This study was undertaken to identify and functionally characterize virulence genes from Salmonella isolates in street food and stool cultures. From February 2017 to May 2018, clinical and food ...Salmonella strains were isolated in three regions in Burkina Faso. Salmonella was serotyped according to the White-Kauffmann-Le Minor method, and polymerase chain reaction (PCR) was used to detec invA, spvR, spvC, fimA and stn virulence genes commonly associated with salmonellosis in Sub-Saharan Africa.
A total of 106 Salmonella isolates (77 human stools; 14 sandwiches) was analyzed using a serological identification with an O-group test reagent. The presence of Salmonella was confirmed in 86% (91/106) of the samples were reactive (OMA-positive/OMB-positive). Salmonella serogroup O:4,5 was the most common serogroup detected (40%; 36/91). Salmonella Enteritidis and Typhimurium represented 5.5% (5/91) and 3.3% (3/91), respectively and were identified only from clinical isolates. Furthermore, 14 serotypes of Salmonella (12/91 human strains and 2/15 sandwich strains) were evocative of Kentucky/Bargny serotype. For the genetic profile, 66% (70/106) of the Salmonella had invA and stn genes; 77.4% (82/106) had the fimA gene. The spvR gene was found in 36.8% (39/106) of the isolates while 48.1% (51/106) had the spvC gene. Among the identified Salmonella Enteritidis and Salmonella Typhimurium isolated from stools, the virulence genes detected were invA (3/5) versus (2/3), fimA (4/5) versus (3/3), stn (3/5) versus (2/3), spvR (4/5) versus (2/3) and spvC (3/5) versus (2/3), respectively.
This study reports the prevalence of Salmonella serotypes and virulence genes in clinical isolates and in street foods. It shows that food could be a significant source of Salmonella transmission to humans. Our results could help decision-making by the Burkina Faso health authority in the fight against street food-related diseases, in particular by training restaurateurs in food hygiene.
Malaria control remains a challenge in many parts of the Sahel and sub-Sahel regions of Africa.
We conducted an individually randomized, controlled trial to assess whether seasonal vaccination with ...RTS,S/AS01
was noninferior to chemoprevention in preventing uncomplicated malaria and whether the two interventions combined were superior to either one alone in preventing uncomplicated malaria and severe malaria-related outcomes.
We randomly assigned 6861 children 5 to 17 months of age to receive sulfadoxine-pyrimethamine and amodiaquine (2287 children chemoprevention-alone group), RTS,S/AS01
(2288 children vaccine-alone group), or chemoprevention and RTS,S/AS01
(2286 children combination group). Of these, 1965, 1988, and 1967 children in the three groups, respectively, received the first dose of the assigned intervention and were followed for 3 years. Febrile seizure developed in 5 children the day after receipt of the vaccine, but the children recovered and had no sequelae. There were 305 events of uncomplicated clinical malaria per 1000 person-years at risk in the chemoprevention-alone group, 278 events per 1000 person-years in the vaccine-alone group, and 113 events per 1000 person-years in the combination group. The hazard ratio for the protective efficacy of RTS,S/AS01
as compared with chemoprevention was 0.92 (95% confidence interval CI, 0.84 to 1.01), which excluded the prespecified noninferiority margin of 1.20. The protective efficacy of the combination as compared with chemoprevention alone was 62.8% (95% CI, 58.4 to 66.8) against clinical malaria, 70.5% (95% CI, 41.9 to 85.0) against hospital admission with severe malaria according to the World Health Organization definition, and 72.9% (95% CI, 2.9 to 92.4) against death from malaria. The protective efficacy of the combination as compared with the vaccine alone against these outcomes was 59.6% (95% CI, 54.7 to 64.0), 70.6% (95% CI, 42.3 to 85.0), and 75.3% (95% CI, 12.5 to 93.0), respectively.
Administration of RTS,S/AS01
was noninferior to chemoprevention in preventing uncomplicated malaria. The combination of these interventions resulted in a substantially lower incidence of uncomplicated malaria, severe malaria, and death from malaria than either intervention alone. (Funded by the Joint Global Health Trials and PATH; ClinicalTrials.gov number, NCT03143218.).
•Hydroxychloroquine + azithromycin (HCQ + AZ) did not reduce recovery time in COVID-19•HCQ + AZ had no effect on the risk of worsening or transfer to the intensive care unit•The use of HCQ + AZ ...appeared to be associated with lower mortality rates
Our study aimed to assess the statistical relationship between the use of chloroquine phosphate or hydroxychloroquine plus azithromycin (CQ/HCQ + AZ) and virological recovery, disease worsening, and death among out- and inpatients with COVID-19 in Burkina Faso.
This was a retrospective observational study that compared outcomes in terms of time to recovery, worsening, and death in patients who received CQ/HCQ + AZ and those who did not using a multivariable Cox or Poisson model before and after propensity matching.
Of the 863 patients included in the study, about 50% (432/863) were home-based follow-up patients and 50% were inpatients. Of these, 83.3% (746/863) received at least 1 dose of CQ/HCQ + AZ and 13.7% (118/863) did not. There were no significant differences in associated time to recovery for patients receiving any CQ/HCQ + AZ (adjusted HR 1.44; 95% CI 0.76–2.71). Similarly, there was no significant association between CQ/HCQ + AZ use and worsening (adjusted IRR 0.80; 95% CI 0.50–1.50). However, compared with the untreated group, the treated group had a lower risk of death (adjusted HR 0.20; 95% CI 0.10–0.44).
The study provided valuable additional information on the use of CQ/HCQ in patients with COVID-19 and did not show any harmful outcomes of CQ/HCQ + AZ treatment.
Global health partnerships (GHPs) involve complex relationships between individuals and organizations, often joining partners from high-income and low- or middle-income countries around work that is ...carried out in the latter. Therefore, GHPs are situated in the context of global inequities and their underlying sociopolitical and historical causes, such as colonization. Equity is a core principle that should guide GHPs from start to end. How equity is embedded and nurtured throughout a partnership has remained a constant challenge. We have developed a user-friendly tool for valuing a GHP throughout its lifespan using an equity lens. The development of the EQT was informed by 5 distinct elements: a scoping review of scientific published peer-reviewed literature; an online survey and follow-up telephone interviews; workshops in Canada, Burkina Faso, and Vietnam; a critical interpretive synthesis; and a content validation exercise. Findings suggest GHPs generate experiences of equity or inequity yet provide little guidance on how to identify and respond to these experiences. The EQT can guide people involved in partnering to consider the equity implications of all their actions, from inception, through implementation and completion of a partnership. When used to guide reflective dialogue with a clear intention to advance equity in and through partnering, this tool offers a new approach to valuing global health partnerships. Global health practitioners, among others, can apply the EQT in their partnerships to learning together about how to cultivate equity in their unique contexts within what is becoming an increasingly diverse, vibrant, and responsive global health community.
Globally violence against children and adolescents is a significant public health problem. Since children rely on family for early learning and socialization, evidence of the factors associated with ...exposure to violence within households may inform the development of policies and measures to prevent violence and aid the victims of violence. This study examines the risk and protective factors associated with adolescents' exposure to violence at home and how these differ by gender and age in four regions of Burkina Faso.
We used data from the baseline survey of the Child-Sensitive Social Protection Programme (CSSPP) conducted in four regions of Burkina Faso. The CSSPP is a cash transfer programme accompanied by complimentary nutrition, and water and sanitation interventions to address multidimensional child poverty. We employed bivariate and multivariable regression analysis on a sample of 2222 adolescents aged 10-19 to explore the risk and protective factors associated with exposure to violence.
Results show that exposure to psychological violence (22.7%) was more common within the households when compared to physical violence (9.1%). Adolescent girls reported more exposure to physical violence while boys reported more exposure to psychological violence. Significant risk factors associated with the likelihood of exposure to violence among girls are orphanhood, living in a household receiving safety nets and living in a Muslim-majority community. Among boys, age, school attendance, disability, a household receiving safety nets, sharing a household with a depressed individual, and living in a Muslim-majority community, were associated with exposure to violence.
These gender-specific findings highlight the importance of family background characteristics and can be used to inform and strengthen the targeting of vulnerable children and adolescents in interventions aimed at reducing exposure to violence against children.
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•Chemistry of pyrite and arsenopyrite from the Mana gold deposits.•Four hydrothermal fluid events identified with 2 source reservoirs over ∼150 Ma.•Early magmatic and metamorphic ...fluid events as olds as ∼2172 Ma.•Regional Au-As metamorphic fluid events during D3MD and D4MD with late gold remobilization.•Geochemical diagram using As, Ag, Sb, Bi for separating the pyrite origin in orogenic gold deposit.
Mana is a world-class Paleoproterozoic orogenic gold district (∼8.0 Moz) that includes five gold deposits (Fofina, Nyafé, Siou, Wona-Kona and Yaho) hosted in various rocks in the northern part of the Birimian Houndé greenstone belt, western Burkina Faso. The gold deposits recorded different styles of mineralization associated with sulfides during polyphase deformation events. Detailed petrographic and LA-ICP-MS analyses of pyrites and arsenopyrites from the main mineralization of each deposit provide new information on the potential gold and arsenic sources and timing of fluids responsible for mineralization at Mana. Four hydrothermal fluid events associated with two distinct source reservoirs and at least two hydrothermal systems were recognized. The first hydrothermal fluid event was generated during the Eoeburnean D1MD (MD for Mana district) shortening event (∼2172 Ma), evidence of which is preserved in the Fofina and Siou deposits, and occurred under greenschist metamorphic facies conditions. Economic gold deposits at Fofina are associated with metamorphic disseminated pyrite (Py1F) in black shale, zoned pyrite (Py2F) enriched in As, Ni, Cu, Ag, Sb, W, Au and Pb, and arsenopyrite in folded V1F quartz-carbonate veins. In contrast, the Siou deposit exhibits Au in porous pyrite cores (Py1S), which are associated with Ag, Bi, Te and W (±Sb) in V1S quartz veins hosted in the Siou granodiorite. These two trace element suites are interpreted as having been induced by a metamorphic source in the Fofina deposit and by a local contribution of a magmatic source in the Siou deposit. The second hydrothermal fluid event occurred during the Eburnean D3MD transpressional event (2113–2090 Ma) in the Nyafé deposit. This event is defined by Au-As-rich rims in hydrothermal pyrite (Py3N) and by the co-precipitation of Au-rich arsenopyrite in the V3N quartz veinlets (V3N) controlled by a second-order dextral shear zone. The third and main hydrothermal fluid event during the D4MD transpressional event (∼2090 Ma) is characterized by the development of strong silicification and by zoned pyrites (Py3WK and Py2Y) and Au-rich arsenopyrite in the Wona-Kona and Yaho deposits. However, the same late Au-As-rich rims in hydrothermal pyrite are observed in both deposits and in the Nyafé deposit, and these rims are interpreted to be related to the same economic gold source related to the Lower Birimian metamorphic reservoir, composed of black shale (diagenetic framboidal pyrite) and tholeiitic basalts. The diagenetic framboidal Py1WK in black shale (Lower Birimian group) is enriched in Au (median of 0.8 ppm), low in As (median of 70 ppm), with other trace elements (Ni, Cu, Zn, Ag, Sb and Pb). The last hydrothermal event is associated with free gold remobilization in late microfractures in the Wona-Kona and Siou deposit during the reactivation of major transcurrent shear zones during the D4MD event or the D5MD shortening event (as late as 2022 Ma). A binary diagram of As/Ag vs. Sb/Bi appears to be effective at separating the diagenetic, magmatic and metamorphic pyrites and could be used in orogenic gold exploration to ascertain potential gold endowment at the district scale.
Female sex workers (FSWs) are vulnerable to violence within and beyond the workplace. Violence is associated with increased burden of HIV, possibly explained through physiologic or behavioral causal ...pathways. These analyses sought to determine the relationship between lifetime sexual violence with unprotected, condomless vaginal intercourse (UVI) among FSWs in West Africa.
FSWs (aged ≥18 years) were recruited into a cross-sectional study through respondent-driven sampling in two West African countries, Togo and Burkina Faso. A total of 1380 participants were enrolled from January to July 2013, and completed a sociobehavioral questionnaire and HIV testing. Measures included sex work history, lifetime experiences of violence victimization, sexual practices, and UVI (past month). Crude and adjusted robust log binomial regression was conducted to estimate prevalence ratios (PrR) as a measure of association between UVI with clients and the primary exposure, forced sex.
Self-reported lifetime physical abuse (47.3%), forced sex (33.0%), and any violence (57.9%) were common. Almost one-quarter (23.9%) reported recent UVI with clients. History of forced sex was independently associated with recent UVI with clients vs. none, adjusted PrR: 1.49; 95% confidence interval (CI): 1.18 to 1.88, with evidence of partial mediation by difficult condom negotiation with regular (aPrR: 1.83; 95% CI: 1.43 to 2.34) and new clients (aPrR: 1.60; 95% CI: 1.13 to 2.29).
These data demonstrate the significant relationship between sexual violence experienced by FSWs and unprotected sex with clients. Comprehensive interventions reducing vulnerabilities to violence combined with improved condom negotiation are needed to address the complex influences of condom use during sex work as a means of ultimately lowering HIV acquisition and transmission.
In 2013, Burkina Faso introduced 13-valent pneumococcal conjugate vaccine (PCV13) into the routine childhood immunization program, to be administered to children at 8, 12, and 16 weeks of age. We ...evaluated the impact of PCV13 on pneumococcal meningitis.
Using nationwide surveillance, we gathered demographic/clinical information and cerebrospinal fluid (CSF) results for meningitis cases. Pneumococcal cases were confirmed by culture, polymerase chain reaction (PCR), or latex agglutination; strains were serotyped using PCR. We compared annual incidence (cases per 100 000) 4 years after PCV13's introduction (2017) to average pre-PCV13 incidence (2011-2013). We adjusted incidence for age and proportion of cases with CSF tested at national laboratories.
In 2017, pneumococcal meningitis incidence was 2.7 overall and 10.5 (<1 year), 3.8 (1-4 years), 3.5 (5-14 years), and 1.4 (≥15 years) by age group. Compared to 2011-2013, PCV13-serotype incidence was significantly lower among all age groups, with the greatest decline among children aged <1 year (77%; 95% confidence interval CI, 65%-84%). Among all ages, the drop in incidence was larger for PCV13 serotypes excluding serotype 1 (79%; 95% CI, 72%-84%) than for serotype 1 (52%; 95% CI, 44%-59%); incidence of non-PCV13 serotypes also declined (53%; 95% CI, 37%-65%). In 2017, 45% of serotyped cases among all ages were serotype 1 and 12% were other PCV13 serotypes.
In Burkina Faso, meningitis caused by PCV13 serotypes continues to decrease, especially among young children. However, the concurrent decline in non-PCV13 serotypes and short pre-PCV13 observation period complicate evaluation of PCV13's impact. Efforts to improve control of serotype 1, such as switching from a 3 + 0 schedule to a 2 + 1 schedule, may improve overall control of pneumococcal meningitis in this setting.
Evidence on sociodemographic determinants and spatial variations in the fruit and/or vegetable (FV) consumption was reported. This study aimed to explore geographical and sociodemographic disparities ...in the level of FV consumption among adults in Burkina Faso, using the national baseline data.
This was a cross-sectional secondary study of primary data obtained by the 2013 (September to October) World Health Organization Stepwise Approach to Surveillance survey conducted in Burkina Faso. The participants were 4402 women and men aged 25-64 years and living in all 13 Burkinabè Regions. Descriptive and analytical analyses were performed using Student's t test, ANOVA, the chi-square test, Fisher's exact test and logistic regressions.
The prevalence of a typical daily consumption of at least three servings was 4.1% (95% CI: 3.6-4.8) for fruits and 6.6% (95% CI: 5.9-7.3) for vegetables. The national prevalence of adequate FV intake was 5.1% (95% CI: 4.4-5.8), and for two Regions ("Centre-Ouest" and "Nord") the pooled prevalence was 22.4%, while in the other eleven Regions its was significantly lower, 2.4% (p = 0.0001). Using quartiles derived from the national level of consumption, each of these two Regions had a higher proportion (about 50%) of their participants in the fourth quartile (the higher level). The associated sociodemographic factors with the adequate intake were being rural residents (aOR = 1.7, p = 0.011) and women (aOR = 1.3; p = 0.03).
Except for the Regions of "Centre-Ouest" and "Nord" of Burkina Faso, the prevalence of adequate consumption of FV was very low in its other eleven Regions. Measures to increase consumption in urban people are urgent while women should be the key actor in the family-based approaches implementation and the nutrition education promoting FV consumption.
This study collected baseline data on malaria vectors to characterize the drivers and the factors of persistent malaria transmission in two villages in the western part of Burkina Faso. Mosquitoes ...were collected in each village using the Human landing catch and pyrethrum spray catch and identified using the morphological keys. Molecular analyses were performed for the identification of An. gambiae complex species, the detection of Plasmodium infection and kdr-995F mutation. Anopheles mosquito larvae were also collected in the same villages, reared to adult's stage for the WHO tube and cone tests performing. The physical integrity of the LLINs already used by people in each village was assessed using the proportional hole index (pHI). An. gambiae s.l. was the main malaria vector accounting for 79.82% (5560/6965) of all collected mosquitoes. The biting pattern of An. gambiae s.l. was almost constant during the survey with an early aggressiveness before 8 p.m. and later biting activity after 6 a.m. The EIR varied from 0.13 to 2.55 infected bites per human per night (average: 1.03 infected bites per human per night). An. gambiae s.l. populations were full susceptible to Chlorpyrifos-methyl (0.4%) and Malathion (5%) with high kdr-995F mutation frequencies (>0.8). The physical integrity assessment showed high proportion of good nets in Santidougou compared to those collected in Kimidougou. This study highlighted a persistence of malaria transmission despite the intense use of vector control tools as LLINs and IRS by correlating mosquito biting time and human behavior. It provided a baseline guide for the monitoring of the residual malaria transmission in sub-Saharan Africa and encouraging the development of new alternative strategies to support the current malaria control tools.
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