Fati Kirakoya-Samadoulougou

Prevalence of symptoms of vaginal fistula in 19 sub-Saharan Africa countries: a meta-analysis of national household survey data.

BACKGROUND Vaginal fistula is a serious medical disorder characterised by an abnormal opening between the vagina and the bladder or rectum, which results in continuous leakage of urine or stool. The burden of this disorder in sub-Saharan Africa is uncertain. We estimated the lifetime and point prevalence of symptoms of vaginal fistula in this region using national household surveys based on self-report of symptoms. METHODS We considered all Demographic and Health Surveys (DHS) and Multiple Indicators Cluster Surveys (MICS) from sub-Saharan Africa and included data for women of reproductive age (15-49 years). We estimated lifetime prevalence and point prevalence of vaginal fistula with use of Bayesian hierarchical meta-analysis. FINDINGS We included 19 surveys in our analysis, including 262,100 respondents. Lifetime prevalence was 3.0 cases (95% credible interval 1.3-5.5) per 1000 women of reproductive age. After imputation of missing data, point prevalence was 1.0 case (0.3-2.4) per 1000 women of reproductive age. Ethiopia had the largest number of women who presently have symptoms of vaginal fistula. INTERPRETATION This study is the first to estimate the burden of vaginal fistula in 19 sub-Saharan Africa countries using nationally representative survey data. Point prevalence was slightly lower than previously estimated but these earlier estimates are within the prevalences credible intervals. Although vaginal fistula is relatively rare, it is still too common in sub-Saharan Africa. FUNDING None.

Epidemiology of herpes simplex virus type 2 infection in rural and urban Burkina Faso.

Background: Herpes simplex virus type 2 (HSV-2) infection enhances human immunodeficiency virus (HIV) susceptibility and may increase sexual transmission, but few data on HSV-2 prevalence are available from West Africa. The main objective of this study was to describe the prevalence and determinants of HSV-2 among adults in urban and rural Burkina Faso. Methods: We conducted (i) a 2-stage clustered population-based survey among adults aged 15 to 49 years in Ouagadougou (N = 883 women and 791 men), the capital city of Burkina Faso, and (ii) a cross-sectional study among attendees (N = 2018) of all 98 antenatal clinics from 4 provinces of the country. HSV-2 infection was diagnosed using a specific IgG2 enzyme-linked immunosorbent assay test (Kalon). Results: The prevalence of HSV-2 among pregnant women was 18.0% (95% confidence interval (CI): 16.3%–19.7%), with a trend for lower rates in rural (17.3%; CI: 15.5%–19.2%) versus semiurban areas (21.4%; CI: 17.2%–26.2%) (P = 0.08), whereas the prevalence of HSV-2 was 23.7% (CI: 20.9%–26.6%) among women in Ouagadougou (N = 883), and 15.3% (CI: 12.9%–18.0%) among men (N = 791). Using multivariable logistic regression analysis among women, older age, being married, contraceptives, bacterial vaginosis (BV), and HIV infection were significantly associated with HSV-2 infection. Among men, only increased age and HIV were independently associated with HSV-2. Conclusion: The prevalence of HSV-2 infection was high among young women, including in rural areas, with a strong association with BV. Therefore, rural areas should not be neglected in prevention programs. New potent BV, hormonal contraceptives, and HSV control strategies may be helpful for HIV control.

Bacterial vaginosis among pregnant women in Burkina Faso.

Objectives: Bacterial vaginosis (bv) is a common cause of abnormal or altered vaginal discharge in women of childbearing age. Its association with obstetric and gynecologic complications and HIV are increasingly recognized. Few population-based surveys of BV have been conducted in Africa. The objective of the study was to examine the role of genital infections including Herpes simplex virus type 2 (HSV-2) and demographic factors on the prevalence of BV among pregnant women in Burkina Faso. Methods: Consenting pregnant women from Burkina Faso answered a face-to-face interview on their demographic characteristics. Then, genital and blood swabs were collected and tested for BV and other genital infections. Univariable and multivariable models were used to investigate the risk factors of BV. Results: Among the 2133 women included in the analyses (over 2284 enrolled), the prevalence of BV was 6.4% [95% confidence interval (CI), 5.5%–7.6%], ranging from 3% to 12% between regions. In multivariable analyses, HSV-2 [odds ratio (OR), 1.64; 95% CI 1.04–2.59) was the only genital infection that remained significantly associated with BV. Other factors related to BV were history of abortion (OR, 1.57; 95% CI, 1.01–2.43) and geographical origin. HIV infection (OR, 1.98; 95% CI, 0.90–5.20) and polygamy (OR, 1.48; 95% CI, 1.00–2.36) tended to be associated with BV without reaching statistical significance. Conclusion: The prevalence of BV among pregnant women was lower than expected, with large geographical disparities. Our data confirm the potential interaction between BV and HSV-2.

Paracheck® rapid diagnostic test for detecting malaria infection in under five children: a population-based survey in Burkina Faso.

BackgroundOver the past ten years, Rapid Diagnostic Tests (RDT) played a major role in improving the use of biological malaria diagnosis, in particular in poor-resources settings. In Burkina Faso, a recent Demography and Health Survey (DHS) gave the opportunity to assess the performance of the Paracheck® test in under five children nationwide at community level.MethodsA national representative sample of 14,947 households was selected using a stratified two-stage cluster sampling. In one out of two households, all under five children were eligible to be tested for malaria using both RDT and microscopy diagnosis. Paracheck® performance was assessed using miscroscopy as the gold standard. Sensitivity and specificity were calculated as well as the diagnosis accuracy (DA) and the Youden index.ResultsThe malaria infection prevalence was estimated at 66% (95% CI: 64.8-67.2) according to microscopy and at 76.2% (95% CI: 75.1-77.3) according to Paracheck®. The sensitivity and specificity were estimated at 89.9% (95% CI: 89.0-90.8) and 50.4% (95% CI: 48.3-52.6) respectively with a Diagnosis Accuracy of 77% and a Youden index of 40%. The positive predictive value for malaria infection was 77.9% (95% CI: 76.7-79.1) and the negative predictive value was 72.1% (95% CI: 69.7-74.3). Variations were found by age group, period of the year and urban and rural areas, as well as across the 13 regions of the country.ConclusionWhile the sensitivity of the Paracheck® test was high, its specificity was poor in the general under five population of Burkina Faso. These results suggest that Paracheck® is not suitable to assess malaria infection prevalence at community level in areas with high malaria transmission. In such settings, malaria prevalence in the general population could be estimated using microscopy.

Are teachers at higher risk of HIV infection than the general population in Burkina Faso

In order to assess the human immunodeficiency virus (HIV) prevalence among teachers in Burkina Faso, we carried out a national survey in 336 primary and secondary schools from urban and rural areas. Among 2088 teachers who agreed to participate, 1498 (71.7%) provided urine for HIV testing. The crude prevalence of HIV among teachers was 2.8% (95% confidence interval [CI]: 2.0–3.6), with no difference between teachers from primary schools (2.9%, 95%CI: 2.1–4.0) and those from secondary schools (2.5%, 95%CI: 0.5–4.5). Age- and area-standardized HIV prevalence was 1.0% (95%CI: 0.4–1.2) in male teachers, 2.5 times lower than among men in the general population (as assessed from a concomitant Demographic Health Survey), and it was 3.5% (95%CI: 2.5–5.2) in female teachers, 1.7 times higher than in Demographic Health Survey women. This finding calls for the implementation of specific HIV prevention programmes in the education sector targeting women more specifically.

Declining HIV Prevalence in Parallel With Safer Sex Behaviors in Burkina Faso: Evidence From Surveillance and Population-Based Surveys

HIV prevalence among pregnant women ages 15–49 declined from 7.1% to 2.0% in urban areas between 1998 and 2014, and from 2.0% to 0.5% in rural areas between 2003 and 2014; similar declines were reported in the Demographic and Health Surveys. During the same time period, individuals reported safer sex behaviors, including delayed sexual debut and reduced number of sex partners among youth, as well as increased condom use at last sex with nonmarital partners among men and women ages 15–49. HIV prevalence among pregnant women ages 15–49 declined from 7.1% to 2.0% in urban areas between 1998 and 2014, and from 2.0% to 0.5% in rural areas between 2003 and 2014; similar declines were reported in the Demographic and Health Surveys. During the same time period, individuals reported safer sex behaviors, including delayed sexual debut and reduced number of sex partners among youth, as well as increased condom use at last sex with nonmarital partners among men and women ages 15–49. ABSTRACT Objective: To investigate trends in HIV prevalence and changes in reported sexual behaviors between 1998 and 2014 in Burkina Faso. Methods: We obtained data on HIV prevalence from antenatal care (ANC) surveillance sites (N = 9) that were consistently included in surveillance between 1998 and 2014. We also analyzed data on HIV prevalence and reported sex behaviors from 3 population-based surveys from the Demographic and Health Surveys (DHS), conducted in 1998–99, 2003, and 2010. Sex behavior indicators comprised never-married youth who have never had sex; sex with more than 1 partner; sex with a nonmarital, non-cohabiting partner; condom use at last sex with a nonmarital, non-cohabiting partner; and sex before age 15. We calculated survey-specific HIV prevalence with 95% confidence intervals (CIs) and used the chi-square test or chi-square test for trend to compare HIV prevalence across survey years and to analyze trends in reported sex behaviors. Results: HIV prevalence among pregnant women ages 15–49 decreased by 72% in urban areas, from 7.1% in 1998 to 2.0% in 2014, and by 75% in rural areas, from 2.0% in 2003 to 0.5% in 2014. HIV declined most in younger age groups, which is a good reflection of recent incidence, with declines of 55% among 15–19-year-olds, 72% among 20–24-year-olds, 40% among 25–29-year-olds, and 7% among those ≥30 years old (considering urban and rural data combined). Data reported in the DHS corroborated these declines in HIV prevalence: between 2003 and 2010, HIV prevalence dropped significantly—by 89% among girls ages 15–19, from 0.9% (95% CI, 0.2 to 1.6) to 0.1% (95% CI, 0.0 to 0.4), and by 78% among young women ages 20–24, from 1.8% (95% CI, 1.6 to 3.0) to 0.4% (95% CI, 0.0 to 0.7). During the same time period, people reported safer sex behaviors. For example, significantly higher percentages of never-married youth reported they had never had sex, lower percentages of sexually active youth reported multiple sex partners, and lower percentages of youth reported having sex before age 15. In addition, the percentage of men ages 20–49 reporting sex with a nonmarital, non-cohabiting partner declined significantly, while condom use at last sex with such a partner increased significantly among both men and women ages 15–49. Conclusions: Both ANC surveillance and population-based surveys report sharp declines in HIV prevalence in Burkina Faso between 1998 and 2014, accompanied by improvements in reported risky sex behaviors.

Psychometric properties of Moore version of WHOQOL HIV-BREF in persons living with HIV in Burkina Faso

This study aims to examine psychometric properties of Moore version of World Health Organizations Quality of Life assessment short instrument in HIV patients (WHOQOL HIV-BREF). A study was conducted on 100 persons living with HIV/AIDS in Ouagadougou, Burkina Faso. The internal consistency was evaluated using Cronbachs α. For the convergent validity of the Moore version WHOQOL-HIV BREF, the Satisfaction With Life Scale (SWLS) was used as a comparison instrument and cross-product correlations were calculated. The test-retest reliability was assessed using the interclass correlation coefficient. The study showed high internal consistency with Cronbachs α at 0.92 for the whole instrument. According to domains, Cronbachs α found was ranged from 0.58 to 0.87, showing acceptable internal consistency for all domains. Domains scores for test-retest reliability, using Interclass Correlation gave coefficients ranged from 0.40 (Spiritual domain) to 0.99 (Level of Independence domain) with p 0.05). As a demonstrated cross-cultural instrument, the WHOQOL HIV-BREF in its Moore version can be used for quality of life assessment in a routine way or longitudinal studies in Burkina Faso with persons living with HIV/AIDS

High seroprevalence of hepatitis B virus and hepatitis C virus among human immunodeficiency virus carriers in blood donors of Burkina Faso: a need for their screening before HARRT therapy

High seroprevalence of hepatitis B virus and hepatit is C virus among human immunodeficie ncy virus carriers in blood donors of Burkina Faso: a need for their screening before HARRT therapy

Who Is Going for VCT? A Case Study in Urban Burkina Faso

Introduction. Voluntary HIV counselling and testing (VCT) is a key element of treatment and is essential for prevention of vertical HIV transmission. Little information is available on the uptake of VCT in Burkina Faso. This study aims to assess the prevalence of VCT in urban Burkina Faso, where the epidemic is still highly concentrated. Methods. We conducted a two-stage clustered population-based survey among 1,694 subjects living in Ouagadougou, Burkina Faso. After informed consent was obtained, a behavioural questionnaire was administered to participants. Results. Overall, 10.2% of individuals had used VCT, while 9% were women. Among women who had a child after the launch of the programme to prevent mother-to-child transmission (PMTCT), only 10.4% have been tested for HIV. Almost all participants (99.3%) were aware of HIV/AIDS, and 65% knew the main methods of prevention. In multivariate analysis, older age and being married and better educated were independent factors associated with VCT. Conclusions. Despite high public knowledge and awareness about HIV, VCT uptake was still very low and PMTCT coverage was poor. New strategies are required to increase VCT uptake in urban areas, in particular among the youngest age.

Plaidoyer pour un renforcement du système de pharmacovigilance au Burkina Faso

Large-scale deployment of new medicines has been observed over the last two decades in many Sub-Saharan Africa countries faced with major public health issues such as malaria and HIV/AIDS. However, some of these medicines may be responsible for varying degrees of toxicity, with adverse drug reactions leading to decreased compliance or even discontinuation of treatment. Pharmacovigilance systems therefore had to be set up in these countries, such as in Burkina Faso, West Africa, which initiated the organization of pharmacovigilance activities in 2008. Despite this progress, the systems in place have not yet achieved a sufficient level of performance to deal with drug-related health issues, highlighting the need for further actions. Pharmacovigilance in Burkina Faso can be strengthened at multiple levels: pre-service and in-service training of health workers; the establishment of active surveillance based on sentinel sites; informing the public and raising awareness; and strengthening national coordination.