[Physicochemical composition of bottled drinking water marketed in Ouagadougou (Burkina Faso)]. / Composition physicochimique des eaux de boisson conditionnées commercialisées à Ouagadougou (Burkina Faso).

The bottled drinking water marketed in urban areas includes natural mineral water, spring water, and treated drinking water. Their physicochemical qualities depend on the type and quantity of their components and define their safe use. Bottled water is widely consumed in Ouagadougou (Burkina Faso), and many brand names exist. Although many publications have examined the microbiological qualities of such water, no study has examined the physicochemical quality of water from Burkina Faso. This study, conducted from March 2005 through January 2006, aimed to assess the physicochemical composition of drinking water sold in Ouagadougou to facilitate better choices and use by consumers. Results showed that all the water analyzed in Ouagadougou is soft (TH < 50 ppm) or moderately soft (50 < TH < 200 ppm) and weakly mineralized (total dissolved solid content < 500 mg/L, sulfates [SO(2-)(4)] < 200 mg/L, [Ca(++)] < 150 mg/L, [Mg(2+)] < 50 mg/L, and [HCO(3)-] < 600 mg/l). Some imported water, however, is hard and highly mineralized. French standards do not set limit values for the natural mineral water parameters described above, and much of the water sold in Ouagadougou was natural mineral water. The spring water met potability standards, except for the Montagne d'Arrée brand, which had a pH value of 5.8, below the WHO standards of 6.5 < pH 8.5.

Methylene blue for malaria in Africa: results from a dose-finding study in combination with chloroquine.

The development of safe, effective and affordable drug combinations against malaria in Africa is a public health priority. Methylene blue (MB) has a similar mode of action as chloroquine (CQ) and has moreover been shown to selectively inhibit the Plasmodium falciparum glutathione reductase. In 2004, an uncontrolled dose-finding study on the combination MB-CQ was performed in 435 young children with uncomplicated falciparum malaria in Burkina Faso (CQ monotherapy had a > 50% clinical failure rate in this area in 2003). Three serious adverse events (SAE) occurred of which one was probably attributable to the study medication. In the per protocol safety analysis, there were no dose specific effects. The overall clinical and parasitological failure rates by day 14 were 10% [95% CI (7.5%, 14.0%)] and 24% [95% CI (19.4%, 28.3%)], respectively. MB appears to have efficacy against malaria, but the combination of CQ-MB is clearly not effective in the treatment of malaria in Africa.

Safety of the methylene blue plus chloroquine combination in the treatment of uncomplicated falciparum malaria in young children of Burkina Faso [ISRCTN27290841].

BACKGROUND: Safe, effective and affordable drug combinations against falciparum malaria are urgently needed for the poor populations in malaria endemic countries. Methylene blue (MB) combined with chloroquine (CQ) has been considered as one promising new regimen. OBJECTIVES: The primary objective of this study was to evaluate the safety of CQ-MB in African children with uncomplicated falciparum malaria. Secondary objectives were to assess the efficacy and the acceptance of CQ-MB in a rural population of West Africa. METHODS: In this hospital-based randomized controlled trial, 226 children (6-59 months) with uncomplicated falciparum malaria were treated in Burkina Faso. The children were 4:1 randomized to CQ-MB (n = 181; 25 mg/kg CQ and 12 mg/kg MB over three days) or CQ (n = 45; 25 mg/kg over three days) respectively. The primary outcome was the incidence of severe haemolysis or other serious adverse events (SAEs). Efficacy outcomes were defined according to the WHO 2003 classification system. Patients were hospitalized for four days and followed up until day 14. RESULTS: No differences in the incidence of SAEs and other adverse events were observed between children treated with CQ-MB (including 24 cases of G6PD deficiency) compared to children treated with CQ. There was no case of severe haemolysis and also no significant difference in mean haemoglobin between study groups. Treatment failure rates were 53.7% (95% CI [37.4%; 69.3%]) in the CQ group compared to 44.0% (95% CI [36.3%; 51.9%]) in the CQ-MB group. CONCLUSION: MB is safe for the treatment of uncomplicated falciparum malaria, even in G6PD deficient African children. However, the efficacy of the CQ-MB combination has not been sufficient at the MB dose used in this study. Future studies need to assess the efficacy of MB at higher doses and in combination with appropriate partner drugs.