[Lymphatic Filariasis Transmission Assessment Survey in Burkina Faso in Connection with 4 Districts]. / Évaluation de la Transmission de la Filariose Lymphatique au Burkina Faso: À Propos de 4 Districts Sanitaires.

Objective: In this impact survey on the preventive chemotherapy against lymphatic filariasis, the national neglected tropical diseases programme team conducted a Transmission Assessment Survey in the health districts of Leo, Sapouy, Boromo and Dedougou. The purpose of this study was to assess lymphatic filariasis transmission in these four districts (included in two evaluation units (EU): Boucle du Mouhoun 3 and Centre-Ouest 2 after more than ten to thirteen years of mass drug treatment. Methodology: The study was a cross sectional survey which targeted the school aged children based on the cluster survey method conducted at community level. Results: Among the 1649 school aged children covered by the survey in the Centre Ouest EU, four were found positive at the Filariasis Test Strip (FTS), i.e. the proportion of children with circulating filarial antigens (i.e. with live adult stages of W. bancrofti ) was 0.24%. In the BMH3 EU, none of the 1716 children tested was FTS-positive. Conclusion: From the findings, we can infer that filariasis transmission has been interrupted in these districts and that mass treatment with albendazole and ivermectin can be stopped.

Evaluation of the effect of mass drug administration against lymphatic filariasis in three health districts and public health implications: study of 12 epidemiological surveillance sites in Burkina Faso.

The implementation of mass drug administration (MDA) campaigns of albendazole (400 mg) and ivermectin (150-200 µm/kg) since 2001 has helped to change the epidemiological profile of lymphatic filariasis (LF) in many health districts in Burkina Faso. From 2002 to 2016, 14 rounds of MDA have taken place in the Central East zone, with therapeutic coverage exceeding 65%. The objective of the current study was to evaluate the impact of MDA in the fight against LF at 12 sentinel and spot-check sites. This descriptive cross-sectional study surveyed subjects aged 5 years and older between April and July 2017 at these 12 sites. The blood smear performed on nocturnal samples was used to diagnose Wuchereria bancrofti infection. The study included 4364 subjects. Their mean age was 20.55 years with a standard deviation of 14.22 and a range of 5 to 96 years. The overall prevalence of microfilaremia was 0.62% (27/4364), with rates exceeding 1% at three (3) sites. The average microfilaremia density was 106 µf/mL. The overall prevalence of morbidity was low (0.91%), predominantly lymphedema (0.60%). The MDA strategy has helped to reduce the prevalence of LF significantly in Burkina Faso, but some outbreaks still have microfilarial prevalence greater than 1%. Continuation of the additional 2-year strategy with improved adherence to treatment and vector control would help break LF transmission.

[Onchocerciasis in Burkina Faso: a Re-Emerging Vector-Borne Endemic Disease]. / Onchocercose au Burkina Faso : une endémie à transmission vectorielle en voie de réémergence.

Burkina Faso, like other countries, reported a focal interruption of onchocerciasis transmission and was thus placed under post-therapeutic surveillance. However, the country seems to be experiencing a resurgence of the disease according to recent surveys at certain sentinel sites and data from various surveys. The aim of our study is to take stock of the evolution of the current epidemiological situation of onchocerciasis in Burkina Faso. For data collection, in addition to the scientific articles, we have used data from different epidemiological and entomological surveys conducted by the National Program for the Control of Neglected Tropical Diseases (PNLMTN) through its onchocerciasis elimination unit in Burkina Faso. Prior to implementation of the Onchocerciasis Control Program in West Africa (OCP), Burkina Faso had onchocerciasis prevalence between 60% and 80%. In 2002, the maximum prevalence dropped to 15%. However, in 2010 and 2011, epidemiological surveys indicated that some villages in the Comoé River basin had prevalence rate ranging from 0.7% to 71%. Thirteen (13) villages had prevalence rates above the tolerable threshold of 5%. Despite the implementation of the community-directed treatment with ivermectin (CDTI) since 2011, recent surveys show a tendency for a recrudescence of the disease in some sites, yet covered by the TIDC. This suggests that the elimination of onchocerciasis requires the integration of new control strategies. Thus, an essential condition for the elimination of onchocerciasis is the analysis of the situation in each focus in order to define the most cost-effective strategy for permanently interrupting the transmission of the parasite. National onchocerciasis elimination committees put in place will play a key role in determining the best strategy.

Le Burkina Faso, comme d'autres pays, avait signalé une interruption focale de la transmission de l'onchocercose et était ainsi placé sous surveillance post-thérapeutique. Cependant, le pays semble connaître une résurgence de la maladie selon les récentes enquêtes au niveau de certains sites sentinelles et les données de diverses enquêtes. Le but de notre étude est de faire le point sur l'évolution de la situation épidémiologique actuelle de l'onchocercose au Burkina Faso. Pour la collecte des données, nous nous sommes servis, en plus des articles scientifiques, des données des différentes enquêtes épidémiologiques et entomologiques menées par le Programme national de lutte contre les maladies tropicales négligées (PNLMTN) au travers de son unité d'élimination de l'onchocercose au Burkina Faso. Avant la mise en oeuvre du Programme de lutte contre l'onchocercose en Afrique de l'Ouest (Onchocerciasis Control Programme in West Africa), le Burkina Faso enregistrait des prévalences de l'onchocercose comprises entre 60 et 80 %. En 2002, la prévalence maximale a chuté à 15 %. Cependant, en 2010 et 2011, des enquêtes épidémiologiques indiquent que certains villages du bassin de la Comoé avaient des prévalences allant de 0,7 à 71 %. Treize villages avaient des prévalences supérieures au seuil tolérable de 5 %.Malgré la mise en place du traitement à l'ivermectine sous directives communautaires (TIDC) depuis 2011, les récentes enquêtes montrent une tendance à la recrudescence de la maladie dans certains sites, pourtant couverts par le TIDC. Cela suggère que l'élimination de l'onchocercose nécessite l'intégration de nouvelles stratégies de lutte. Ainsi, une condition essentielle pour l'élimination de l'onchocercose est l'analyse de la situation dans chaque foyer afin de définir la stratégie la plus rentable pour interrompre de manière permanente la transmission du parasite. Les comités nationaux d'élimination de l'onchocercose mis en place joueront un rôle clé dans la détermination de la meilleure stratégie.

Primary healthcare providers' practices related to non-malarial acute febrile illness in Burkina Faso.

Background: In Africa, fever is the main reason for consultation, with malaria playing a prominent role. Studies have reported that the widespread use of rapid diagnostic tests for malaria, implemented since 2010, has revealed an increasing proportion of non-malaria acute febrile illnesses (NMAFI). It is an important public health issue because evidence shows that mortality is higher among patients presenting with non-malarial fever than among those with malaria. Methods: This cross-sectional study assessed the professional practices of healthcare providers in the management of NMAFI in urban and rural sites in Burkina Faso. Data was collected from 286 healthcare providers through a questionnaire based on the clinical situation in 2014. Factors have been associated using a hierarchical linear mixed model with random intercepts to model dependence of outcomes for healthcare providers working on the same site. Results: Survey results showed limited knowledge about management of NMAFI, global survey score on General Practice Indicator being 60% (36.02/60.00). This gap was more evident at the admission and diagnosis level. The study's population from rural areas had better survey score than that of urban areas concerning the respect of adequacy diagnosis, treatment and use of antibiotics in NMAFI, 15.71 vs 13.93 mean score (p=0.01) (75 vs 66% on a 0 to 100% scale, with 100% being the best). Overall, more educated participants performed relatively better. A total of 46% (134/286) of participants felt that they needed training in at least one of the fever-related issues. Conclusions: Increased awareness and knowledge of management for NMAFI are urgently required in Burkina Faso. This must be done through regular supervision and training courses targeted specifically at primary healthcare providers.

[Assessment of knowledge and pain management by traumatological emergencies staff of the teaching hospital of Ouagadougou]. / Evaluation des connaissances et pratiques du personnel des urgences traumatologiques de Ouagadougou sur la prise en charge de la douleur.

INTRODUCTION: Pain is a frequent reason of consultation in traumatological emergencies. Its management is characterized by oligoanalgesia whose causes are multiple. The purpose of this study is to assess the knowledge and practices of pain management by traumatological emergencies staff of the teaching hospital Yalgado Ouedraogo of Ouagadougou. MATERIALS AND METHODS: A questionnaire survey of health workers performing in traumatological emergencies has been conducted. Two different questionnaires, one for medical staff and one for the paramedics were administered. RESULTS: A total of 67 health workers participated in the study with a participation rate of 98% and 100%, respectively, for the medical and paramedical staff. According to their report, 65.3% of medical and 77.7% of paramedical staff had never received training on pain and its management. For 85.7% of physicians, pain should be assessed before treatment, but 79.6% of them didn't know any conventional pain assessment method. All the nurses and 40.8% of physicians felt that pain in the emergency services should not be treated immediately to prevent misdiagnosis. Morphine and regional anesthesia were not used for pain treatment in the emergency room. 10.2% of medical staff and 27.8% of the paramedics said that they systematically search for the analgesicsside effects. CONCLUSION: The knowledge of health workers about pain and its management is insufficient. The lack of training of health workers on the management of pain is the cause and contributes to explain the oligoanalgesia in this service.

INTRODUCTION: La douleur est un motif fréquent de consultation aux urgences traumatologiques. Sa prise en charge est caractérisée par une oligoanalgésie dont les causes sont multiples. Le but de cette étude est d'évaluer les connaissances et pratiques du personnel des urgences traumatologiques du Centre hospitalier universitaire Yalgado Ouédraogo de Ouagadougou sur la prise en charge de la douleur. MATÉRIEL ET MÉTHODE: Une enquête par questionnaire auprès du personnel de santé exerçant aux urgences traumatologiques a été menée. Deux questionnaires différents, l'un pour le personnel médical et l'autre pour le personnel paramédical ont été administrés. RÉSULTATS: Au total, 67 agents de santé ont participé à l'étude avec un taux de participation de 98% et 100% respectivement pour le personnel médical et paramédical. Selon leur déclaration, 65,3% du personnel médical et 77,7% du personnel paramédicaux n'avaient jamais bénéficié de formation sur la douleur et sa prise en charge. Pour 85,7% des médecins, la douleur devrait être évaluée avant traitement mais 79,6% d'entre eux ne connaissaient aucune méthode conventionnelle d'évaluation de la douleur. L'ensemble des infirmiers et 40,8% des médecins estimaient que la douleur aux urgences ne devrait pas être traitée d'emblée afin d'éviter des erreurs diagnostiques. La morphine et l'anesthésie locorégionale n'étaient pas utilisées aux urgences pour traiter la douleur. 10,2% du personnel médical et 27,8% du personnel paramédical ont affirmé rechercher systématiquement les effets secondaires des antalgiques. CONCLUSION: Les connaissances des agents de santé sur la douleur et sa prise en charge sont insuffisantes. L'absence de formation du personnel de santé en algologie en est la cause et contribue à expliquer l'oligoanalgésie observée dans ce service.