International journal of gynaecology and obstetrics, Jan 30, 2022
OBJECTIVE To assess the quality of the maternal death review (MDR) cycle in selected health facil... more OBJECTIVE To assess the quality of the maternal death review (MDR) cycle in selected health facilities in Burkina Faso in accordance with national standards. METHODS A multiple case study using a qualitative approach performed in five health districts and two regional hospital centers in Burkina Faso. The facilities were chosen by contrasted purposive sampling based on hospital maternal mortality rate and urban or rural location. Structured and semistructured interviews were conducted and data analyzed thematically, horizontally, and vertically. RESULTS Of the seven facilities included, six performed MDR. The MDR cycle was incomplete in five facilities because the implementation of recommendations had not been assessed. All cases of maternal death lacked vital information. Case analysis was not conducted in accordance with the national standards in most of the facilities. The action plans for implementing recommendations were not commonly used. CONCLUSION The MDR process and its various stages did not meet quality standards. Identifying the determinants leading to lack of adherence to MDR standards will contribute to optimal choice of interventions and improving good practices in health facilities.
The implementation of mass drug administration (MDA) campaigns of albendazole (400 mg) and iverme... more 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 ...
Introduction The satisfaction of users of the health facilities is common used in order to apprec... more Introduction The satisfaction of users of the health facilities is common used in order to appreciate quality of care. The objective of the present research was to study satisfaction of women inpatients from the care units of the Department of Gynecology, Obstetrics and Reproductive Medicine of the National teaching hospital Souro Sanou, in Bobo Dioulasso, Burkina Faso. Methods A cross-sectional analytical study conducted in 8 months. The areas of satisfaction were calculated according to the SAPHORA model (version 7). Results Two hundred (200) clients were eligible and were all interviewed, with the participation rate of 100.0%. The mean age of clients was 28.4 (95% CI: 27.3-29.5) years-old with extremes ranged from 15 to 56 years-old. The low score domains of satisfaction were: reception, catering and staff organization. The scores per domain of satisfaction and per service and the overall satisfaction score were less than 50%. The differences between the services were related to:...
La cesarienne est une intervention obstetricale majeure pratiquee en chirurgie obstetricale pour ... more La cesarienne est une intervention obstetricale majeure pratiquee en chirurgie obstetricale pour sauver la mere ou l’enfant. L’objectif de la presente etude etait d’etudier les aspects cliniques, therapeutiques et pronostics des cesariennes realisees a l’hopital de district de Orodara (HDO), de 2002 a 2013, au Burkina Faso. Il s’est agi d’une etude retrospective a visee descriptive ayant porte sur 2093 cas de cesariennes. Au cours des 12 annees d’etude, la proportion moyenne annuelle de realisation des cesariennes etait de 26,04 % (minimum de 5,83 % en 2003 et maximum de 47,42 % en 2012) et les cesariennes ont represente 46,89 % (minimum de 17,84 % en 2003 et maximum de 68,44% en 2013) des interventions realisees au bloc operatoire de l’HDO de Orodara. L’âge moyen des femmes cesarisees etait 22,73 ans [20,21 ; 25,52]. La tranche d’âge la plus representative etait celle de 20 a 24 ans (24,41%). Les indications de disproportion foeto-pelvienne (DFP) et de souffrance foetale (SF) etaient les plus retrouvees 47,33 % et 22,75 % respectivement. Il a ete realise seulement huit (08) cesariennes prophylactiques (soit 0,38 % des cas). La rachianesthesie a ete pratiquee en premiere intention (94,31 %). Le mode cephalique a ete le mode d’extraction plus observe soit 67,12 % des cas suivi de celui podalique avec 11,18 % des cas. Le poids de l’enfant dans 63,90 % des cas etait compris entre 2500 et 3000 grammes. La letalite maternelle intra-hospitaliere en per et post-cesarienne etait de 0,81 %. La letalite neonatale intra-hospitaliere en per et post-cesarienne etait de 11,69 %. Dans 90,04 % des cas, ces deces avaient eu lieu dans les 24 heures. La cesarienne reste un element majeur pour reduire les besoins obstetricaux non couverts et pour reduire les morbi-mortalites maternelle et neonatale. La prise en compte des insuffisances constatees doit permettre d’ameliorer la qualite des soins et services offerts aux patientes beneficiant d’une cesarienne afin de reduire les besoins obstetricaux non couverts. Des donnees plus exhaustives sur les elements de causalite seront d’une aide significative a la reduction de la mortalite maternelle et neonatale. Il ressort du travail une augmentation de la proportion des accouchements par cesarienne au niveau de l’hopital de district. Une amelioration de la qualite de la realisation devrait permettre de reduire la mortalite maternelle et neonatale dans le district Mots-cles : Cesarienne, aspects cliniques, aspects therapeutiques, pronostic, soins obstetricaux et neonatals d’urgence, soins de qualite.
le Syndrome immunodeficitaire acquis (Sida) constitue l’une des epidemies les plus meurtrieres de... more le Syndrome immunodeficitaire acquis (Sida) constitue l’une des epidemies les plus meurtrieres de l’histoire de l’humanite. l’avenement des medicaments antiretroviraux(aRV) en modifiant l’histoire naturelle de la maladie, par l’amelioration de la survie des patients, les exposeraient a l’emergence des pathologies cardiovasculaires. Ce travail avait pour objectif de decrire les aspects epidemiologique, clinique, paraclinique et evolutif des affections cardio-vasculaires au cours de l’infection a Vih, et entrevoir les implications en sante publique. il s’est agi d’une etude retrospective realisee du 01 Janvier 2011 au 31 mars 2015, elle a inclus 91 patients Vih recrutes au Centre hospitalier universitaire Yalgado ouedraogo de ouagadougou, presentant des anomalies cliniques et/ou des facteurs de risque cardiovasculaires (FdRCV) evoquant une maladie cardiovasculaire. un bilan cardiologique etait realise en vue d’une confirmation. l’âge moyendes patients ayant presente une pathologie cardiovasculaire associant l’infection au Vih etait de 45 ± 10 ans avec les extremes de 20 et de 83 ans. il y avait 53 femmes (58,24 %) pour un sexe ratio homme / femme de 0,7. les sujets du niveau socio- economique faible etaient les plus representes avec une frequence de 56 % des cas. le tableau clinique cardiovasculaire etait domine par l’insuffisance cardiaque globale (28,57 %). les signes majeurs etaient la dyspnee, la douleur precordiale, la toux, la tachycardie et la grosse jambe douloureuse. les manifestations cardiovasculaires etaient diverses, les maladies thromboemboliques (48,35 %) etaient les plus representees. les atteintes myocardiques (17,59 %), les atteintes pericardiques (15,39 %) et les atteintes de l’endocarde (12,09 %) etaient notees en leurs proportions respectives. il est ressorti que 3,30 % des patients ont presente un infarctus du myocarde chez des patients vivant avec le Vih (PVVih) sous traitement antiretroviral (aRV). la mortalite hospitaliere etait de 14,29 %. au vu de leur frequence, de leur taux de deces et pour leur prise en charge precoce, les atteintes cardiovasculaires au cours de l’infection par le Vih seraient multiformes. une bonne connaissance de la question par le personnel medical et paramedical et une prise en charge precoce contribuerait a la reduction de letalite y afferente.Mots-cles : affection cardio-vasculaire, infection a Vih, traitement aRV, sante publique. Cardiovascular diseases and HIV infection in teaching hospital setting in Burkina Faso : epidemiological, clinical and progressive profile, and implications for public healthacquired immunodeficiency Syndrome (aidS) is one of most deadly epidemics in mankind history. The advent of antiretroviral drugs (aRV) has changed the natural history of the disease, through improving patients’ survival. This could therefore expose those patients to cardiovascular risks. The aim of this study was to describe the epidemiological, clinical, para-clinical and progressive aspects of cardiovascular diseases in hiV infection, and point out public health implications. it was a retrospective study, performed from January 1st to March 31st 2015. we enrolled 91 patients with clinical abnormalities and/or cardiovascular risk factors suggesting a cardiovascular disease from Yalgado ouedraogo university hospital of ouagadougou, Burkina Faso. The condition was confirmed through cardiologic investigations. Mean age of patients having a cardiovascular disease associated with hiV infection, was 45 ± 10 years with extremes of 20 and 83 years. Females accounted for 53 (58.24%) with a sex ratio of 0.7. People with low socioeconomic level 56%.Congestive heart failure was the main cardiovascular clinical presentation (28.57%). Major signs were dyspnoea, chest pain, cough, tachycardia and painful swollen leg. Cardiovascular manifestations were various, and thromboembolic diseases were the most represented (48.35%). Myocardial lesions (17.59%), pericardial lesions (15.39%) and endocardial lesions (12.09%) were reported in their respective proportions. about 3.30% patients living with hiV and under aRV treatment and having myocardial infarction () were identified. in-hospital mortality was 14.29%. Regarding their frequency, the mortality rate, and for early management, cardiovascular diseases during hiV infection could be various clinical forms. hence, there is a need for a good knowledge related to this issue by medical and paramedical staff in order to contribute for reducing it lethality.Keywords: Cardiovascular diseases, hiV infection, aRV treatment, public health.
Objective This study aimed to evaluate the seroprevalence of anti-SARS-CoV-2 IgG and factors asso... more Objective This study aimed to evaluate the seroprevalence of anti-SARS-CoV-2 IgG and factors associated with the infection among PLWHIV over the first 12 months following the outbreak of COVID-19 in Burkina Faso. Design A retrospective cross-sectional study of plasma samples collected from March 9, 2020, and March 8, 2021, at the outpatient HIV referral center, before the introduction of the SARS-CoV-2 vaccine in Burkina Faso. Methods Anti-SARS-CoV-2 IgG were detected in plasma using DS-ЕIA-ANTI-SARS-CoV-2-G (S) kit. Logistic regressions were used to compare SARS-CoV-2 specific immune responses between groups and within subgroups. Results and discussion A total of 419 plasma were subjected to serological diagnosis. None of the participants was vaccinated against COVID-19 during the period of sample collection, and 130 samples were positive for anti-SARS-CoV-2 IgG, giving a prevalence of 31.0% (95% CI 26.6–35.7). The median CD4 cell count was 661 cells/μL (IQR,422–928). Retailers had...
The American Journal of Tropical Medicine and Hygiene
To reduce child mortality in children younger than 5 years, Burkina Faso has been offering free c... more To reduce child mortality in children younger than 5 years, Burkina Faso has been offering free care to this population of children since 2016. The free care program is aligned with the Integrated Management of Childhood Illness (IMCI) guidelines. Given that the number of studies that evaluated the competence of health-care workers (HCWs) during the free care program was limited, we assessed the adherence level of HCWs to the IMCI guidelines in the context of free care. This was a secondary data analysis. Data were obtained from a cross-sectional study conducted from July to September 2020 in 40 primary health-care centers and two district hospitals in the Hauts-Bassins region in Burkina Faso. Our analysis included 419 children younger than 5 years old who were consulted according to IMCI guidelines. Data were collected through direct observation using a checklist. The overall score of adherence of HCWs to IMCI guidelines was 57.8% (95% CI, 42.6–73.0). The mean adherence score of th...
International journal of gynaecology and obstetrics, Jan 30, 2022
OBJECTIVE To assess the quality of the maternal death review (MDR) cycle in selected health facil... more OBJECTIVE To assess the quality of the maternal death review (MDR) cycle in selected health facilities in Burkina Faso in accordance with national standards. METHODS A multiple case study using a qualitative approach performed in five health districts and two regional hospital centers in Burkina Faso. The facilities were chosen by contrasted purposive sampling based on hospital maternal mortality rate and urban or rural location. Structured and semistructured interviews were conducted and data analyzed thematically, horizontally, and vertically. RESULTS Of the seven facilities included, six performed MDR. The MDR cycle was incomplete in five facilities because the implementation of recommendations had not been assessed. All cases of maternal death lacked vital information. Case analysis was not conducted in accordance with the national standards in most of the facilities. The action plans for implementing recommendations were not commonly used. CONCLUSION The MDR process and its various stages did not meet quality standards. Identifying the determinants leading to lack of adherence to MDR standards will contribute to optimal choice of interventions and improving good practices in health facilities.
The implementation of mass drug administration (MDA) campaigns of albendazole (400 mg) and iverme... more 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 ...
Introduction The satisfaction of users of the health facilities is common used in order to apprec... more Introduction The satisfaction of users of the health facilities is common used in order to appreciate quality of care. The objective of the present research was to study satisfaction of women inpatients from the care units of the Department of Gynecology, Obstetrics and Reproductive Medicine of the National teaching hospital Souro Sanou, in Bobo Dioulasso, Burkina Faso. Methods A cross-sectional analytical study conducted in 8 months. The areas of satisfaction were calculated according to the SAPHORA model (version 7). Results Two hundred (200) clients were eligible and were all interviewed, with the participation rate of 100.0%. The mean age of clients was 28.4 (95% CI: 27.3-29.5) years-old with extremes ranged from 15 to 56 years-old. The low score domains of satisfaction were: reception, catering and staff organization. The scores per domain of satisfaction and per service and the overall satisfaction score were less than 50%. The differences between the services were related to:...
La cesarienne est une intervention obstetricale majeure pratiquee en chirurgie obstetricale pour ... more La cesarienne est une intervention obstetricale majeure pratiquee en chirurgie obstetricale pour sauver la mere ou l’enfant. L’objectif de la presente etude etait d’etudier les aspects cliniques, therapeutiques et pronostics des cesariennes realisees a l’hopital de district de Orodara (HDO), de 2002 a 2013, au Burkina Faso. Il s’est agi d’une etude retrospective a visee descriptive ayant porte sur 2093 cas de cesariennes. Au cours des 12 annees d’etude, la proportion moyenne annuelle de realisation des cesariennes etait de 26,04 % (minimum de 5,83 % en 2003 et maximum de 47,42 % en 2012) et les cesariennes ont represente 46,89 % (minimum de 17,84 % en 2003 et maximum de 68,44% en 2013) des interventions realisees au bloc operatoire de l’HDO de Orodara. L’âge moyen des femmes cesarisees etait 22,73 ans [20,21 ; 25,52]. La tranche d’âge la plus representative etait celle de 20 a 24 ans (24,41%). Les indications de disproportion foeto-pelvienne (DFP) et de souffrance foetale (SF) etaient les plus retrouvees 47,33 % et 22,75 % respectivement. Il a ete realise seulement huit (08) cesariennes prophylactiques (soit 0,38 % des cas). La rachianesthesie a ete pratiquee en premiere intention (94,31 %). Le mode cephalique a ete le mode d’extraction plus observe soit 67,12 % des cas suivi de celui podalique avec 11,18 % des cas. Le poids de l’enfant dans 63,90 % des cas etait compris entre 2500 et 3000 grammes. La letalite maternelle intra-hospitaliere en per et post-cesarienne etait de 0,81 %. La letalite neonatale intra-hospitaliere en per et post-cesarienne etait de 11,69 %. Dans 90,04 % des cas, ces deces avaient eu lieu dans les 24 heures. La cesarienne reste un element majeur pour reduire les besoins obstetricaux non couverts et pour reduire les morbi-mortalites maternelle et neonatale. La prise en compte des insuffisances constatees doit permettre d’ameliorer la qualite des soins et services offerts aux patientes beneficiant d’une cesarienne afin de reduire les besoins obstetricaux non couverts. Des donnees plus exhaustives sur les elements de causalite seront d’une aide significative a la reduction de la mortalite maternelle et neonatale. Il ressort du travail une augmentation de la proportion des accouchements par cesarienne au niveau de l’hopital de district. Une amelioration de la qualite de la realisation devrait permettre de reduire la mortalite maternelle et neonatale dans le district Mots-cles : Cesarienne, aspects cliniques, aspects therapeutiques, pronostic, soins obstetricaux et neonatals d’urgence, soins de qualite.
le Syndrome immunodeficitaire acquis (Sida) constitue l’une des epidemies les plus meurtrieres de... more le Syndrome immunodeficitaire acquis (Sida) constitue l’une des epidemies les plus meurtrieres de l’histoire de l’humanite. l’avenement des medicaments antiretroviraux(aRV) en modifiant l’histoire naturelle de la maladie, par l’amelioration de la survie des patients, les exposeraient a l’emergence des pathologies cardiovasculaires. Ce travail avait pour objectif de decrire les aspects epidemiologique, clinique, paraclinique et evolutif des affections cardio-vasculaires au cours de l’infection a Vih, et entrevoir les implications en sante publique. il s’est agi d’une etude retrospective realisee du 01 Janvier 2011 au 31 mars 2015, elle a inclus 91 patients Vih recrutes au Centre hospitalier universitaire Yalgado ouedraogo de ouagadougou, presentant des anomalies cliniques et/ou des facteurs de risque cardiovasculaires (FdRCV) evoquant une maladie cardiovasculaire. un bilan cardiologique etait realise en vue d’une confirmation. l’âge moyendes patients ayant presente une pathologie cardiovasculaire associant l’infection au Vih etait de 45 ± 10 ans avec les extremes de 20 et de 83 ans. il y avait 53 femmes (58,24 %) pour un sexe ratio homme / femme de 0,7. les sujets du niveau socio- economique faible etaient les plus representes avec une frequence de 56 % des cas. le tableau clinique cardiovasculaire etait domine par l’insuffisance cardiaque globale (28,57 %). les signes majeurs etaient la dyspnee, la douleur precordiale, la toux, la tachycardie et la grosse jambe douloureuse. les manifestations cardiovasculaires etaient diverses, les maladies thromboemboliques (48,35 %) etaient les plus representees. les atteintes myocardiques (17,59 %), les atteintes pericardiques (15,39 %) et les atteintes de l’endocarde (12,09 %) etaient notees en leurs proportions respectives. il est ressorti que 3,30 % des patients ont presente un infarctus du myocarde chez des patients vivant avec le Vih (PVVih) sous traitement antiretroviral (aRV). la mortalite hospitaliere etait de 14,29 %. au vu de leur frequence, de leur taux de deces et pour leur prise en charge precoce, les atteintes cardiovasculaires au cours de l’infection par le Vih seraient multiformes. une bonne connaissance de la question par le personnel medical et paramedical et une prise en charge precoce contribuerait a la reduction de letalite y afferente.Mots-cles : affection cardio-vasculaire, infection a Vih, traitement aRV, sante publique. Cardiovascular diseases and HIV infection in teaching hospital setting in Burkina Faso : epidemiological, clinical and progressive profile, and implications for public healthacquired immunodeficiency Syndrome (aidS) is one of most deadly epidemics in mankind history. The advent of antiretroviral drugs (aRV) has changed the natural history of the disease, through improving patients’ survival. This could therefore expose those patients to cardiovascular risks. The aim of this study was to describe the epidemiological, clinical, para-clinical and progressive aspects of cardiovascular diseases in hiV infection, and point out public health implications. it was a retrospective study, performed from January 1st to March 31st 2015. we enrolled 91 patients with clinical abnormalities and/or cardiovascular risk factors suggesting a cardiovascular disease from Yalgado ouedraogo university hospital of ouagadougou, Burkina Faso. The condition was confirmed through cardiologic investigations. Mean age of patients having a cardiovascular disease associated with hiV infection, was 45 ± 10 years with extremes of 20 and 83 years. Females accounted for 53 (58.24%) with a sex ratio of 0.7. People with low socioeconomic level 56%.Congestive heart failure was the main cardiovascular clinical presentation (28.57%). Major signs were dyspnoea, chest pain, cough, tachycardia and painful swollen leg. Cardiovascular manifestations were various, and thromboembolic diseases were the most represented (48.35%). Myocardial lesions (17.59%), pericardial lesions (15.39%) and endocardial lesions (12.09%) were reported in their respective proportions. about 3.30% patients living with hiV and under aRV treatment and having myocardial infarction () were identified. in-hospital mortality was 14.29%. Regarding their frequency, the mortality rate, and for early management, cardiovascular diseases during hiV infection could be various clinical forms. hence, there is a need for a good knowledge related to this issue by medical and paramedical staff in order to contribute for reducing it lethality.Keywords: Cardiovascular diseases, hiV infection, aRV treatment, public health.
Objective This study aimed to evaluate the seroprevalence of anti-SARS-CoV-2 IgG and factors asso... more Objective This study aimed to evaluate the seroprevalence of anti-SARS-CoV-2 IgG and factors associated with the infection among PLWHIV over the first 12 months following the outbreak of COVID-19 in Burkina Faso. Design A retrospective cross-sectional study of plasma samples collected from March 9, 2020, and March 8, 2021, at the outpatient HIV referral center, before the introduction of the SARS-CoV-2 vaccine in Burkina Faso. Methods Anti-SARS-CoV-2 IgG were detected in plasma using DS-ЕIA-ANTI-SARS-CoV-2-G (S) kit. Logistic regressions were used to compare SARS-CoV-2 specific immune responses between groups and within subgroups. Results and discussion A total of 419 plasma were subjected to serological diagnosis. None of the participants was vaccinated against COVID-19 during the period of sample collection, and 130 samples were positive for anti-SARS-CoV-2 IgG, giving a prevalence of 31.0% (95% CI 26.6–35.7). The median CD4 cell count was 661 cells/μL (IQR,422–928). Retailers had...
The American Journal of Tropical Medicine and Hygiene
To reduce child mortality in children younger than 5 years, Burkina Faso has been offering free c... more To reduce child mortality in children younger than 5 years, Burkina Faso has been offering free care to this population of children since 2016. The free care program is aligned with the Integrated Management of Childhood Illness (IMCI) guidelines. Given that the number of studies that evaluated the competence of health-care workers (HCWs) during the free care program was limited, we assessed the adherence level of HCWs to the IMCI guidelines in the context of free care. This was a secondary data analysis. Data were obtained from a cross-sectional study conducted from July to September 2020 in 40 primary health-care centers and two district hospitals in the Hauts-Bassins region in Burkina Faso. Our analysis included 419 children younger than 5 years old who were consulted according to IMCI guidelines. Data were collected through direct observation using a checklist. The overall score of adherence of HCWs to IMCI guidelines was 57.8% (95% CI, 42.6–73.0). The mean adherence score of th...
Uploads
Papers by Ziemle Clement Meda