Understanding the influence of the COVID-19 pandemic on hospital-based mortality in Burundi: a cross-sectional study comparing two time periods.

This study used hospital records from two time periods to understand the implication of COVID-19 on hospital-based deaths in Burundi. The place of COVID-19 symptoms was sought among deaths that occurred from January to May 2020 (during the pandemic) vs. January to May 2019 (before the pandemic). First, death proportions were tested to seize differences between mortality rates for each month in 2020 vs. 2019. In the second time, we compared mean time-to-death between the two periods using the Kaplan-Meier survival curve. Finally, a logistic regression was fitted to assess the likelihood of dying from COVID-19 symptoms between the two periods. We found statistical evidence of a higher death rate in May 2020 as compared to May 2019. Moreover, death occurred faster in 2020 (mean = 6.7 days, s.d. = 8.9) than in 2019 (mean = 7.8 days, s.d. = 10.9). Unlike in 2019, being a male was significantly associated with a much lower likelihood of dying with one or more COVID-19 symptom(s) in 2020 (odds ratio 0.35, 95% confidence interval 0.14-0.87). This study yielded some evidence for a possible COVID-19-related hospital-based mortality trend for May 2020. However, considering the time-constraint of the study, further similar studies over a longer period of time need to be conducted to trace a clearer picture on COVID-19 implication on hospital-based deaths in Burundi.

Bridgehead invasion of a monomorphic plant pathogenic bacterium: Xanthomonas citri pv. citri, an emerging citrus pathogen in Mali and Burkina Faso.

Molecular epidemiology studies further our understanding of migrations of phytopathogenic bacteria, the major determining factor in their emergence. Asiatic citrus canker, caused by Xanthomonas citri pv. citri, was recently reported in Mali and Burkina Faso, a region remote from other contaminated areas. To identify the origin and pathways of these emergences, we used two sets of markers, minisatellites and microsatellites, for investigating different evolutionary scales. Minisatellite typing suggested the introduction of two groups of strains in Mali (DAPC 1 and DAPC 2), consistent with microsatellite typing. DAPC 2 was restricted to Bamako district, whereas DAPC 1 strains were found much more invasive. The latter strains formed a major clonal complex based on microsatellite data with the primary and secondary founders detected in commercial citrus nurseries and orchards. This suggests that human activities played a major role in the spread of DAPC 1 strains via the movement of contaminated propagative material, further supported by the frequent lack of differentiation between populations from geographically distant nurseries and orchards. Approximate Bayesian Computation analyses supported the hypothesis that strains from Burkina Faso resulted from a bridgehead invasion from Mali. Multi-locus variable number of tandem repeat analysis and Approximate Bayesian Computation are useful for understanding invasion routes and pathways of monomorphic bacterial pathogens.

Analysis of Xanthomonas oryzae pv. oryzicola population in Mali and Burkina Faso reveals a high level of genetic and pathogenic diversity.

Bacterial leaf streak (BLS) caused by Xanthomonas oryzae pv. oryzicola was first reported in Africa in the 1980s. Recently, a substantial reemergence of this disease was observed in West Africa. Samples were collected at various sites in five and three different rice-growing regions of Burkina Faso and Mali, respectively. Sixty-seven X. oryzae pv. oryzicola strains were isolated from cultivated and wild rice varieties and from weeds showing BLS symptoms. X. oryzae pv. oryzicola strains were evaluated for virulence on rice and showed high variation in lesion length on a susceptible cultivar. X. oryzae pv. oryzicola strains were further characterized by multilocus sequence analysis (MLSA) using six housekeeping genes. Inferred dendrograms clearly indicated different groups among X. oryzae pv. oryzicola strains. Restriction fragment length polymorphism analysis using the transcriptional activator like effector avrXa7 as probe resulted in the identification of 18 haplotypes. Polymerase chain reaction-based analyses of two conserved type III effector (T3E) genes (xopAJ and xopW) differentiated the strains into distinct groups, with xopAJ not detected in most African X. oryzae pv. oryzicola strains. XopAJ functionality was confirmed by leaf infiltration on 'Kitaake' rice Rxo1 lines. Sequence analysis of xopW revealed four groups among X. oryzae pv. oryzicola strains. Distribution of 43 T3E genes shows variation in a subset of X. oryzae pv. oryzicola strains. Together, our results show that African X. oryzae pv. oryzicola strains are diverse and rapidly evolving, with a group endemic to Africa and another one that may have evolved from an Asian strain.

Seroprevalence et facteurs associes au statut serologique des enfants nes de meres seropositives au VIH dans les sites de prevention de Cotonou au Benin

L'objectif de l'etude etait de determiner les facteurs qui sont associes au statut serologique des enfants nes de meres seropositives dans quatre sites de Prevention de la Transmission Mere-Enfant (PTME) de Cotonou. Une etude transversale et retrospective; a double volet quantitatif et qualitatif a porte sur 114 dossiers d'enfants nes de meres seropositives ainsi que leurs meres en 2010; 60 meres seropositives ayant frequente ces sites et 29 agents de sante assurant leur prise en charge en 2011. Elle a ete basee sur le depouillement des dossiers medicaux; des entretiens individuels et des observations du cadre de travail. Des analyses bi-variees ont ete realisees pour rechercher les facteurs associes au statut serologique de l'enfant dans Epi Info 3.5.3. L'etude a montre que le traitement aux ARV; le type du VIH; le sexe de l'enfant; la prophylaxie au Cotrimoxazole ont ete associes significativement au statut serologique de l'enfant. Le cadre de travail inadequat; les ruptures de stock des ARV; Cotrimoxazole et reactifs et leur gestion insuffisante; les difficultes pour faire face aux depenses supplementaires liees aux soins ont ete releves. En conclusion; l'acces aux ARV et au Cotrimoxazole et leur gestion adequate; l'observance rigoureuse des traitements et le soutien financier aux meres seropositives contribueront a la baisse considerable du taux de transmission de la mere a l'enfant du VIH dans les sites PTME de Cotonou

Determinants of long-lasting insecticidal net use in Burkina Faso after a mass distribution in the Diébougou health district.

BACKGROUND: In 2009, a mass distribution of long-lasting insecticidal nets (LLINs) was conducted in an experimental site of the Diébougou health district. Carried out 1year after the distribution, this study aimed to determine the presence of LLINs in households, to determine the LLIN use rate, and thirdly, to identify key factors associated with LLIN use in households. METHODS: We conducted a cross-sectional descriptive and analytical study, which covered the entire Diébougou health district. The study population consisted of households in the district. The statistical unit was the household head, or if absent his designated representative. For the selection of households to be studied, we considered the health centers and their geographic accessibility. We thus defined three zones: an area within 5 km of health centers, the area between 5 and 10 km away, and the area beyond 10 km. In each area, we randomly selected 20 households, totaling 60 households in the area of each health center, giving a sample of 840 households to be surveyed. We selected 60 households per health center in accordance with the time and financial resources allocated to data collection. The data were analyzed using the Epi Info 3.5.1 software package. The Chi square test was used to investigate the association between the dependent and independent variables with statistical significance set at P<0.05. When an association was demonstrated, the relative risk (RR) was calculated with the 95% confidence interval. RESULTS: A total of 822 households (97.8%) were surveyed, households inhabited by 6379 people including 1175 (11.4%) children under 5 years of age and 158 (2.5%) pregnant women. The overall use of LLINs was 76.5%. This rate was 81.7% in children under 5 years and 57.6% among pregnant women. Factors influencing the use of LLINs were the implementation of a communication plan by health actors (RR=2.42 [2.03-2.83]), the social position of the household head (RR=1.62 [1.43-1.83]), the marital status of the household head (RR=1.41 [1.33-1.49]), the number of persons per room (RR=1.39 [1.08-1.78]), the religion of household head (RR=1.21 [1.15-1.27]), the level of education of the household head (RR=1.15 [1.06-1.24]), and the number of IECs (information, education, communication) sessions followed by the household (RR=1.14 [1.08-1.20]). CONCLUSION: The results of this study provide guidance on measures to ensure the success of the mass distribution of LLINs to the entire country.

First Report of Xanthomonas citri pv. citri Causing Asiatic Citrus Canker in Burkina Faso.

Citrus canker, caused by Xanthomonas citri pv. citri, is a bacterial disease of economic importance in tropical and sub-tropical citrus-producing areas (EPPO-PQR online database). X. citri pv. citri causes severe infection in a wide range of citrus species, and induces erumpent, callus-like lesions with water-soaked margins leading to premature fruit drop and twig dieback. It has consequently been subjected to eradication efforts and international regulations. It was first described on the African continent in South Africa at the beginning of the 20th century, from which it was eventually eradicated. Since 2006, several outbreaks caused by phylogenetically diverse strains of X. citri pv. citri have been reported from several African countries (Ethiopia, Mali, Senegal, and Somalia). In July 2011, citrus canker in Burkina Faso was suspected in the area adjacent to the Sikassso Province of Mali where X. citri pv. citri has been confirmed. In November and December 2012, leaves of clementine (Citrus clementina), lemon (C. limon), Volkamer lemon (C. volkameriana), sweet orange (C. sinensis), tangelo (C. paradisi× C. reticulata), and mandarin (C. reticulata) were collected from orchards with trees showing symptoms of citrus canker in the Comoé, Houet, and Kénédougou provinces of Burkina Faso. Isolations performed using KC semi-selective medium (4) recovered 45 Xanthomonas-like strains. All Xanthomonas-like strains were tentatively identified as X. citri pv. citri by PCR (4/7 primers) using IAPAR 306 and sterile distilled water as the positive and negative controls, respectively (3). Among these, two strains (LK4-4 and LK4-5) produced a 'fuscans'-like brown diffusible pigment, a phenotype never reported previously for X. citri pv. citri. MultiLocus Sequence Analysis targeting six housekeeping genes (atpD, dnaK, efp, gltA, gyrB, and lepA) (1,2) fully identified seven strains from Burkina Faso (LJ301-1, LJ303-1, LK1-1, LK2-6, LK4-3, LK4-4, and LK4-5) as X. citri pv. citri (and not to any other Xanthomonas pathovars pathogenic to citrus or host range-restricted pathotypes of pathovar citri), and more specifically as sequence type ST2 which is composed mostly of pathotype A strains of X. citri pv. citri (2). The same seven strains were inoculated to at least four leaves of each of grapefruit cv. Henderson, Mexican lime SRA 140 (C. aurantifolia), Tahiti lime SRA 58 (C. latifolia), and sweet orange cv. Washington Navel, using a detached leaf assay (2). All strains developed typical erumpent, callus-like tissue at wound sites on all citrus species inoculated. No lesions developed on the negative control (sterile 10 mM tris buffer). Koch's postulate was fulfilled after reisolation of Xanthomonas-like yellow colonies from symptoms on Mexican lime produced by the seven strains. Boiled bacterial suspensions were assayed by PCR with 4/7 primers (3) and produced the expected 468-bp amplicon in contrast with the PCR negative control. To our knowledge, this is the first report of X. citri pv. citri in Burkina Faso. Citrus canker-free nurseries and grove sanitation should be implemented for reducing the prevalence of Asiatic canker in Burkina Faso and a thorough survey of citrus nurseries and groves in the region should be conducted. References: (1) N. F. Almeida et al. Phytopathology 100:208, 2010. (2) L. Bui Thi Ngoc et al. Int. J. Syst. Evol. Microbiol. 60:515, 2010. (3) J. S. Hartung et al. Phytopathology 86:95, 1996. (4) O. Pruvost et al. J. Appl. Microbiol. 99:803, 2005.

First Report of Bacterial Leaf Streak Caused by Xanthomonas oryzae pv. oryzicola on Rice in Burkina Faso.

Bacterial leaf streak (BLS) caused by Xanthomonas oryzae pv. oryzicola is prevalent in Asia where it can decrease yield by as much as 30%. In Africa, BLS has been reported in Madagascar, Nigeria, Senegal, and recently in Mali (1). The pathogen is seed transmitted and rice seeds can be a source of primary inoculum (3). In October 2009, leaf streak symptoms were observed on 3-month-old field rice grown in three regions of Burkina Faso (Haut-Bassin, Cascades, and East Center). Disease was found on cultivated Oryza sativa (varieties TS2, FKR19, and FKR56N), wild rice species (O. longistaminata and O. barthii), and weeds. Symptoms consisted of water-soaked lesions that developed into translucent, yellow streaks with visible exudates at the leaf surface. Yellow-pigmented Xanthomonas-like colonies were isolated on PSA semiselective medium (peptone 10 g, sucrose 10 g, bacto agar 16 g, distilled water 1,000 ml, actidione 50 mg liter-1, cephalexin 40 mg liter-1, and kasugamycin 20 mg liter-1). A multiplex PCR developed for the identification of Xanthomonas oryzae pathovars (2) was used to check the identity of Xanthomonas-like isolates. X. oryzae pv. oryzicola strains BLS256 from the Philippines and CFBP 7331 from Mali were used as positive controls. Three expected DNA fragments (331, 691, and 945 bp) corresponding to X. oryzae pv. oryzicola were obtained from all isolates using the multiplex PCR. No fragment was observed for negative controls (distilled water as the template). Five X. oryzae pv. oryzicola isolates were further analyzed by sequence analysis using portions of the gyrB housekeeping gene together with reference strains. Two sequence types were identified among Burkinabe isolates differing by only one nucleotide. When compared with the nucleotide database with BLAST, three isolates (BAI6, BAI15, and BAI19) were 100% identical to the type culture strain X. oryzae pv. oryzicola BLS256 (gyrB sequence was obtained from GenBank AAQN01000001.1) while the other two (BAI5 and BAI20) demonstrated 99% sequence similarity. The nucleotide sequence of isolate BAI5 was submitted to GenBank (HQ112342). Pathogenicity tests were performed on greenhouse-grown 3-week-old rice plants cv. Nipponbare. Cultures were grown overnight in PSA medium and adjusted in sterile water to 1 × 108 CFU/ml and inoculated into rice leaves with the blunt end of a 1-ml syringe. Four infiltrations were done per isolate per leaf and two leaves were inoculated per plant. Control plants were inoculated with sterile water. After 15 days of incubation in the greenhouse at 27 ± 1°C with a 12-h photoperiod, inoculated leaves exhibited water-soaked lesions with yellow exudates that were identical to symptoms seen in the field. Control plants remained symptomless. Colonies with morphology typical of Xanthomonas were recovered from the symptomatic leaves and typed using multiplex PCR to fulfill Koch's postulates. Three isolates have been deposited in the Collection Française de Bactéries Phytopathogènes (CFBP) and identified as X. oryzae pv. oryzicola strains CFBP7341-43. To our knowledge, this is the first report of X. oryzae pv. oryzicola in Burkina Faso. Further surveys and strain collection will be necessary to evaluate the geographic distribution and prevalence of BLS in Burkina Faso and neighboring countries. References: (1) C. Gonzalez et al. Mol. Plant-Microbe Interact. 20:534, 2007. (2) J. Lang et al. Plant Dis. 94:311, 2010. (3) G. Xie and T. Mew. Plant Dis. 82:1007, 1998.

[Prevalence and factors associated with low back pain among hospital staff in Ouagadougou (Burkina Faso)]. / Prévalence et facteurs de risque associés à la lombalgie chez le personnel hospitalier à Ouagadougou (Burkina Faso).

OBJECTIVE: The aim of our study was to determine the prevalence, risk factors, associated with low back pain among hospital staff in a developing country. PATIENTS AND METHODS: This transversal study was conducted from March 2007 to February 2008 at Yalgado Ouédraogo Teaching Hospital in Ouagadougou (CHU-YO), Burkina Faso. RESULTS: There were 256 men and 180 women with an average age of 38 +/- 8.25 years (range, 22 to 58). Mean BMI was 25.11 +/- 4.03 Kg/m2. The prevalence of chronic low back pain was 56.4% overall, 47.3% in men and 69.4% in women. Individual risk factors included female sex (p=0.000004), age (p=0.026), and high BMI (p=0.0002). Sports activity appeared to be a protective factor (p=0,035). Professional risk factors were the number of working hours per week (p=0,005) and numbers of guards per month (p=0.014) and posture during work (p=0.01). Analysis of socioprofessional consequences revealed significant impact in 43 (17,5%) patients. The loss work hours in 2007 were estimated to 1020. Three patients had to change working stations due to disability and 82 (19%) reported restricted working capacity. CONCLUSION: The prevalence of low back pain is high among hospital staff of CHU-YO. Preventive measures are needed to reduce socioprofessional consequences.

[Self-medication in the treatment of acute malaria: study based on users of private health drug stores in Ouagadougou, Burkina Faso]. / Automédication dans le traitement de l'accès palustre: étude auprès de clients d'officines pharmaceutiques privées de la ville de Ouagadougou, Burkina Faso.

In order to contribute to the national debate on the change of protocol of the simple forms of malaria treatment in Burkina Faso, we conducted a transversal descriptive study among 397 private pharmacies users in Ouagadougou. The aims of the study were: - making an inventory of the antimalarials and signs which led to self-medication; - identifying the factors favouring self-treatment and the reasons why these antimalarials have been bought; - making an inventory of the misuses of antimalarial drugs by individuals practicing self-medication; - checking the knowledge base in individuals practicing self-medication in relation to resistance to antimalarials. We noticed that chloroquine (39.3%), sulfadoxine-pyrimethamin (24.4%), arthemisinin and its by products (15.1%) were the three main molecules which account for antimalarial self-treatment However the use of these molecules was inappropriate regarding the dosage (41.3%) as well as the rate of intake (40.7%). Self-medication was motivated by the common signs of malaria and the way in which this parasitosis has become an every day feature in people's minds. The choice of the molecule, the knowledge of the directions for use and the rate of intake were significantly linked to the level of education (p < 0.001). Self-medication being one of the major causes of resistance development, it is necessary together with local pharmacies retailers, to organize information campaigns on the correct use of molecules of the new antimalarial therapeutic scheme which will be adopted.

[Retrospective study of urogenital fistula in Burkina Faso from 2001 to 2003]. / Bilan rétrospectif des fistules urogénitales obstétricales de 2001 a 2003 au Burkina Faso.

The purpose of this study was to analyze aspects of obstetric urogenital fistulae to provide a foundation for implementation of a national control program in Burkina Faso. A cross-sectional study with quantitative and qualitative components was carried out in 47 hospitals in January 2004. The quantitative component consisted of analyzing available data for 2001, 2002 and 2003. The qualitative component consisted of interviewing women with fistulae to evaluate the impact of the disease on the quality of life and persons in charge of the health reference centers to identify the difficulties and needs of the facility. In the 3-year study period, 1,500,000 deliveries were attended and 347 fistulae were identified in the health reference centers. The incidence rate of obstetric fistulae was 23.1 per 100 000 deliveries (CI 95% 20.8-25.7). Women with fistulae were young and usually without paid employment. Many had a history of dystocia during the labor. Most fistulae were recent, small or average in size and located at the level of the vesico-vaginal septum. The failure rate of surgical treatment was about 17.5%. Four of the 12 women interviewed reported social alienation and ostrasization. Only 4 of the 47 hospitals studied had a personnel qualified to manage women with urogenital fistula on a daily basis. One NGO assisted women in obtaining care. Proposals for improvement of the situation were considered at a national validation workshop. These findings support the need to implement a national program that should be evaluated to see lessons learned from this study.

[Herpes zoster and human imunodeficiency virus in the medical centers of Ouagadougou]. / Le zona dans les formations sanitaires de Ouagadougou dans le contexte de la pandemie du VIH/SIDA.

Herpes zoster is an acute posterior ganglio-radiculitis related to the reactivation of the chicken pox-herpes zoster virus remained quiescent in the neurons of the nerve-knots. It usually occurs at the subject after 60 years old. For young patient, it is closely related to the infection by the HIV. Our exploratory descriptive and analytical study was carried out from 1 October 2002 to 30 September 2003, in order to describe the epidemiological, clinical aspects of the herpes zoster in the medical formations of the town of Ouagadougou (Burkina Faso) and to determine the prevalence of the infection by the HIV in the patients. We have collected 118 patients who have a herpes zoster through 6500 consultants. There were 79 women and 39 men. The average age was 34.4 years. The age bracket from 20 to 40 years was the most touched. The blistered eruption was the first reason for consultation; the light with type of burn, intermittent pain prevailed. The lesions healed in one month but there were 28 ulcerated necrotic cases. Post zoster pains have been observed in 33 cases. The localizations were the members in 44 cases (37.29%), the head in 35 cases (29.66%) and the trunk in 40 cases (33.90%). We have observed a case with double localization of herpes zoster. On 65 patients tested for the HIV, 58 (89.2%) were infected. The age bracket from 20 to 40 was the most concerned. A case of corneal necrosis isolated, with blindness and another with an opposed, spasmodic and total hemi paresis were notified. Fourteen patients having an antecedent of herpes zoster were all infected by HIV. Since the pandemic infection by the HIV, the incidence of the herpes zoster increases within the young population. The high frequency of HIV infection among our patients (89.2%) showed that the herpes zoster is closely related to this disease.

Bilan retrospectif des fistules urogenitales obstetricales de 2001 a 2003 au Burkina Faso

Pour analyser les fistules urogenitales au Burkina Faso en vue de la mise en place d'un programme national; une etude transversale a visee quantitative et qualitative en janvier 2004 a ete realisee dans les formations sanitaires de reference. L'etude quantitative a analyse les donnees disponibles sur les annees 2001; 2002 et 2003. L'etude qualitative a permis d'interviewer des femmes vivant avec la fistule et les responsables des services de sante. Au cours des 3 ans sur environ 1 500 000 accouchements attendus dans le pays; 347 cas de fistules ont ete identifies soit un taux d'incidence de 23;1 pour 100 000 accouchements (IC a 9520;8 - 25;7). Les femmes avec fistules etaient jeunes et surtout sans emploi remunere avec des antecedents de dystocie a l'accouchement. Les fistules etaient le plus souvent recentes; de tailles petites ou moyennes et localisees au niveau de la cloison vesico-vaginale. Les resultats de la chirurgie etaientmarques par un taux d'echec de l'ordre de 17;5. Quatre femmes sur 12 interviewees ont declare avoir ete abandonnees par le conjoint. Sur 47 hopitaux visites; seulement 4 avaient un personnel qualifie pour la realisa- tion de la prise en charge quotidienne des fistules. Une organisation non gouvernementale aidait les patientes pour l'obtention de soins. Un atelier national de validation a permis de faire des propositions pour l'amelioration de la situation. Les resultats montrent la necessite de la mise en place d'un programme national qui devrait etre evalue pour voir les acquis obtenus apres cette etude

[Factors for non-observance of the extended program timetable for vaccination in health districts: the case of Boussé in Burkina Faso]. / Déterminants du non-respect du calendrier vaccinal du programme élargi de vaccination au niveau district sanitaire: cas du district sanitaire de Boussé, Burkina Faso.

UNLABELLED: Prevention through vaccination is a strong means to fight pediatric lethal diseases. In Burkina Faso, one of the main problems for vaccination is the non-respect of the vaccination timetable bringing about a significant reduction of validity of administered doses. OBJECTIVES: The authors had for aim to assess reasons for the non-compliance to the timetable. A transversal study was carried out in the Boussé health district to: 1) analyze the qualitative and organizational factors of the vaccination services linked to this non compliance; 2) analyze community factors accounting for this situation. POPULATION AND METHOD: The study target group included mothers of children aged 0 to 11 months vaccinated by the vaccination team of the Boussé health district from August 1st, 2003 to June 30th, 2004, and the vaccination team. Variables covered in this study included sociodemographic factors, the organization of vaccination campaigns, the mothers' perception of health service organization, the vaccination team's experience, vaccinal safety, knowledge of vaccination timetable. RESULTS: The following were identified as key factors for the non-observance of the vaccination timetable: poor organization of the vaccination services, inadequate competence of the vaccination team, poor educational level of mothers, poor communication level with mothers, postvaccination side effects. CONCLUSION: The study recommends the following: training of vaccination providers, a better organization of vaccination services, and the implementation of a communication plan.

[A study of the unmet needs for major obstetric interventions: the experience of Burkina Faso]. / Etude des besoins obstétricaux non couverts pour les interventions obstétricales majeures: l'expérience du Burkina Faso.

The fight against maternal mortality requires strategies adapted to every socio-economic and geographic context. To define these strategies, it is essential to have relevant information and to obtain the participation of the various actors involved. One of the indicators which summarizes the maternal mortality level and which it the basis for the mobilization of resources is the maternal mortality ratio. This ratio remains difficult to measure especially in countries with limited resources. Based on the major obstetric interventions for absolute maternal indications, the unmet needs for major obstetric intervention approach is an opportunity for developing countries. We applied this approach in Burkina Faso i) to determine the number of major obstetric interventions for absolute maternal indications carried out in 1998; ii) to quantify the deficit in major obstetric interventions for absolute maternal indications carried out in 1998. In order to do this, we conducted a retrospective study based on files in four sanitary regions. Once the data was collected, we listed 610 major obstetric interventions for absolute maternal indications (IOM/IMA). For the same period, the expected number of IOM/IMA was of 1,470, i.e. a relative global deficit of 58.5%. The analysis per sanitary district revealed disparities with deficits going from 87.5% to 15.5%. The lack of qualified personnel and of surgical infrastructures, the low economic level of the populations and the high cost of the services were identified as factors having favoured these deficits.

[Prevalence of minor psychiatric disorders among women working in the health sector in Ouagadougou, Burkina Faso: results of an evaluation using the GHQ-28]. / Prévalence des troubles psychatriques mineurs chez les femmes travaillant dans le secteur de la santé a Ouagadougou au Burkina Faso: résultats d'une evaluation a l'aide de GHQ-28.

In a developing country like Burkina Faso, where the mental health care relates to only a minority of people affected by the mental disorders, investigations among the general population are very informative. The present study aimed to determine the prevalence of minor psychiatric disorders among the female population in the urban environment of Ouagadougou in Burkina Faso, as well as the sociodemographic factors possibly associated with mental troubles among these women. The study was a descriptive transverse investigation with single passage carried out on 227 women whose mean age was 37.38 +/- 7.50 years old. The French version of the GHQ-28 was used to evaluate minor psychiatric disorders. The prevalence of the the psychiatric disorders within the population was 33.48%. The results of the GHQ-28 showed that social abnormal operations (59.03%), anxiety and insomnia (45.37%) were the disorders most frequently detected. The importance of psychiatric morbidity within the surveyed population suggests complementary studies aiming at specifying the supporting factors among others.

[Preliminary information to patients and presentation by Burkinabe physicians of the results of HIV detection test in Burkina Faso]. / Information préalable des patients et annonce par les médecins burkinabé des résultats des tests sérologiques de dépistage de l'infection à VIH au Burkina Faso.

BACKGROUND: The action of individuals and their family is determining in the result of AIDS control and the knowledge of people's serological situation facilitates their involvement in AIDS control. This study was carried out in order METHODS: A transversal investigation through a self-administered anonymous questionnaire was carried out among the 250 Burkinabe physicians working in a public, private or religious health care sector. The questionnaire was sent by mail, attached to a response coupon. A response of 74% was obtained. RESULTS: Seventy seven physicians, that is 48.7% of the sample, informed patients who were likely to be HIV infected about their intention to ask for an HIV test. Seventy five physicians, that is 47.5% of the sample informed patients on the results of their serological tests on HIV infection. The characteristics of physicians who informed customers on the results of their serological test were similar to those of physicians who informed their patients on the demand for test concerning them. There were often specialists, physicians with long experience in medical practice and physicians more involving in curative consultations than in preventive ones (respectively 54.7% versus 23.3%, p=0.002). CONCLUSIONS: These results show the necessity of providing young physicians with counselling training, especially general practitioners who should be working in prevention services. Moreover, they constitute a basis for an objective discussion between physicians working in hospital, officials in charge of the national program for AIDS control and medical training schools.

Receptors involved in the positive inotropic action induced by dopamine on the ventricle of a 7-day-old chick embryo heart.

Earlier experiments only revealed involvement of sympathetic pre-synaptic dopaminergic receptors in dopamine induced inotropism in myocardium. We therefore used electrically stimulated (1 Hz) isolated 7-day-old chick embryo heart ventricles, thought to be devoid of functional sympathetic nerves, to re-investigate post-synaptic receptors involvement and particularly that of dopaminergic receptors in the positive inotropic effect of dopamine. The results showed that noradrenaline, isoprenaline and dopamine produced a positive inotropic effect with a similar efficacy and with an order of potency as follows: Isoprenaline = Noradrenaline > Dopamine. Tyramine induced no significant modification of the "initial tension" indicating that functional sympathetic innervation and/or releasable endogenous catecholamines were not demonstrable in the 7-day-old chick embryo heart ventricle. Propranolol (1 microM) competitively antagonized the positive inotropic response to isoprenaline, noradrenaline and dopamine, meanwhile phentolamine (3 microM) failed to significantly modify the effects of both noradrenaline and dopamine, indicating that these catecholamines induced their positive inotropic effects via stimulation of beta-adrenoceptors; involvement of alpha-adrenergic receptors stimulation was not demonstrable in these effects. Moreover, haloperidol (2 microM) antagonized the positive inotropic response to dopamine but had not any significant effect on the response to isoprenaline. The combined application of both propranolol and haloperidol antagonized the positive inotropic response to dopamine to a greater extent than when these two antagonists were given alone. Consequently, post-synaptic dopaminergic receptors were also involved in the positive inotropic effect of dopamine. Furthermore, in preparations in which sodium channels were inactivated by high potassium physiological salt solution, high concentrations of dopamine (0.1 mM to 1 mM) induced a slow developing electrical and positive inotropic responses which were also inhibited by propranolol and haloperidol, but not by phentolamine. These latter results indicated that like beta-adrenergic stimulation, the slow inward calcium current activated by stimulation of adenylate cyclase, was at least in part involved in the positive inotropic response to dopamine. In conclusion, dopamine induced its positive inotropism via stimulation of post-synaptic beta-adrenergic and dopaminergic receptors. The contribution of dopaminergic receptors in this positive inotropic effect might be of the DA-2 receptors since haloperidol used had been reported to be more DA-2 than DA-1 antagonist. These DA-2 receptors subtypes would mediate activation of adenylate cyclase.

[Inotropic effect of isoprenaline and noradrenaline on chick embryo heart]. / Effet inotrope de l'isoprénaline et de la noradrénaline sur le coe ur embryonnaire de poulet.

Isolated ventricles of developing chick embryo heart, paced at 1 Hz, were used to assess the positive inotropic responses to isoprenaline and noradrenaline in order to characterize the adrenergic receptors involved in these effects. In 7 day-old-chick embryo heart ventricle, isoprenaline and noradrenaline exhibited similar potencies and efficacies. Moreover, propranolol (1 microM) inhibited the positive inotropic effect of isoprenaline and noradrenaline, while pentholamine (3 microM) failed to affect the latter response; in addition, phenylephrine (1 microM-1 mM) had no positive inotropic effect. It was therefore concluded that isoprenaline and noradrenaline induce their effect via stimulation of beta-adrenergic receptors. The efficacy of isoprenaline and noradrenaline and the potency of isoprenaline increased from the 7th to 10th day while the potency of noradrenaline decreased. The decrease in noradrenaline potency with age was attributed to its uptake, while the increase in isoprenaline potency was attributed to the increase in beta-adrenergic receptors. However, the increase in efficacy of both isoprenaline and noradrenaline with age might be due to the higher density and/or higher maturity of contractile proteins.

Mother-to-child transmission of human immunodeficiency virus type 1 and type 2 and dual infection: a cohort study in Banfora, Burkina Faso.

A prospective cohort study on the mother-to-child transmission of human immunodeficiency virus type 1 (HIV1), type 2 (HIV2) and dual positivity (HIV1 + HIV2) was carried out in Banfora, West Burkina Faso. The study samples consist of 117 newborns of HIV-seropositive women matched to 234 newborns of HIV-seronegative women. Among cases, 91 were born of HIV1-seropositive mothers, 15 were born of HIV2-seropositive mothers and 11 were born of HIV1 and HIV2 dual-seropositive mothers and were included in an 18-month follow-up. Calculation of the mother-to-child transmission rate was according to the recommendations of the European Economic Community working group. The HIV1 mother-to-child transmission rate was estimated to be 27.8% (95% confidence interval (CI) 24.5 to 32.4) with one method and 25.5% (95% CI 13.5 to 37.5) with a second method. For HIV2, this rate was estimated to be 29.5% (95% CI 26.0 to 39.8) and was not statistically different from the HIV1 mother-to-child transmission rate. No case of transmission was observed in children born of dual seropositive mothers. Survival rate at month 18 was significantly lower for children born of HIV1 mothers: 83.7% (95% CI 78.2 to 92.2). Survival rates were similar between children born of HIV2-seropositive (86.7), dual HIV1 + 2-positive (100) and seronegative mothers (92.0%). Findings suggest a higher mother-to-child transmission rate of HIV2 in children born in Burkina Faso than in Europe and a low clinical expression of HIV2 in children.

Choice of traditional or modern treatment in west Burkina Faso.

A recent survey shows that patients turn to modern medicine more than traditional medicine for most of their needs except rheumatic and neurological complaints. However, the preferences stated are influenced on the one hand by the much lower cost of traditional services, and on the other by official disapproval of animistic practices.