Mobility and HIV-Related Sexual Behavior in Burkina Faso

This study compared HIV-related sexual behavior among mobile and non-mobile populations in Burkina Faso and identified venues where HIV/AIDS interventions targeting mobile individuals should be implemented. Men (N = 940) and women (N = 430) responded to a sexual behavior survey while socializing at venues where people meet sexual partners in eight Burkina Faso villages. Mobile women were more likely than non-mobile women to report new sexual partnerships (adjusted prevalence odds ratio (POR): 2.07, 95% confidence interval (CI): 1.19-3.59) and transactional sex (adjusted POR: 2.30, 95% CI: 1.55-3.42) in the past month. Mobility was most common and associations between mobility and sexual partnership levels were particularly strong among women interviewed in urban commercial towns situated near international borders. Mobile women were most likely to be interviewed at venues such as bars and clubs, making these appropriate locations for HIV/AIDS interventions. Mobility was not associated with HIV-related sexual behaviors among men.     

The Role of HIV-Related Knowledge and Ethnicity in Determining HIV Risk Perception and Willingness to Undergo HIV Testing Among Rural Women in Burkina Faso

We conducted a random community based survey of 300 young (15–29 years) rural women in Nouna, Burkina Faso. Only one-third of women were aware that a person could have HIV without having symptoms and these women were significantly more likely to classify themselves to be at high risk for getting HIV. Furthermore, multiple partners, Bwaba ethnicity and having mentioned a health worker as a source of HIV information were significantly associated with perceived high personal risk. Perceived willingness to participate in VCT was high (69%). The dissemination of information on the asymptomatic nature of HIV infection could potentially be very important in forming risk perception, awareness, and their willingness to participate in HIV interventions.     

Antiretroviral use in Ouagadougou, Burkina Faso

Burkina Faso has the second highest seroprevalence rate for HIV in West Africa, estimated at 6.5% of the population. Although it is one of the poorest countries in the world, antiretrovirals have been used on an extremely limited basis in Burkina Faso since at least the early 1990s. In this article we will review the evolution of antiretroviral availability in this country, describe the mechanisms by which drugs are being accessed, and review our experience with expanding antiretroviral access through drug donations in community-based settings. Finally, we will discuss some of the implications for future attempts to expand access to treatment for people living with HIV in Africa.     

Birthweight distribution in rural North-West Burkina Faso

Summary Two thousand and twenty-six delivery records from 1987 to 1989 in 5 rural health units in North Western Burkina Faso were analysed. The mean birthweight was 2899 g, with an overall incidence of low birthweight of 9.3%. Increasing birth order from 1 to 3 was associated with increasing birthweight; for birth orders >3, birthweight was relatively constant. There is a marked seasonal variation in birthweight, with a decrease in the rainy season and an increase during the dry season. These findings are compared with other African populations. The anthropometric measurements of these newborns were slightly lower than standards from industrialized North America.     

Epidemiology of HIV infection in urban Burkina Faso

We conducted a cross-sectional study of sexually transmitted disease and HIV infections among a random sample of the 2364 adult population in 2000 in Bobo-Dioulasso, the second largest town in Burkina Faso. The prevalence of HIV infection was 5.2%. Risk factor analysis was conducted among sexually active men 20 to 34 years old and women 15 to 24 years old. Factors independently associated with HIV infection among men were having been married (adjusted odds ratio (aOR)=8.19 [1.70-39]), reporting more than two non-marital partners in the last 12 months (aOR=6.07 [1.14-32.4]), reporting a past urban residence other than Bobo-Dioulasso (aOR =6.37 [1.96-20.7] and having a positive serology for HSV-2 infection (aOR=12.0 [3.49-40.9]). Among women the factors were being Christian (aOR=3.73 [1.20-11.6]), having had a first sexual partner more than 24 years old (aOR =4.30 [1.35-13.6]) and having a positive serology for HSV-2 infection (aOR =4.40 [1.32-14.6]). HIV infection in Bobo-Dioulasso therefore depends on both exposure factors (sexual behaviours) and transmissibility cofactors (HSV-2).     

Genomic Epidemiology of SARS-CoV-2 in Western Burkina Faso,West Africa

Background: After its initial detection in Wuhan, China, in December 2019, SARS-CoV-2 has spread rapidly, causing successive epidemic waves worldwide. This study aims to provide a genomic epidemiology of SARS-CoV-2 in Burkina Faso. Methods: Three hundred and seventy-seven SARS-CoV-2 genomes obtained from PCR-positive nasopharyngeal samples (PCR cycle threshold score < 35) collected between 5 May 2020, and 31 January 2022 were analyzed. Genomic sequences were assigned to phylogenetic clades using NextClade and to Pango lineages using pangolin. Phylogenetic and phylogeographic analyses were performed to determine the geographical sources and time of virus introduction in Burkina Faso. Results: The analyzed SARS-CoV-2 genomes can be assigned to 10 phylogenetic clades and 27 Pango lineages already described worldwide. Our analyses revealed the important role of cross-border human mobility in the successive SARS-CoV-2 introductions in Burkina Faso from neighboring countries. Conclusions: This study provides additional insights into the genomic epidemiology of SARS-CoV-2 in West Africa. It highlights the importance of land travel in the spread of the virus and the need to rapidly implement preventive policies. Regional cross-border collaborations and the adherence of the general population to government policies are key to prevent new epidemic waves.     

Rheumatoid arthritis in Burkina Faso: clinical and serological profiles

The objective of this work was to study the clinical and serological profiles of rheumatoid arthritis in Burkina Faso (West Africa). It is a cross-sectional study conducted from March 2006 to February 2009 in the Internal Medicine Department of the University Hospital Yalgado Ouedraogo. All patients seen in the rheumatologic consultation unit during this period, with rheumatoid arthritis fulfilling the ACR criteria, were routinely selected. The determination of anticyclic citrullinated peptide antibodies (ACPA) was carried out with a computerized method (Elia CCP, Phadia AB, Uppsala, Sweden). Values higher than 10 IU/l were considered positive. Forty-eight cases of rheumatoid arthritis (RA) were recruited throughout the study period among 2,194 (2.2 %) patients. Forty-two files were subjected to the study. There were 34 women and 8 men. The average age was 41.70 ± 13 years with extremes of 22 and 71 years. The average duration of the disease was 86.17 ± 82.01 months with extremes of 8 and 360 months. Rheumatoid factors (RF) were positive in 21 out of 30 patients (70.0%). The determination of ACPA carried out in all the patients was positive in 34 (81%) patients; their average value was 217 IU/l with extremes of 38 and 1,170. RF and ACPA were associated to bones erosions (p = 0.0001). Twenty-two patients were placed on methotrexate, eight on hydroxychloroquine, and three on salazopyrine. Nine were given only NSAIDs or prednisolone. No patients had had a biotherapy agent. The frequency of RA was low in our study compared to other African studies published so far. The particularity of RA cases reported in African series, including ours, is the rarity of extra-articular manifestations of the disease. The severity of the disease at presentation in the rheumatology clinic may be due to their late consultation among other causes.     

Prevalence and genotype characterization of human papillomaviruses among HIV-seropositive in Ouagadougou, Burkina Faso

Background

Approximately, 15–20 of 40 HPVs that infect the female genital tract confer a high-risk of invasive cancer, thus HPVs account for 95% of cervix cancers. The objectives of this study were to: (i) estimate the prevalence of HPV infection in women infected with HIV in Ouagadougou, (ii) identify potential carcinogenic HPV strains and (iii) determine whether existing HPV vaccines match the isolated strains.

Methods

From May 2009 to April 2010, 250 HIV-infected women were included in this study. Each woman was screened for the presence of HPV and for HPV genotype using PCR/hybridization technique.

Results

Of the 250 HIV-infected women, 59.6% were infected with at least one type of HPV. High-risk HPVs were identified with the following prevalence: HPV-18 (25.0%); HPV-50′S (25.5%); HPV-30′S (20.8%); HPV-16 (4.7%); HPV-45 (3.7%). Low-risk HPVs were represented by HPV-6 (5.7%) and HPV-11 (0.9%).

Conclusion

The issue of the study showed that the existing vaccines: Gardasil and Cervarix may be used in the country although they match only HPV-16, HPV-18, HPV-6 and HPV-11. Further investigations should be continued for the establishment of vaccine that matches all genotypes circulating in the country.     

Diagnostic quality in rural health centres in Burkina Faso

Summary
objective   To study the quality of diagnostic practice in rural Burkina Faso.
method   In 9 health centres of 3 districts, 313 outpatient consultations were observed, and 417 diagnoses by 15 nurses were analysed. Criteria for evaluation of patient history and clinical examination were based on the diagnostic guidelines distributed by the Ministry of Health.
results   In only 20% of the diagnoses the nurses took a sufficient history and in only 40% they conducted a sufficient clinical examination. In 21% patients underwent no clinical examination at all. Only 12% of all diagnoses were based on sufficient history-taking and adequate clinical examinations. The individual elements of clinical examination were performed correctly in 82% of cases. The variation between nurses was immense, but no correlation could be found with regard to their basic training. However, nurses who had received the diagnostic guidelines examined patients more carefully than those who had not. Larger numbers of patients per day are not associated with shorter nurse-patient contact, and neither is sufficiency of patient history associated with duration of the consultation.
conclusion  The low diagnostic quality of the outpatient consultations in the studied area indicates that this issue has been neglected in national public health initiatives. But examination skills are good and diagnostic guidelines may have had a positive effect on the diagnostic quality.     

某地区农村基层医务人员艾滋病知识、态度及相关行为研究

目的 了解基层医务人员艾滋病基本知识、态度和个人性行为。方法 对某地五个县(市)的县、乡两级医疗卫生单位医务人员进行分层随机抽样,用匿名调查表收集有关个人背景、艾滋病知识、态度和个人性行为资料。计算县、乡两级医务人员各项艾滋病知识正确率和不同态度的分布情况及危险性行为。结果 共调查296名医务人员。三条传播途径知识为44.44％～97.24％,非传播途径知识为62.28％～86.85％,两条预防方法知识为59.3％～63.76％,非预防方法知识为68.51％～85.07％。24.41％的人知道“普遍性防护原则”。65.52％的人认为开展艾滋病抗体检查有助于预防艾滋病传播。认为应该公开感染者身份和允许感染者继续工作的人分别占33.79％和42.76％。多数知识和态度问题县、乡两级间无明显差别。未婚者与至少2个人发生过性行为者占14.29％,已婚者过去6个月发生婚外性行为者为3.88％。结论 基层医务人员艾滋病基本知识比较低,要加强艾滋病预防专项培训工作,特别是“普遍性防护原则”的培训及具体实施,以减少艾滋病医源性传播。     

Living with HIV: women's experience in Burkina Faso, West Africa

Our study aimed at studying HIV-infected women's experience with sharing serostatus with their partner and their group support. A survey was carried out among 79 seropositive women involved in a therapeutic trial in Bobo-Dioulasso, following freely consented prenatal HIV testing. The study revealed that women are reluctant to inform their partners and fear being stigmatized by relatives and friends. The major concern reported was health consequences and most women wished to receive care. The non-governmental organizations supporting people living with HIV were not known by these women, but providing this information raised a high interest and many women considered joining them soon and getting themselves involved. These community-based organizations, lead by qualified and highly motivated volunteers, could facilitate a better social integration of HIV infected women in Burkina Faso.     

Stabilization of HIV infection rates in urban Burkina Faso, 1995-1999

The objectives of this study were to monitor the trends of the HIV epidemic between 1995 and 1999 among pregnant women in Bobo-Dioulasso, the second largest town of Burkina Faso, and to discuss the possible effect of preventive interventions (condom availability) on sexual transmission of HIV in this context. Age-specific trends in HIV prevalence obtained from sentinel surveillance programme were analysed. Among antenatal clinic attendees, HIV prevalence was 7.5% (n=401) in 1995, 10% (n=200) in 1996, 7.6% (n=448) in 1997, 8.4% (n=642) in 1998 and 5.3% (n=716) in 1999 without demonstrated temporal trend (P=0.12). The average number of condoms available per person (aged 15-49 years) per year increased from 0.6 in 1992 to 5.7 in 1995 and 6.0 in 1999. Anonymous surveys are less subject to selection bias and suggest a stabilization of the HIV prevalence around 7.3% in Bobo-Dioulasso. Distribution of condoms could explain at least, partly, this stabilization of the HIV epidemic.     

Outcome and Predictive Factors of Mortality in Hospitalized HIV-Patients in Burkina Faso

Abstract Background:   The aim of this study was to describe the clinical presentation and predictors of death in a HIV population hospitalized in Ouagadougou, Burkina Faso. Materials and Methods:   Baseline demographics, viro-immunological status, clinical presentations, and outcome have been analyzed by univariate analysis and a multivariate model. Results:   A total of 1,071 hospitalizations of HIV-positive patients was recorded between 1 January, 2004 and 31 August, 2006, the majority of whom were female (64.1%). The baseline CD4 cell count/μl was higher in the female patients than in the male ones (166.1 vs 110.9). Gastroenteric symptoms were the first cause of hospitalization (61.7%). The crude mortality rate was higher in males than females (38% vs 25.3%). Baseline World Health Organization clinical stage IV (OR 9.22), neurological syndrome (OR 3.04) or wasting syndrome at admission (OR 2.9), positive malaria film (OR 2.17), and an older age independently predicted death. Weight at admission > 40 kg and a higher platelet count at admission were independently associated with a better outcome. Conclusions:   Females are admitted to hospital earlier than males, probably as an indirect result of the Prevention of Mother-to-Child Transmission (PMTCT) public health initiative. An active search of HIV status in other members of the family (PMTCT-plus) may result in the detection of asymptomatic HIV-infected patients as well. A Plasmodium falciparum-positive smear during admission significantly impacted on outcome as well as low platelet count.     

Sexual Risk Behavior in Urban Populations of Northeastern Africa

Three representative 2-stage cluster sample surveys on sexual risk behavior and its correlates were conducted in Djibouti City and selected urban sites in Ethiopia and Sudan during 1994–95. The analysis in this paper is based on data collected from adults aged 15–49 on topics concerning marriage and regular partnerships (i.e., lasting 12+ months), nonregular sexual partnerships in the preceding 12 months, condom use, and related topics. In Djibouti City and urban sites in Ethiopia, about 10% of males reported 1 or more nonregular partnerships in the last 12 months, compared with 3% in Sudan. Between 20 and 30% of most recent nonregular contacts involved payment of money. Men with no schooling are less likely to report nonregular partnerships than other men in all 3 populations. Less than 5% of females in all 3 populations reported a nonregular partner in the preceding 12 months, but in all settings, the level is higher in divorced, separated, and widowed women. Condom use during the most recent sex act with nonregular partner ranges from 70% in Djibouti to 50% in Ethiopia and 20% in Sudan. In Sudan, the survey results suggest that the risks of rapid spread of HIV/STDs in the general population are low in Khartoum and the town of El Fashir but much higher in El Gadaif, where there is a large refugee population. In Djibouti and urban Ethiopia, risks are more generalized. Because of the lengthening interval between sexual debut and marriage, single males emerge as a priority group and further efforts are badly needed to promote condom use among the less educated.