Genetic Diversity and Population Structure of Local Chicken Ecotypes in Burkina Faso Using Microsatellite Markers.

The objective of this study was to investigate the genetic diversity and population structure of local chicken ecotypes from Burkina Faso using microsatellite markers. A total of 71 individuals representing local chicken populations from the Centre-East (18), Centre-North (17), Sahel (18) and South-West (18) were used to estimate genetic diversity indices, population structure and phylogenetic relationships using 20 selected polymorphic microsatellite markers. The number of alleles, mean number of alleles, mean of observed and expected heterozygosity and polymorphic information content were 127, 6.35, 0.391, 0.521, 0.539 and 0.541, respectively. The estimated overall fixation index between loci (F), among populations (FIS) and inbreeding coefficient within chicken ecotypes were 0.239, 0.267 and 0.243, respectively. Analysis of the molecular variance revealed that 77% of the total genetic diversity was attributed to within-population variation and the remaining 1% and 22% were attributed to among-regions differentiation (FST) and among-individual differentiation (FIT), respectively. The highest pairwise genetic distance (0.026) was found between the local Konde ecotype and those from the Centre-North region while the lowest distance was observed between local chickens from the Sahel and the Centre-North regions (0.003). Neighbour-joining phylogenetic tree and principal component discriminant analyses confirmed the observed genetic distances between populations. The results show that local chickens in Burkina Faso have a rich genetic diversity with little differentiation between the studied populations. This study provides important information on measures of genetic diversity that could help in the design and implementation of future genetic improvement and conservation programs for local chickens in Burkina Faso.

User fees and access to ARV treatment for persons living with HIV/AIDS: implementation and challenges in Burkina Faso, a limited-resource country.

Access to antiretroviral (ARV) treatment remains a crucial problem for patients living with HIV/AIDS (PLWHA) in limited-resources countries. Some African countries have adopted the principle of providing ARV free of charge, but Burkina Faso opted for a direct out-of-pocket payment at the point of care delivery, with subsidized payments and mechanisms for the poorest populations to receive these services free of charge. Our objectives were to determine the proportion of PLWHA who pay for ARV and to identify the factors associated with ARV access in Burkina Faso. A cross-sectional study was performed in 13 public health facilities, 10 Nongovernmental Organizations and association health facilities, and three faith-based health facilities. In each facility, 20 outpatients receiving ARV were interviewed during a routine clinic visit. A multivariate analysis by logistic regression was performed. Among the expected 520 patients receiving ARV, 499 (96.0%) were surveyed. The majority of patients (79%) did not pay for their ARV treatment, thereby limiting cost recovery from patient payments. In a multivariate analysis, level of education and income were associated with free access to ARV. Patients with no education more frequently received free ARV than those who had received some level of education (OR 2.7, 95% CI [1.3-5.6]). Patients without any income or with less than US$10 per month were more likely to receive free ARV (OR 2.6 [95% CI 1.3-5.2]) than those who earned more than US$10 per month. However, 16% of patients without any income and 21% of those without employment paid for ARV, and the costs of drugs for opportunistic infections, food, and transport remained a burden for 85%, 91%, and 74%, respectively, of those who did not pay for ARV. Free access to a minimum care package for every PLWHA would enhance access to ARV.

Effect of dietary calcium intake on weight gain in type 2 diabetic patients following initiation of insulin therapy.

OBJECTIVES: This pilot study analyses weight gain in type 2 diabetic patients at initiation of insulin therapy, according to daily calcium intake. METHODS: Type 2 diabetic patients consecutively admitted for initiation of insulin therapy were studied between January and March 2004 in a monocenter study. Dietary intake was assessed by a 7-day food history before insulin treatment (initial visit) and 4 to 6 months later (final visit). RESULTS: Thirty-one patients were studied (18 males and 13 females; mean age 62+/-9 years, with diabetes duration 14+/-10 years). Weight significantly increased between initial and final visits (81.9+/-16.2 vs. 84.8+/-17.8 kg; P=0.0272). Median weight gain was 2.4 kg (IQR: -1.15 to +5.27 kg). Waist circumference increased by 2 cm (IQR: 0 to +4 cm). There was no difference between weight change and tertile of calcium intake adjusted on energy intake. We did not find any correlation between weight change and total calcium intake (Rho=0.186; P=0.3165) or dairy calcium intake (Rho=0191; P=0.3040). Similarly, we did not find any correlation between waist circumference change and total calcium intake (Rho=0.324; P=0.1205) or dairy calcium intake (Rho=0.285; P=0.0755). CONCLUSION: We found no relation between total or dairy calcium intake and weight change during initiation of insulin therapy in type 2 diabetic patients. Dietary calcium intake does probably not play a major role on insulin-induced body weight gain.

Tuberculosis and human immunodeficiency virus infection in west Burkina Faso: clinical presentation and clinical evolution.

OBJECTIVE: To study the relationship between human immunodeficiency virus (HIV) infection and tuberculosis (TB) in a West African country. DESIGN: A cohort study in TB patients at the TB centre of Bobo Dioulasso, Burkina Faso. RESULTS: HIV seroprevalence rose from 12.5% in 1987 to 24.7% in 1990. Analysis of clinical findings showed that extra-pulmonary TB was not more frequent in HIV-positive patients (18.5%) than in HIV negative patients (17.3%). Four symptoms were independently associated with HIV infection: diarrhoea, lymphadenopathy, weight loss and oral candidiasis. At the end of six months of chemotherapy for TB (2SHRZ/4HR), the mortality rate among HIV-positive TB patients was 27%, versus 10% among HIV-negative TB patients (P < 0.001). There was no difference between treatment failure rates among HIV-positive patients (3.8%) and HIV-negative patients (3.9%). At the final evaluation, 18 months after the start of chemotherapy, the relapse rate was 8% in HIV-positive patients versus 5.6% in HIV-negative patients (NS). Global mortality rate during the whole study period was significantly higher in HIV-1 (40.3%) and HIV-1 + 2 (20%) patients than in HIV-2 (11.1%) and HIV-negative (12.9%) patients. CONCLUSION: We conclude that, according to previous African studies, despite a higher mortality rate due generally to HIV disease itself, short-course chemotherapy of 6 months is as effective in HIV-positive patients as in HIV-negative patients, and must be continued.

Impact of short-course therapy on tuberculosis drug resistance in South-West Burkina Faso.

SETTING: The Regional Tuberculosis Centre and the Muraz Centre in Bobo-Dioulasso, Burkina Faso. OBJECTIVES: To observe the trend of primary drug resistance in pulmonary tuberculosis patients 5 years into a short-course treatment programme and to assess the possible implementation of a further programme. DESIGN: Bacteriological study of stains isolated from all newly diagnosed tuberculosis patients (n = 300), all relapse cases (n = 20) and all failure cases (n = 58) from the Houet province, during the period from April 1992 to April 1994. Human immunodeficiency virus (HIV) serostatus was determined for the first 119 patients included in the study. RESULTS: Mycobacterium tuberculosis was the predominant species as shown by 75.1% of the isolates; next was M. africanum, then atypical mycobacteria and finally M. bovis, representing 18.4%, 6.5% and 0.4% of the isolates respectively. Primary resistance (excluding atypical strains) was as follows: isoniazid 7.6%, ethambutol 1.0%, rifampicin 2.5%, and streptomycin 12.4%; 33.6% of the patients tested for HIV were HIV positive. There was no relationship between HIV serostatus and the identity of strains or drug resistance. However, negative acid-fast bacilli smear microscopy with positive culture was significantly more frequent in HIV-positive patients than in HIV-negative patients. CONCLUSION: This study shows a drop in primary resistance compared with previous studies carried out in Bobo-Dioulasso under the same conditions (setting, materials and methods, sampling procedures) in 1982 and 1986. This is consistent with the hypothesis that treatment monitoring and the introduction of short-course therapy in 1989 (2 HERZ/4 HR or 2 HRSZ/4 HR) have contributed to lower rates of primary drug resistance.

A study of Toxoplasma and Cytomegalovirus serology in tuberculosis and in HIV-infected patients in Burkina Faso.

Seroreactivity to Toxoplasma gondii (Tg) and to Cytomegalovirus (Cmv) was compared between symptomatic HIV-infected patients (40 with pulmonary tuberculosis and 38 with AIDS) and HIV-seronegative patients (40 tuberculosis patients and 30 healthy patients), in an urban area of Burkina Faso. Prevalence of IgG antibodies to Tg antigens (> 50.0%) did not differ amongst the four groups, but tuberculosis HIV+ patients and AIDS patients showed more higher titers of Tg antibodies more often than healthy patients (p < 0.05 and p < 0.005, respectively). Prevalence of specific IgG to Cmv was higher in tuberculosis HIV-seronegative patients (97.5%) and in AIDS patients (100%) than in healthy patients (82%; p < 0.03 and p < 0.001, respectively). Higher Cmv antibodies titers were found in relation to AIDS but also to tuberculosis. Tuberculosis HIV+ as tuberculosis HIV-patients showed higher Cmv antibodies titers than healthy patients (p < 0.002 and < 0.02 respectively). These data emphasize the need for taking into account the risk of Tg reactivation during the follow-up of HIV infected patients in Burkina Faso and suggest possible relationships between Cmv and tuberculosis reactivations.

Marqueurs biologiques d'immunopression chez les malades tuberculeux seropositifs

La double infection du VIH et de la tuberculose en Afrique de l'Ouest connait aujourd'hui une augmentation considerable. Ainsi une etude a ete menee en vue d'evaluer le degre d'atteinte immunitaire des patients seropositifs lors du diagnostic de la tuberculose ; d'ameliorer la definition du SIDA chez les patients et de proposer les marqueurs alternatifs aux marqueurs classiques d'immunodepression. Lors du diagnostic de la tuberculose seuls 33 pour cent des patients presentaient biologiquement du SIDA