerning AD research in SSA were discussed and should be implemented in close collaboration with the WHO and assessed at follow-up meetings, in particular, at the next ISAD meeting in Seoul, South Korea and African Society of Dermatology and Venereology (ASDV) meeting in Nairobi, Kenya, both in 2020.

Evaluation of sexual dysfunctions among women living with a partner in Ouagadougou, Burkina.

To study the sexual dysfunctions of women living with a partnerin relationship in the city of Ouagadougou. This was a descriptive, and analytical cross-sectional study collectedwith prospective data collection over the a period of seven (07-) months period from March 1st through November 30th, 2016,. by interviewing It consisted of collecting from 633 women living with a partner in relationship in Ouagadougou data aboutn their sex livfes. The data werehas been processed and analyzed with epi-info software, in version 3.5.3. Statistical tests (Chi-square and, Fisher's exact tests) were used to assess the association between the different variables at athe 5% significance level of 5%. The study participation rate was 90.8%. In our study, 84.5% (n=or 486) women reported having at least one sexual dysfunction in their lifetime. Of those surveyed, 84.5% (486/575) had anorgasmia, 64.3% (370/575) had dyspareunia, 35.8% (206/575) had an problems of arousalexcitement disorder, and 35.1% had (202/575) frigidity. In addition,There were 116 of them (20.3%) hadwith lowdecreased libidosexual desire and 0.7% (4/575) with vaginismus. Female circumcision was the main factor associated with the sexual dysfunction of the respondents. Dyspareunia was 4.2 times more common in women with genital excisioned women than in uncircumcised women The sSexual dysfunction is frequent amongof a womean living within a partnercouple in the city of Ouagadougou is frequent. Because excision is one of the factors [[[The leading factor]]] found in the occurrence of sexual dysfunction in women, hence the need to proscribe this harmful practice must be proscribed in our societies.

Factors limiting the use of modern contraceptive methods in mothers with children aged 12-23 months at the Yalgado Ouedraogo University Hospital in Ouagadougou, Burkina Faso.

Knowledge of the factors of non-use of modern contraceptive methods should help to reduce the number of infants born after short interpregnancy intervals, which are associated with adverse effects for mothers, children, and families. For this reason, this study aimed to determine the factors associated with this non-use among mothers of infants aged 12 to 23 months. This case-control study included a sample of mothers of children aged 12 to 23 months. The case mothers were users of modern contraceptive methods and the control mothers were non-users. Data were collected from January 1 through March 31, 2018. Six factors were significantly associated with the use of modern contraceptive methods: age younger than 25 years, lack of gainful activity, desire for a family size ≥ 4 children, BMI greater than 25, opposition by husband, and failure to attend the 45-day postnatal consultation. Modifiable socio-economic factors were significantly associated with the non-use of modern contraceptive methods by mothers of children aged 12 to 23 months.

[The current situation with sputum positive pulmonary tuberculosis in Niamey (Niger)]. / État des lieux de la tuberculose pulmonaire à bacilloscopie positive à Niamey (Niger).

Tuberculosis is a major public health problem and the main reason for hospital admission in developing countries. No study of tuberculosis has been undertaken in the pulmonary/tuberculosis service of Lamordé National Hospital in Niamey since its foundation in April 2009. The aim of our study is to assess the current situation of sputum positive new and relapsed cases of tuberculosis and to determine their epidemiological, clinical and therapeutic profiles. It comprised a retrospective four-year study of the records of patients hospitalized for sputum positive pulmonary tuberculosis (433 patients), both new and relapsed cases, in the pulmonary/tuberculosis service of the Lamordé National Hospital. The latter is the unique reference and management centre for lung disease for the capital of Niger. Of the 975 patients admitted to the pulmonary/tuberculosis centre 433 had sputum positive tuberculosis, both new and relapsed cases, making up 44.5% of admissions. 76.2% were male giving a sex ratio of 3.2. The mean age of the patients was 42.6 years with a range of 2-85 years. More than half of the patients (54.7%) came from the Niamey region and 68.6% were referred from there. Antecedents were tuberculosis, HIV infection and smoking in 8.3%, 6.2% and 6%, respectively. Weight loss (80.4%), productive cough (63%) and fever (68%) were the main general and functional signs identified. Sputum examination revealed the diagnosis in 99.8% of cases and 62.1% had a chest X-ray before starting treatment. Cavitation was present in 67.3% and infiltration in 46.9%. Serology for HIV was positive in 17.1%. A treatment regime was instituted in 89.6% of new cases and 10.4% of relapsed cases. The rate of recovery was 74.6% and pleurisy, which was the most common complication, developed in 5.6%. Tuberculosis constitutes the main cause of hospitalization in the pulmonary/tuberculosis service of the Lamordé National Hospital in Niamey. It is therefore necessary to educate the public and reinforce the training of health care professionals in the management of tuberculosis.

Prevalence of symptoms of sleep apnoea syndrome in Burkina Faso.

INTRODUCTION: Sleep apnoea syndrome (SAS) is a frequent and underdiagnosed pathology. Epidemiological studies in sub-Saharan Africa are few. Our study aimed to determine the prevalence of SAS symptoms in an adult population in Burkina Faso. METHODS: A cross-sectional study whose data collection took place at the Yalgado Ouédraogo Teaching Hospital, from 1 September to 31 October 2014. We randomly enrolled all subjects aged at least 25 accompanying an outpatient t the time of a visit. A strong suspicion of SAS was established for every combination of ordinary snoring with excessive daytime sleepiness and/or sleep apnoea. RESULTS: The study included 311 subjects - 181 men and 130 women. The mean (standard deviation (SD)) age was 31.84 (8.25) years and the average (SD) BMI was 23.14 (3.67) kg/m². The prevalence of excessive daytime sleepiness, snoring and sleep apnoea was 4.5%, 26% and 9.6%, respectively. A strong suspicion of SAS was found in 9.6% of respondents and the risk factors associated with this strong suspicion were BMI≥25 kg/m² (odds ratio (OR) 2.7; p=0.012), and poor-quality sleep (OR 3.7; p<0.001). CONCLUSION: A significant proportion of our sample had symptoms suggestive of SAS. Testing with either respiratory polygraphy or polysomnography should be proposed to the presumptive cases for early diagnosis and treatment.