ABSTRACT
Reported are the results of a cross-sectional survey in Burkina Faso to identify reliable, practical strategies for the serological diagnosis of HIV-1 and/or HIV-2 infections, using less-expensive commercial test kits in various combinations, as an alternative to the conventional Western blot (WB) test, which costs US$ 60. Serum samples, collected from blood donors, patients with acquired immunodeficiency syndrome (AIDS) and pregnant women, were tested between December 1995 and January 1997. Twelve commercial test kits were available: five Mixt enzyme-linked immunosorbent assays (ELISA), three Mixt rapid tests, and four additional tests including monospecific HIV-1 and HIV-2 ELISA. The reference strategy utilized a combination of one ELISA or one rapid test with WB, and was conducted following WHO criteria. A total of 768 serum samples were tested; 35 were indeterminate and excluded from the analysis. Seroprevalence of HIV in the remaining 733 sera was found to be 37.5% (95% confidence interval: 34.0-41.1). All the ELISA tests showed 100% sensitivity, but their specificities ranged from 81.4% to 100%. GLA (Genelavia Mixt) had the highest positive delta value, while ICE HIV-1.0.2 (ICE) produced the most distinct negative results. Among the rapid tests, COM (CombAIDS-RS) achieved 100% sensitivity and SPO (HIV Spot) 100% specificity. Various combinations of commercial tests, according to recommended WHO strategies I, II, III, gave excellent results when ICE was included in the sequence. The best combination of tests for strategy II, which achieved 100% sensitivity and specificity, was to use ICE and COM, the cost of which was US$ 2.10, compared with US$ 55.60 for the corresponding conventional strategy. For strategy III, the best combination, which achieved 100% sensitivity and specificity, was to use ICE, ZYG (Enzygnost Anti HIV-1/HIV-2 Plus) and COM, the cost of which was US$ 2.90 (19.2 times lower than the corresponding strategy requiring WB). No rapid test combination showed 100% sensitivity and specificity. Our results indicate that the serodiagnosis of HIV in Burkina Faso is possible by using reliable, less-expensive strategies which do not require Western blot testing. Moreover, there is a choice of strategies for laboratories working with or without an ELISA chain.
Subject(s)
AIDS Serodiagnosis/methods , AIDS Serodiagnosis/economics , AIDS Serodiagnosis/instrumentation , Algorithms , Blotting, Western , Burkina Faso , Confidence Intervals , Costs and Cost Analysis , Enzyme-Linked Immunosorbent Assay , Evaluation Studies as Topic , False Negative Reactions , False Positive Reactions , Female , HIV Seroprevalence , Humans , Male , Pregnancy , Pregnancy Complications, Infectious/diagnosis , Reagent Kits, Diagnostic , Reference Values , Sensitivity and Specificity , Statistics as TopicABSTRACT
The aim of this first study was to assess parasitic diseases encountered in histological practice in Burkina Faso. An examination of 3410 pathological specimens showed 138 cases of parasitic diseases which represented 4% of the results observed for 5 years in the laboratory of YALGADO OUEDRAOGO National Hospital. The parasitic diseases diagnosed were in decreasing order Schistosomiasis 53.6%, Cysticercosis 13.1%, Mycetoma 12.3%, Cutaneous Leishmaniasis 8%, Amebiasis 6.6%, Filariasis 4.3%, and Histoplasmosis 2.1%. We recommend better data collection for integration of these diseases into the health policy of Burkina.
Subject(s)
Parasitic Diseases/epidemiology , Parasitic Diseases/pathology , Adolescent , Adult , Amebiasis/diagnosis , Child , Cysticercosis/diagnosis , Female , Filariasis/diagnosis , Histoplasmosis/diagnosis , Humans , Leishmaniasis, Cutaneous/diagnosis , Male , Mycetoma/diagnosis , Parasitic Diseases/diagnosis , Schistosomiasis/diagnosisABSTRACT
Little information is available regarding human immunodeficiency virus (HIV) infection among female sex workers (FSW) in Burkina Faso, West Africa. A cross-sectional study was conducted in Ouagadougou and Bobo-Dioulasso, the 2 largest cities of the country, to determine the prevalence of HIV infection and other sexually transmitted diseases (STDs) among FSWs, and to investigate the factors which were associated with HIV infection in this population. From October to November 1994, 426 FSWs were recruited. The method of anonymous and unlinked HIV screening recommended by the World Health Organization (WHO) was used. The overall HIV seroprevalence was 58.2% (95% confidence interval: 53.4-62.9) and 52.6% of FSWs had at least one STD agent. The most common STDs were trichomoniasis (23%), syphilis (15%) and gonorrhoea (13%). In a logistic regression analysis, risk factors for HIV infection were high gravidity (> or = 2 pregnancies), low perception of personal risk of HIV infection, syphilis and the presence of genital warts. These results suggest that FSWs in Burkina Faso need better information about HIV transmission and prevention and then need better access to STD detection and management services.
Subject(s)
HIV Infections/epidemiology , Sex Work , Adult , Burkina Faso/epidemiology , Cross-Sectional Studies , Female , Humans , Prevalence , Risk FactorsABSTRACT
BACKGROUND: It is important for HIV/AIDS control programmes to determine population knowledge on AIDS in order to develop appropriate Information, Education and Communication (IEC) messages. The objectives of our study were to determine the seroprevalence of HIV and syphilis among pregnant women, female prostitutes and long-distance truck drivers and to evaluate knowledge, attitudes, beliefs, and practice (KABP) with respect to the HIV/AIDS epidemic in these three groups in Burkina Faso. METHODS: We performed three cross-sectional serosurveys including face-to-face interviews on KABP between October 1994 and February 1995 in three population groups. RESULTS: Overall, 1,294 pregnant women, 236 long-distance truck drivers and 426 female prostitutes were recruited. HIV seroprevalence was 8% (95% Confidence Interval (CI): 6.6-9.6) among pregnant women, 18.6% (95% CI: 13.9-24.2) among long-distance truck drivers and 58.2% (95% CI: 53.4-62.9) in female prostitutes. The prevalence of syphilis was 2.5%, 9.3% and 15%, respectively. Most pregnant women (98%), long-distance truck drivers (96%) and female prostitutes (98%) had already heard of AIDS. However, the level of knowledge of HIV transmission routes, of risk factors for HIV transmission and of available preventive measures was very low. Consequently, 41% of pregnant women, 40% of long-distance truck drivers and an alarming 61% of female prostitutes reported that they did not feel themselves at risk for HIV. In each group, high levels of knowledge on AIDS were associated with increased awareness of AIDS risk and the adoption of preventive behaviours. Level of education was associated with knowledge of AIDS and condom use. However, in the 12 months preceding the surveys, condom use was very low among pregnant women (0.1%), long-distance truck drivers (18%) and among female prostitutes (42%). CONCLUSIONS: These results indicate that HIV is widespread in Burkina Faso and that there is an urgent need to develop and evaluate HIV prevention strategies in the general population and among core groups such as female prostitutes and long-distance truck drivers. Interventions must include information campaigns, condom promotion and distribution, and sexually transmitted diseases control.
Subject(s)
Acquired Immunodeficiency Syndrome , Disease Outbreaks , HIV Infections/epidemiology , Health Knowledge, Attitudes, Practice , Acquired Immunodeficiency Syndrome/epidemiology , Acquired Immunodeficiency Syndrome/prevention & control , Acquired Immunodeficiency Syndrome/transmission , Adult , Burkina Faso/epidemiology , Condoms , Confidence Intervals , Cross-Sectional Studies , Educational Status , Female , HIV Infections/prevention & control , HIV Infections/transmission , HIV Seroprevalence , Health Behavior , Health Education , Health Promotion , Humans , Interviews as Topic , Male , Pregnancy , Pregnancy Complications, Infectious/epidemiology , Risk Factors , Sex Work , Sexually Transmitted Diseases/prevention & control , Syphilis/epidemiology , TransportationABSTRACT
OBJECTIVES: (1) To determine the prevalence of sexually transmitted diseases (STDs) in pregnant women in Burkina Faso. (2) To evaluate the potential of clinical management of STDs based on screening with clinical data and urine leucocyte esterase test (LET). METHODS: Cross sectional study among antenatal clinic attendees was conducted in 1994 in Ouagadougou and Bobo-Dioulasso, the two largest urban centres in Burkina Faso, where more than 94% of the pregnant women benefit from antenatal care at least twice during their pregnancy. Each woman selected underwent an interview, general and gynaecological examination. Genital samples were collected to confirm the presence of STD pathogens. Logistic regression analysis was done to identify models that predict (a) gonorrhoea and/or chlamydia, (b) trichomoniasis and/or bacterial vaginosis, (c) candidiasis. Sensitivity, specificity and positive and negative predictive values of these models were assessed using standard methods. RESULTS: All 645 consecutive pregnant women were enrolled in the two sites. Among these women 32.4% presented at least one STD. The major STDs were: trichomoniasis (14%), bacterial vaginosis (13%), recent syphilis (3.6%), chlamydial infection (3.1%), genital warts (3%), gonococcal infection (1.6%) and genital ulcer (0.8%). Prevalence of vaginal candidiasis was 14%. The use of a risk marker (length of relationship with regular sexual partner < 3 years), and the positivity +3 of the urine LET provided a sensitivity of 80% and a positive predictive value of 7% for the screening of gonococcal and/or chlamydial infection. If clinical signs and positivity of the urine LET were taken into account sensitivity and positive predictive value of trichomoniasis and/or bacterial vaginosis screening were 77% and 37%, respectively. Clinical signs and positivity of the urine LET showed a low sensitivity (23%) for screening vaginal candidiasis. CONCLUSIONS: The prevalence of STDs in pregnant women is high in urban Burkina Faso. Systematic screening combined with effective treatment should be included in antenatal care in the future. Urine LET, if associated with interview and clinical examination offers a simple, rapid and affordable tool for systematic screening of STDs in pregnant women. However, the proportion of overtreatments with proposed strategies will be high. Further studies are needed to develop and validate better algorithms with probably cheap laboratory tests.
Subject(s)
Genital Diseases, Female/epidemiology , Pregnancy Complications, Infectious/epidemiology , Sexually Transmitted Diseases/epidemiology , Adolescent , Adult , Burkina Faso/epidemiology , Cross-Sectional Studies , Esterases/urine , Female , Humans , Leukocytes/enzymology , Logistic Models , Models, Biological , Multivariate Analysis , Predictive Value of Tests , Pregnancy , Prevalence , Sensitivity and Specificity , Urban Health/statistics & numerical dataABSTRACT
A partir du depistage systematique aux ELISA 1;2 et mixte chez les malades d'orthopedie presentant une affection opportuniste; les auteurs rapportent 33 cas de seropositifs sur 2185 malades hospitalise du 1er janvier 1989 au 23 fevrier 1995. Seuls 16 avaient un dossier complet et un suivi regulier. L'etude des 16 dossiers a permis de retrouver des resultats epidemiologiques corroborant avec ceux de la litterature; a savoir : une atteinte plus frequente des hommes (sex ratio = 4;3); de la population citadine (75 pour cent des cas); l'age moyen de seroprevalence = 35;6 ans avec des pics entre 10 -19 ans et 30-39 ans; par contre; ils trouvent une atteinte plus elevee chez les personnes sans emploi. Parmi les pathologies osteo-articulaires repertoriees; ils retrouvent une association frequente des infections osteo-articulaires (osteo-arthrite de la hanche; mal de pott; osteomyelite chronique a infection VIH : de ce constat ils proposent la systematisation de la serologie VIH devant toutes ces infections osseuses. Ils considerent comme facteurs de risques le nombre eleve de seropositifs (33/2185 cas =0;15) par rapport aux donnees de la litterature; la manipulation de ces seropositfs par une equipe soignante travaillant dans une ambiance et un contexte favorable a la contamination par le VIH. Ils suggerent des recommandations dont l'application permettrait de minimiser ces risques
Subject(s)
Bone Diseases , HIV Infections/epidemiologyABSTRACT
De janvier a mai 1995; les auteurs ont observe; comme chaque annee a la poussee de meningite qui s'est traduite par une augmentation sensible du nombre des hospitalisation au service des maladies infectieuses et en pediatrie. Au total 856 liquides cephalo-rachidiens ont ete soumis a un examen bacteriologique et cytologique. Cent trente-six (136) germes ont ete observes a l'examen microscopique direct; 93 souches bacteriennes isolees ont permis la realisation de 93 antibiogrammes. Des taux de sensibilite tres variables ont ete notes par rapport a l'Ampicilline; l'association Amoxicilline-acide clavulanique; au Chloramphenicol et au Sulfamethoxazoltrimethoprime. Les enfants de moins de 15 ans et les patients du sexe masculin ont ete les plus touches
Subject(s)
MeningitisABSTRACT
Dans cette etude; les auteurs rapportent deux cas traites et gueris de meningite cerebro-spinale due au serotype Y de Neisseria meningitidis dans une region ou les methodes de diagnostic ne permettent de detecter que les antigenes A et C du meningocoque. Ils soulevent ainsi un probleme assez frequemment vecu dans les laboratoires africains qui n'arrivent pas souvent a faire une identification complete des souches becteriennes isolees. Ils soulevent egalement le probleme de vaccination qui est un probleme de sante publique dans la mesure ou les vaccins actuellement disponibles en Afrique ne protegent que contre les serotypes A et C de Neisseria meningitidis
Subject(s)
Meningitis , Meningitis/epidemiologyABSTRACT
"Les auteurs rapportent des aspects epidemiologiques relatifs a 24 cas de meningites a Salmonella diagnostiques entre 1984 et 1993 au laboratoire de Bacteriologie du Centre Hospitalier National Yalgado Ouedraogo (CHN-YO) de Ouagadougou. 13 des 24 cas sont survenus chez des enfants de moins de 12 mois et 18/24 chez des enfants de moins de 3 ans; 14 des 24 patients etaient du sexe masculin. Salmonella typhi a ete le serotype le plus frequement en cause. Une etude de la sensibilite des souches a ete faite en faisant les disques d'Ampicilline (AMP); d'Amoxicilline + acide clavulanique (AMC); de cefotaxime (CTX); de Gentamicine (GEN); de Chloramphenicol (C) et de Sulfamethoxazol-trimethoprime (SXT); mais les differences de sensibilite aux antibiotiques n'etaient pas significatives du fait des petits nombres de souches testees. 10 cas de guerison ont ete observes contre 8 cas de deces et 6 ""evasions"""
Subject(s)
Meningitis , Salmonella InfectionsABSTRACT
"Entre janvier 1984 et decembre 1993; 12.843 hemocultures ont ete analysees au laboratoire de Bacteriologie du Centre Hospitalier National Yalgado Ouedraogo (CHN-YO) de Ouagadougou; au Burkina Faso: parmi les 2.211 (17;2 pour cent) hemocultures positives observees; 1.540 (12;0 pour cent) etaient observees dues a des Salmonella; soit 69;6 pour cent des cultures positives. Le serotype Typhi representait 69;7 pour cent des isolats; les salmonelles paratyphiques 10;8 pour cent et les salmonelles dites ""mineures"" 19;5 pour cent. La repartition mensuelle des cas a montre une recrudescence des salmonelloses pendant l'hivernage; de juin a octobre. L'etude de la sensibilite des souches aux antibiotiques in vitro a permis d'observer un important taux de resistance au Cotrimoxazol (47;1 pour cent) et des sensibilites moyennes aux Cyclines (73;8 pour cent); a l'Ampicilline (79;5 pour cent) et a l'Amoxicilline (85;8 pour cent). Les plus importants taux de sensibilite ont ete obtenus avec les Cephalosporines de troisieme generation (93;1 pour cent); le Chloramphenicol (95;7 pour cent) et les Fluoroquinolones (100 pour cent)"
Subject(s)
Salmonella Infections , SepsisABSTRACT
Cette etude vise a determiner l'importance des co-infections VIH/HTLV dans une zone d'endemie des infections par le VIH au Burkina Faso; et evaluer le diagnostic specifique de chaque type retroviral implique dans ces infections grace a des proteines recombinantes d'enveloppe de VIH-1; de VIH-2; de HTLV-1 et de HTLV-2. Pour y parvenir 419 serums ont ete collectes a Bobo-Dioulasso et a Banfora de juin 1990 a juillet 1991; chez 25 (6 pour cent) patients souffrant de maladies sexuellement transmissibles (MST); chez 58 (13;8 pour cent) patients atteints de SIDA et de syndromes apparentes; chez 126 (30;1 pour cent) femmes enceintes et 44 (10;5 pour cent) de leurs epoux et chez 166 (39;6 pour cent) autres sujets temoins. 88 des 419 (21 pour cent) sujets examines etaient infectes par des retrovirus. Les auteurs concluent que les retrovirus sont presents au Burkina Faso; avec une importante prevalence pour les VIH et un taux relativement encore faible pour le HTLV-1. Le HTLV-2 semble absent. Les cas de co-infections VIH/HTL (0;5 pour cent) sont encore rares; alors qu'ils sont importants pour les doubles profils VIH-1/VIH-2 (4;3 pour cent). Les proteines recombinantes etudiees se sont montrees tres efficaces et ont permis d'etablir le diagnostic specifique de types des infections retrovirales associees aux VIH et au HTLV-1