Publications

" Our main objective is to develop and maintain over time a good expertise and infrastructure ensuring high quality training and clinical research."
Prof Halidou TINTO, PharmD, Msc, PhD Head of the CRUN

270 entries « ‹ 4 of 14 › »

2021
Journal Articles
	Daniel Chandramohan, Issaka Zongo, Issaka Sagara, Matthew Cairns, Rakiswendé-Serge Yerbanga, Modibo Diarra, Frédéric Niki`ema, Amadou Tapily, Frédéric Sompougdou, Djibrilla Issiaka, Charles Zoungrana, Koualy Sanogo, Alassane Haro, Mahamadou Kaya, Abdoul-Aziz Sienou, Seydou Traore, Almahamoudou Mahamar, Ismaila Thera, Kalifa Diarra, Amagana Dolo, Irene Kuepfer, Paul Snell, Paul Milligan, Christian Ockenhouse, Opokua Ofori-Anyinam, Halidou Tinto, Abdoulaye Djimde, Jean-Bosco Ouédraogo, Alassane Dicko, Brian Greenwood Seasonal malaria vaccination with or without seasonal malaria chemoprevention (Journal Article) In: N. Engl. J. Med., vol. 385, no. 11, pp. 1005–1017, 2021, ISSN: 1533-4406 0028-4793, (Copyright © 2021 Massachusetts Medical Society. Place: United States PMID: 34432975). (Abstract \| Links \| BibTeX \| Tags: Amodiaquine/therapeutic use, Antimalarials/adverse effects/therapeutic use, Burkina Faso/epidemiology, Chemoprevention, Combination, Combined Modality Therapy, Double-Blind Method, Drug Combinations, Drug Therapy, Falciparum/epidemiology/mortality/prevention & control, Febrile/etiology, Female, Hospitalization/statistics & numerical data, Humans, Infant, Malaria, Malaria Vaccines/administration & dosage/adverse effects, Male, Mali/epidemiology, Pyrimethamine/therapeutic use, Seasons, Seizures, Sulfadoxine/therapeutic use) Close @article{Chandramohan2021-qm, title = {Seasonal malaria vaccination with or without seasonal malaria chemoprevention}, author = {Daniel Chandramohan and Issaka Zongo and Issaka Sagara and Matthew Cairns and Rakiswend\'{e}-Serge Yerbanga and Modibo Diarra and Fr\'{e}d\'{e}ric Niki`ema and Amadou Tapily and Fr\'{e}d\'{e}ric Sompougdou and Djibrilla Issiaka and Charles Zoungrana and Koualy Sanogo and Alassane Haro and Mahamadou Kaya and Abdoul-Aziz Sienou and Seydou Traore and Almahamoudou Mahamar and Ismaila Thera and Kalifa Diarra and Amagana Dolo and Irene Kuepfer and Paul Snell and Paul Milligan and Christian Ockenhouse and Opokua Ofori-Anyinam and Halidou Tinto and Abdoulaye Djimde and Jean-Bosco Ou\'{e}draogo and Alassane Dicko and Brian Greenwood}, doi = {10.1056/NEJMoa2026330}, issn = {1533-4406 0028-4793}, year = {2021}, date = {2021-09-09}, urldate = {2021-09-09}, journal = {N. Engl. J. Med.}, volume = {385}, number = {11}, pages = {1005--1017}, publisher = {Massachusetts Medical Society}, abstract = {BACKGROUND: Malaria control remains a challenge in many parts of the Sahel and sub-Sahel regions of Africa. METHODS: We conducted an individually randomized, controlled trial to assess whether seasonal vaccination with RTS,S/AS01E 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. RESULTS: We randomly assigned 6861 children 5 to 17 months of age to receive sulfadoxine-pyrimethamine and amodiaquine (2287 children [chemoprevention-alone group]), RTS,S/AS01E (2288 children [vaccine-alone group]), or chemoprevention and RTS,S/AS01E (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/AS01E 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. CONCLUSIONS: Administration of RTS,S/AS01E 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.).}, note = {Copyright © 2021 Massachusetts Medical Society. Place: United States PMID: 34432975}, keywords = {Amodiaquine/therapeutic use, Antimalarials/adverse effects/therapeutic use, Burkina Faso/epidemiology, Chemoprevention, Combination, Combined Modality Therapy, Double-Blind Method, Drug Combinations, Drug Therapy, Falciparum/epidemiology/mortality/prevention \& control, Febrile/etiology, Female, Hospitalization/statistics \& numerical data, Humans, Infant, Malaria, Malaria Vaccines/administration \& dosage/adverse effects, Male, Mali/epidemiology, Pyrimethamine/therapeutic use, Seasons, Seizures, Sulfadoxine/therapeutic use}, pubstate = {published}, tppubtype = {article} } Close BACKGROUND: Malaria control remains a challenge in many parts of the Sahel and sub-Sahel regions of Africa. METHODS: We conducted an individually randomized, controlled trial to assess whether seasonal vaccination with RTS,S/AS01E 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. RESULTS: We randomly assigned 6861 children 5 to 17 months of age to receive sulfadoxine-pyrimethamine and amodiaquine (2287 children [chemoprevention-alone group]), RTS,S/AS01E (2288 children [vaccine-alone group]), or chemoprevention and RTS,S/AS01E (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/AS01E 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. CONCLUSIONS: Administration of RTS,S/AS01E 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.). Close doi:10.1056/NEJMoa2026330 Close
	Isidore Tiandiogo Traoré, Samiratou Ouedraogo, Dramane Kania, Firmin Nongodo Kaboré, Blahima Konaté, Rachel Médah, Hermann Badolo, Nathalie Rekeneire, Ariane Mamguem Kamga, Armel Poda, Arnaud Eric Diendere, Boukary Ouédraogo, Esperance Ouédraogo, Oumar Billa, Halidou Tinto, Tienhan Sandrine Dabakuyo-Yonli COVID-19 epidemiological, sociological and anthropological investigation: study protocol for a multidisciplinary mixed methods research in Burkina Faso (Journal Article) In: BMC Infect. Dis., vol. 21, no. 1, pp. 896, 2021, ISSN: 1471-2334, (© 2021. The Author(s). PMID: 34479501 PMCID: PMC8414025). (Abstract \| Links \| BibTeX \| Tags: Burkina Faso/epidemiology, Clinical epidemiology, COVID-19, Humans, Predictive score, Prospective Studies, Retrospective Studies, SARS-Cov-2, Sero-epidemiology, Socio-anthropology) Close @article{Traore2021-vr, title = {COVID-19 epidemiological, sociological and anthropological investigation: study protocol for a multidisciplinary mixed methods research in Burkina Faso}, author = {Isidore Tiandiogo Traor\'{e} and Samiratou Ouedraogo and Dramane Kania and Firmin Nongodo Kabor\'{e} and Blahima Konat\'{e} and Rachel M\'{e}dah and Hermann Badolo and Nathalie Rekeneire and Ariane Mamguem Kamga and Armel Poda and Arnaud Eric Diendere and Boukary Ou\'{e}draogo and Esperance Ou\'{e}draogo and Oumar Billa and Halidou Tinto and Tienhan Sandrine Dabakuyo-Yonli}, doi = {10.1186/s12879-021-06543-4}, issn = {1471-2334}, year = {2021}, date = {2021-09-03}, urldate = {2021-09-03}, journal = {BMC Infect. Dis.}, volume = {21}, number = {1}, pages = {896}, abstract = {BACKGROUND: The world has high hopes of vaccination against COVID-19 to protect the population, boost economies and return to normal life. Vaccination programmes are being rolled out in high income countries, but the pandemic continues to progress in many low-and middle-income countries (LMICs) despite implementation of strict hygiene measures. We aim to present a comprehensive research protocol that will generate epidemiological, sociological and anthropological data about the COVID-19 epidemic in Burkina Faso, a landlocked country in West Africa with scarce resources. METHODS: We will perform a multidisciplinary research using mixed methods in the two main cities in Burkina Faso (Ouagadougou and Bobo-Dioulasso). Data will be collected in the general population and in COVID-19 patients, caregivers and health care professionals in reference care centers: (i) to determine cumulative incidence of SARS-CoV-2 infection in the Burkinabe population using blood samples collected from randomly selected households according to the WHO-recommended protocol; (ii) develop a score to predict severe complications of COVID-19 in persons infected with SARS-CoV-2 using retrospective and prospective data; (iii) perform semi-structured interviews and direct observation on site, to describe and analyze the healthcare pathways and experiences of patients with COVID-19 attending reference care centers, and to identify the perceptions, acceptability and application of preventive strategies among the population. DISCUSSION: This study will generate comprehensive data that will contribute to improving COVID-19 response strategies in Burkina Faso. The lessons learned from the management of this epidemic may serve as examples to the country authorities to better design preventive strategies in the case of future epidemics or pandemics. The protocol was approved by the Ministry for Health (N° 2020-00952/MS/CAB/INSP/CM) and the Health Research Ethics Committee in Burkina Faso (N° 2020-8-140).}, note = {© 2021. The Author(s). PMID: 34479501 PMCID: PMC8414025}, keywords = {Burkina Faso/epidemiology, Clinical epidemiology, COVID-19, Humans, Predictive score, Prospective Studies, Retrospective Studies, SARS-Cov-2, Sero-epidemiology, Socio-anthropology}, pubstate = {published}, tppubtype = {article} } Close BACKGROUND: The world has high hopes of vaccination against COVID-19 to protect the population, boost economies and return to normal life. Vaccination programmes are being rolled out in high income countries, but the pandemic continues to progress in many low-and middle-income countries (LMICs) despite implementation of strict hygiene measures. We aim to present a comprehensive research protocol that will generate epidemiological, sociological and anthropological data about the COVID-19 epidemic in Burkina Faso, a landlocked country in West Africa with scarce resources. METHODS: We will perform a multidisciplinary research using mixed methods in the two main cities in Burkina Faso (Ouagadougou and Bobo-Dioulasso). Data will be collected in the general population and in COVID-19 patients, caregivers and health care professionals in reference care centers: (i) to determine cumulative incidence of SARS-CoV-2 infection in the Burkinabe population using blood samples collected from randomly selected households according to the WHO-recommended protocol; (ii) develop a score to predict severe complications of COVID-19 in persons infected with SARS-CoV-2 using retrospective and prospective data; (iii) perform semi-structured interviews and direct observation on site, to describe and analyze the healthcare pathways and experiences of patients with COVID-19 attending reference care centers, and to identify the perceptions, acceptability and application of preventive strategies among the population. DISCUSSION: This study will generate comprehensive data that will contribute to improving COVID-19 response strategies in Burkina Faso. The lessons learned from the management of this epidemic may serve as examples to the country authorities to better design preventive strategies in the case of future epidemics or pandemics. The protocol was approved by the Ministry for Health (N° 2020-00952/MS/CAB/INSP/CM) and the Health Research Ethics Committee in Burkina Faso (N° 2020-8-140). Close doi:10.1186/s12879-021-06543-4 Close
	Stephen A Roberts, Loretta Brabin, Halidou Tinto, Sabine Gies, Salou Diallo, Bernard Brabin Seasonal patterns of malaria, genital infection, nutritional and iron status in non-pregnant and pregnant adolescents in Burkina Faso: a secondary analysis of trial data (Journal Article) In: BMC Public Health, vol. 21, no. 1, pp. 1764, 2021, ISSN: 1471-2458, (© 2021. The Author(s). PMID: 34579679 PMCID: PMC8477466). (Abstract \| Links \| BibTeX \| Tags: Abnormal vaginal flora, Adolescents, Bacterial vaginosis, Body Mass Index, Burkina Faso/epidemiology, Child, Female, Humans, Iron, iron biomarkers, Malaria, Malaria/drug therapy/epidemiology, MUAC, Pregnancy, Seasons, Vagina) Close @article{Roberts2021-gg, title = {Seasonal patterns of malaria, genital infection, nutritional and iron status in non-pregnant and pregnant adolescents in Burkina Faso: a secondary analysis of trial data}, author = {Stephen A Roberts and Loretta Brabin and Halidou Tinto and Sabine Gies and Salou Diallo and Bernard Brabin}, doi = {10.1186/s12889-021-11819-0}, issn = {1471-2458}, year = {2021}, date = {2021-09-01}, urldate = {2021-09-01}, journal = {BMC Public Health}, volume = {21}, number = {1}, pages = {1764}, publisher = {Springer Science and Business Media LLC}, abstract = {BACKGROUND: Adolescents are considered at high risk of developing iron deficiency. Studies in children indicate that the prevalence of iron deficiency increased with malaria transmission, suggesting malaria seasonally may drive iron deficiency. This paper examines monthly seasonal infection patterns of malaria, abnormal vaginal flora, chorioamnionitis, antibiotic and antimalarial prescriptions, in relation to changes in iron biomarkers and nutritional indices in adolescents living in a rural area of Burkina Faso, in order to assess the requirement for seasonal infection control and nutrition interventions. METHODS: Data collected between April 2011 and January 2014 were available for an observational seasonal analysis, comprising scheduled visits for 1949 non-pregnant adolescents (≤19 years), (315 of whom subsequently became pregnant), enrolled in a randomised trial of periconceptional iron supplementation. Data from trial arms were combined. Body Iron Stores (BIS) were calculated using an internal regression for ferritin to allow for inflammation. At recruitment 11% had low BIS (\< 0 mg/kg). Continuous outcomes were fitted to a mixed-effects linear model with month, age and pregnancy status as fixed effect covariates and woman as a random effect. Dichotomous infection outcomes were fitted with analogous logistic regression models. RESULTS: Seasonal variation in malaria parasitaemia prevalence ranged between 18 and 70% in non-pregnant adolescents (P \< 0.001), peaking at 81% in those who became pregnant. Seasonal variation occurred in antibiotic prescription rates (0.7-1.8 prescriptions/100 weekly visits, P \< 0.001) and chorioamnionitis prevalence (range 15-68%, P = 0.026). Mucosal vaginal lactoferrin concentration was lower at the end of the wet season (range 2-22 μg/ml, P \< 0.016), when chorioamnionitis was least frequent. BIS fluctuated annually by up to 53.2% per year around the mean BIS (5.1 mg/kg(2), range 4.1-6.8 mg/kg), with low BIS (\< 0 mg/kg) of 8.7% in the dry and 9.8% in the wet seasons (P = 0.36). Median serum transferrin receptor increased during the wet season (P \< 0.001). Higher hepcidin concentration in the wet season corresponded with rising malaria prevalence and use of prescriptions, but with no change in BIS. Mean Body Mass Index and Mid-Upper-Arm-Circumference values peaked mid-dry season (both P \< 0.001). CONCLUSIONS: Our analysis supports preventive treatment of malaria among adolescents 15-19 years to decrease their disease burden, especially asymptomatic malaria. As BIS were adequate in most adolescents despite seasonal malaria, a requirement for programmatic iron supplementation was not substantiated.}, note = {© 2021. The Author(s). PMID: 34579679 PMCID: PMC8477466}, keywords = {Abnormal vaginal flora, Adolescents, Bacterial vaginosis, Body Mass Index, Burkina Faso/epidemiology, Child, Female, Humans, Iron, iron biomarkers, Malaria, Malaria/drug therapy/epidemiology, MUAC, Pregnancy, Seasons, Vagina}, pubstate = {published}, tppubtype = {article} } Close BACKGROUND: Adolescents are considered at high risk of developing iron deficiency. Studies in children indicate that the prevalence of iron deficiency increased with malaria transmission, suggesting malaria seasonally may drive iron deficiency. This paper examines monthly seasonal infection patterns of malaria, abnormal vaginal flora, chorioamnionitis, antibiotic and antimalarial prescriptions, in relation to changes in iron biomarkers and nutritional indices in adolescents living in a rural area of Burkina Faso, in order to assess the requirement for seasonal infection control and nutrition interventions. METHODS: Data collected between April 2011 and January 2014 were available for an observational seasonal analysis, comprising scheduled visits for 1949 non-pregnant adolescents (≤19 years), (315 of whom subsequently became pregnant), enrolled in a randomised trial of periconceptional iron supplementation. Data from trial arms were combined. Body Iron Stores (BIS) were calculated using an internal regression for ferritin to allow for inflammation. At recruitment 11% had low BIS (< 0 mg/kg). Continuous outcomes were fitted to a mixed-effects linear model with month, age and pregnancy status as fixed effect covariates and woman as a random effect. Dichotomous infection outcomes were fitted with analogous logistic regression models. RESULTS: Seasonal variation in malaria parasitaemia prevalence ranged between 18 and 70% in non-pregnant adolescents (P < 0.001), peaking at 81% in those who became pregnant. Seasonal variation occurred in antibiotic prescription rates (0.7-1.8 prescriptions/100 weekly visits, P < 0.001) and chorioamnionitis prevalence (range 15-68%, P = 0.026). Mucosal vaginal lactoferrin concentration was lower at the end of the wet season (range 2-22 μg/ml, P < 0.016), when chorioamnionitis was least frequent. BIS fluctuated annually by up to 53.2% per year around the mean BIS (5.1 mg/kg(2), range 4.1-6.8 mg/kg), with low BIS (< 0 mg/kg) of 8.7% in the dry and 9.8% in the wet seasons (P = 0.36). Median serum transferrin receptor increased during the wet season (P < 0.001). Higher hepcidin concentration in the wet season corresponded with rising malaria prevalence and use of prescriptions, but with no change in BIS. Mean Body Mass Index and Mid-Upper-Arm-Circumference values peaked mid-dry season (both P < 0.001). CONCLUSIONS: Our analysis supports preventive treatment of malaria among adolescents 15-19 years to decrease their disease burden, especially asymptomatic malaria. As BIS were adequate in most adolescents despite seasonal malaria, a requirement for programmatic iron supplementation was not substantiated. Close doi:10.1186/s12889-021-11819-0 Close
	Adéla"ide Compaoré, Kadija Ouedraogo, Palwende R Boua, Daniella Watson, Sarah H Kehoe, Marie-Louise Newell, Halidou Tinto, Mary Barker, Hermann Sorgho, INPreP group ‘Men are not playing their roles’, maternal and child nutrition in Nanoro, Burkina Faso (Journal Article) In: Public Health Nutr., vol. 24, no. 12, pp. 3780–3790, 2021, ISSN: 1475-2727 1368-9800, (Place: England PMID: 33000717). (Abstract \| Links \| BibTeX \| Tags: Burkina Faso, Child, Child nutrition, Child Nutritional Physiological Phenomena, Community perceptions, Empowerment, Female, Humans, Male, Maternal nutrition, Mothers, Nutritional Status, Pregnancy, Qualitative research) Close @article{Compaore2021-hg, title = {'Men are not playing their roles', maternal and child nutrition in Nanoro, Burkina Faso}, author = {Ad\'{e}la"ide Compaor\'{e} and Kadija Ouedraogo and Palwende R Boua and Daniella Watson and Sarah H Kehoe and Marie-Louise Newell and Halidou Tinto and Mary Barker and Hermann Sorgho and INPreP group}, doi = {10.1017/S1368980020003365}, issn = {1475-2727 1368-9800}, year = {2021}, date = {2021-08-01}, urldate = {2021-08-01}, journal = {Public Health Nutr.}, volume = {24}, number = {12}, pages = {3780--3790}, publisher = {Cambridge University Press (CUP)}, abstract = {OBJECTIVE: To collect context-specific insights into maternal and child health and nutrition issues, and to explore potential solutions in Nanoro, Burkina Faso. DESIGN: Eleven focus groups with men and women from eleven communities, facilitated by local researchers. SETTING: The study took place in the Nanoro Health district, in the West-Central part of Burkina Faso. PARTICIPANTS: Eighty-six men (18-55 years) and women by age group: 18-25; 26-34 and 35-55 years, participated in the group discussions. RESULTS: Participants described barriers to optimal nutrition of mothers and children related to a range of community factors, with gender inequality as central. Major themes in the discussions are related to poverty and challenges generated by socially and culturally determined gender roles. Sub-themes are women lacking access to food whilst pregnant and having limited access to health care and opportunities to generate income. Although communities believe that food donations should be implemented to overcome this, they also pointed out the need for enhancing their own food production, requiring improved agricultural technologies. Given the important role that women could play in reducing malnutrition, these communities felt they needed to be empowered to do so and supported by men. They also felt that this had to be carried out in the context of an enhanced health care system. CONCLUSIONS: Findings reported here highlight the importance of nutrition-sensitive interventions and women's empowerment in improving maternal and child nutrition. There is a need to integrate a sustainable multi-sectorial approach which goes beyond food support.}, note = {Place: England PMID: 33000717}, keywords = {Burkina Faso, Child, Child nutrition, Child Nutritional Physiological Phenomena, Community perceptions, Empowerment, Female, Humans, Male, Maternal nutrition, Mothers, Nutritional Status, Pregnancy, Qualitative research}, pubstate = {published}, tppubtype = {article} } Close OBJECTIVE: To collect context-specific insights into maternal and child health and nutrition issues, and to explore potential solutions in Nanoro, Burkina Faso. DESIGN: Eleven focus groups with men and women from eleven communities, facilitated by local researchers. SETTING: The study took place in the Nanoro Health district, in the West-Central part of Burkina Faso. PARTICIPANTS: Eighty-six men (18-55 years) and women by age group: 18-25; 26-34 and 35-55 years, participated in the group discussions. RESULTS: Participants described barriers to optimal nutrition of mothers and children related to a range of community factors, with gender inequality as central. Major themes in the discussions are related to poverty and challenges generated by socially and culturally determined gender roles. Sub-themes are women lacking access to food whilst pregnant and having limited access to health care and opportunities to generate income. Although communities believe that food donations should be implemented to overcome this, they also pointed out the need for enhancing their own food production, requiring improved agricultural technologies. Given the important role that women could play in reducing malnutrition, these communities felt they needed to be empowered to do so and supported by men. They also felt that this had to be carried out in the context of an enhanced health care system. CONCLUSIONS: Findings reported here highlight the importance of nutrition-sensitive interventions and women’s empowerment in improving maternal and child nutrition. There is a need to integrate a sustainable multi-sectorial approach which goes beyond food support. Close doi:10.1017/S1368980020003365 Close
	Koudraogo Bienvenue Yaméogo, Rakiswendé Serge Yerbanga, Seydou Bienvenu Ouattara, Franck A Yao, Thierry Lef`evre, Issaka Zongo, Frederic Niki`ema, Yves Daniel Compaoré, Halidou Tinto, Daniel Chandramohan, Brian Greenwood, Adrien M G Belem, Anna Cohuet, Jean Bosco Ouédraogo Effect of seasonal malaria chemoprevention plus azithromycin on Plasmodium falciparum transmission: gametocyte infectivity and mosquito fitness (Journal Article) In: Malar. J., vol. 20, no. 1, pp. 326, 2021, ISSN: 1475-2875, (© 2021. The Author(s). PMID: 34315475 PMCID: PMC8314489). (Abstract \| Links \| BibTeX \| Tags: Amodiaquine/administration & dosage, Animals, Antimalarials/administration & dosage, Chemoprevention, Child, Culicidae/physiology, Drug Combinations, Falciparum/prevention & control/transmission, Gametocytes, Genetic Fitness, Humans, Malaria, Plasmodium falciparum/physiology, Preschool, Pyrimethamine/administration & dosage, seasonal malaria chemoprevention, Seasons, Sulfadoxine/administration & dosage, Transmission) Close @article{Yameogo2021-bb, title = {Effect of seasonal malaria chemoprevention plus azithromycin on Plasmodium falciparum transmission: gametocyte infectivity and mosquito fitness}, author = {Koudraogo Bienvenue Yam\'{e}ogo and Rakiswend\'{e} Serge Yerbanga and Seydou Bienvenu Ouattara and Franck A Yao and Thierry Lef`evre and Issaka Zongo and Frederic Niki`ema and Yves Daniel Compaor\'{e} and Halidou Tinto and Daniel Chandramohan and Brian Greenwood and Adrien M G Belem and Anna Cohuet and Jean Bosco Ou\'{e}draogo}, doi = {10.1186/s12936-021-03855-3}, issn = {1475-2875}, year = {2021}, date = {2021-07-27}, urldate = {2021-07-27}, journal = {Malar. J.}, volume = {20}, number = {1}, pages = {326}, publisher = {Springer Science and Business Media LLC}, abstract = {BACKGROUND: Seasonal malaria chemoprevention (SMC) consists of administration of sulfadoxine-pyrimethamine (SP) + amodiaquine (AQ) at monthly intervals to children during the malaria transmission period. Whether the addition of azithromycin (AZ) to SMC could potentiate the benefit of the intervention was tested through a double-blind, randomized, placebo-controlled trial. The effect of SMC and the addition of AZ, on malaria transmission and on the life history traits of Anopheles gambiae mosquitoes have been investigated. METHODS: The study included 438 children randomly selected from among participants in the SMC + AZ trial and 198 children from the same area who did not receive chemoprevention. For each participant in the SMC + AZ trial, blood was collected 14 to 21 days post treatment, examined for the presence of malaria sexual and asexual stages and provided as a blood meal to An. gambiae females using a direct membrane-feeding assay. RESULTS: The SMC treatment, with or without AZ, significantly reduced the prevalence of asexual Plasmodium falciparum (LRT X(2)(2) = 69, P \< 0.0001) and the gametocyte prevalence (LRT X(2)(2) = 54, P \< 0.0001). In addition, the proportion of infectious feeds (LRT X(2)(2) = 61, P \< 0.0001) and the prevalence of oocysts among exposed mosquitoes (LRT X(2)(2) = 22.8, P \< 0.001) was reduced when mosquitoes were fed on blood from treated children compared to untreated controls. The addition of AZ to SPAQ was associated with an increased proportion of infectious feeds (LRT X(2)(1) = 5.2, P = 0.02), suggesting a significant effect of AZ on gametocyte infectivity. There was a slight negative effect of SPAQ and SPAQ + AZ on mosquito survival compared to mosquitoes fed with blood from control children (LRTX(2)(2) = 330, P \< 0.0001). CONCLUSION: This study demonstrates that SMC may contribute to a reduction in human to mosquito transmission of P. falciparum, and the reduced mosquito longevity observed for females fed on treated blood may increase the benefit of this intervention in control of malaria. The addition of AZ to SPAQ in SMC appeared to enhance the infectivity of gametocytes providing further evidence that this combination is not an appropriate intervention.}, note = {© 2021. The Author(s). PMID: 34315475 PMCID: PMC8314489}, keywords = {Amodiaquine/administration \& dosage, Animals, Antimalarials/administration \& dosage, Chemoprevention, Child, Culicidae/physiology, Drug Combinations, Falciparum/prevention \& control/transmission, Gametocytes, Genetic Fitness, Humans, Malaria, Plasmodium falciparum/physiology, Preschool, Pyrimethamine/administration \& dosage, seasonal malaria chemoprevention, Seasons, Sulfadoxine/administration \& dosage, Transmission}, pubstate = {published}, tppubtype = {article} } Close BACKGROUND: Seasonal malaria chemoprevention (SMC) consists of administration of sulfadoxine-pyrimethamine (SP) + amodiaquine (AQ) at monthly intervals to children during the malaria transmission period. Whether the addition of azithromycin (AZ) to SMC could potentiate the benefit of the intervention was tested through a double-blind, randomized, placebo-controlled trial. The effect of SMC and the addition of AZ, on malaria transmission and on the life history traits of Anopheles gambiae mosquitoes have been investigated. METHODS: The study included 438 children randomly selected from among participants in the SMC + AZ trial and 198 children from the same area who did not receive chemoprevention. For each participant in the SMC + AZ trial, blood was collected 14 to 21 days post treatment, examined for the presence of malaria sexual and asexual stages and provided as a blood meal to An. gambiae females using a direct membrane-feeding assay. RESULTS: The SMC treatment, with or without AZ, significantly reduced the prevalence of asexual Plasmodium falciparum (LRT X(2)(2) = 69, P < 0.0001) and the gametocyte prevalence (LRT X(2)(2) = 54, P < 0.0001). In addition, the proportion of infectious feeds (LRT X(2)(2) = 61, P < 0.0001) and the prevalence of oocysts among exposed mosquitoes (LRT X(2)(2) = 22.8, P < 0.001) was reduced when mosquitoes were fed on blood from treated children compared to untreated controls. The addition of AZ to SPAQ was associated with an increased proportion of infectious feeds (LRT X(2)(1) = 5.2, P = 0.02), suggesting a significant effect of AZ on gametocyte infectivity. There was a slight negative effect of SPAQ and SPAQ + AZ on mosquito survival compared to mosquitoes fed with blood from control children (LRTX(2)(2) = 330, P < 0.0001). CONCLUSION: This study demonstrates that SMC may contribute to a reduction in human to mosquito transmission of P. falciparum, and the reduced mosquito longevity observed for females fed on treated blood may increase the benefit of this intervention in control of malaria. The addition of AZ to SPAQ in SMC appeared to enhance the infectivity of gametocytes providing further evidence that this combination is not an appropriate intervention. Close doi:10.1186/s12936-021-03855-3 Close
	Navideh Noori, Karim Derra, Innocent Valea, Assaf P Oron, Aminata Welgo, Toussaint Rouamba, Palwende Romuald Boua, Athanase M Somé, Eli Rouamba, Edward Wenger, Hermann Sorgho, Halidou Tinto, Andre Lin Ouédraogo Patterns of child mortality in rural area of Burkina Faso: evidence from the Nanoro health and demographic surveillance system (HDSS) (Journal Article) In: BMC Public Health, vol. 21, no. 1, pp. 1425, 2021, ISSN: 1471-2458, (© 2021. The Author(s). PMID: 34281547 PMCID: PMC8287796). (Abstract \| Links \| BibTeX \| Tags: Burkina Faso, Burkina Faso/epidemiology, child mortality, ChildHealth Facilities, Children under 5, Demographic surveillance, HDSS, Humans, Infant, Malaria, Nanoro, Spatial analysis, Travel) Close @article{Noori2021-te, title = {Patterns of child mortality in rural area of Burkina Faso: evidence from the Nanoro health and demographic surveillance system (HDSS)}, author = {Navideh Noori and Karim Derra and Innocent Valea and Assaf P Oron and Aminata Welgo and Toussaint Rouamba and Palwende Romuald Boua and Athanase M Som\'{e} and Eli Rouamba and Edward Wenger and Hermann Sorgho and Halidou Tinto and Andre Lin Ou\'{e}draogo}, doi = {10.1186/s12889-021-11483-4}, issn = {1471-2458}, year = {2021}, date = {2021-07-19}, urldate = {2021-07-19}, journal = {BMC Public Health}, volume = {21}, number = {1}, pages = {1425}, publisher = {Springer Science and Business Media LLC}, abstract = {BACKGROUND: Half of global child deaths occur in sub-Saharan Africa. Understanding child mortality patterns and risk factors will help inform interventions to reduce this heavy toll. The Nanoro Health and Demographic Surveillance System (HDSS), Burkina Faso was described previously, but patterns and potential drivers of heterogeneity in child mortality in the district had not been studied. Similar studies in other districts indicated proximity to health facilities as a risk factor, usually without distinction between facility types. METHODS: Using Nanoro HDSS data from 2009 to 2013, we estimated the association between under-5 mortality and proximity to inpatient and outpatient health facilities, seasonality of death, age group, and standard demographic risk factors. RESULTS: Living in homes 40-60 min and \> 60 min travel time from an inpatient facility was associated with 1.52 (95% CI: 1.13-2.06) and 1.74 (95% CI: 1.27-2.40) greater hazard of under-5 mortality, respectively, than living in homes \< 20 min from an inpatient facility. No such association was found for outpatient facilities. The wet season (July-November) was associated with 1.28 (95% CI: 1.07, 1.53) higher under-5 mortality than the dry season (December-June), likely reflecting the malaria season. CONCLUSIONS: Our results emphasize the importance of geographical proximity to health care, distinguish between inpatient and outpatient facilities, and also show a seasonal effect, probably driven by malaria.}, note = {© 2021. The Author(s). PMID: 34281547 PMCID: PMC8287796}, keywords = {Burkina Faso, Burkina Faso/epidemiology, child mortality, ChildHealth Facilities, Children under 5, Demographic surveillance, HDSS, Humans, Infant, Malaria, Nanoro, Spatial analysis, Travel}, pubstate = {published}, tppubtype = {article} } Close BACKGROUND: Half of global child deaths occur in sub-Saharan Africa. Understanding child mortality patterns and risk factors will help inform interventions to reduce this heavy toll. The Nanoro Health and Demographic Surveillance System (HDSS), Burkina Faso was described previously, but patterns and potential drivers of heterogeneity in child mortality in the district had not been studied. Similar studies in other districts indicated proximity to health facilities as a risk factor, usually without distinction between facility types. METHODS: Using Nanoro HDSS data from 2009 to 2013, we estimated the association between under-5 mortality and proximity to inpatient and outpatient health facilities, seasonality of death, age group, and standard demographic risk factors. RESULTS: Living in homes 40-60 min and > 60 min travel time from an inpatient facility was associated with 1.52 (95% CI: 1.13-2.06) and 1.74 (95% CI: 1.27-2.40) greater hazard of under-5 mortality, respectively, than living in homes < 20 min from an inpatient facility. No such association was found for outpatient facilities. The wet season (July-November) was associated with 1.28 (95% CI: 1.07, 1.53) higher under-5 mortality than the dry season (December-June), likely reflecting the malaria season. CONCLUSIONS: Our results emphasize the importance of geographical proximity to health care, distinguish between inpatient and outpatient facilities, and also show a seasonal effect, probably driven by malaria. Close doi:10.1186/s12889-021-11483-4 Close
	Marie Jaspard, Mamadou Saliou Sow, Sylvain Juchet, Eric Dienderé, Beatrice Serra, Richard Kojan, Billy Sivahera, Caroline Martin, Moumouni Kinda, Hans-Joerg Lang, Fodé Bangaly Sako, Fodé Amara Traoré, Eudoxie Koumbem, Halidou Tinto, Adama Sanou, Apoline Sondo, Flavien Kaboré, Joseph Donamou, Jean-Paul-Yassa Guilavogui, Fanny Velardo, Brice Bicaba, Olivier Marcy, Augustin Augier, Sani Sayadi, Armel Poda, Sakoba Keita, Xavier Anglaret, Denis Malvy, COVISTA group Clinical presentation, outcomes and factors associated with mortality: A prospective study from three COVID-19 referral care centres in West Africa (Journal Article) In: Int. J. Infect. Dis., vol. 108, pp. 45–52, 2021, ISSN: 1878-3511 1201-9712, (Copyright © 2021 The Authors. Published by Elsevier Ltd.. All rights reserved. PMID: 34000419 PMCID: PMC8120805). (Abstract \| Links \| BibTeX \| Tags: Adult, Aged, Burkina Faso/epidemiology, Comorbidities, COVID-19, Female, Hospitalization, Humans, Male, Mortality, Prospective Studies, Referral and Consultation, SARS-Cov-2, sub-Saharan Africa) Close @article{Jaspard2021-bl, title = {Clinical presentation, outcomes and factors associated with mortality: A prospective study from three COVID-19 referral care centres in West Africa}, author = {Marie Jaspard and Mamadou Saliou Sow and Sylvain Juchet and Eric Diender\'{e} and Beatrice Serra and Richard Kojan and Billy Sivahera and Caroline Martin and Moumouni Kinda and Hans-Joerg Lang and Fod\'{e} Bangaly Sako and Fod\'{e} Amara Traor\'{e} and Eudoxie Koumbem and Halidou Tinto and Adama Sanou and Apoline Sondo and Flavien Kabor\'{e} and Joseph Donamou and Jean-Paul-Yassa Guilavogui and Fanny Velardo and Brice Bicaba and Olivier Marcy and Augustin Augier and Sani Sayadi and Armel Poda and Sakoba Keita and Xavier Anglaret and Denis Malvy and COVISTA group}, doi = {10.1016/j.ijid.2021.05.024}, issn = {1878-3511 1201-9712}, year = {2021}, date = {2021-07-01}, urldate = {2021-07-01}, journal = {Int. J. Infect. Dis.}, volume = {108}, pages = {45--52}, publisher = {Elsevier BV}, abstract = {OBJECTIVES: The overall death toll from COVID-19 in Africa is reported to be low but there is little individual-level evidence on the severity of the disease. This study examined the clinical spectrum and outcome of patients monitored in COVID-19 care centres (CCCs) in two West-African countries. METHODS: Burkina Faso and Guinea set up referral CCCs to hospitalise all symptomatic SARS-CoV-2 carriers, regardless of the severity of their symptoms. Data collected from hospitalised patients by November 2020 are presented. RESULT: A total of 1,805 patients (64% men, median age 41 years) were admitted with COVID-19. Symptoms lasted for a median of 7 days (IQR 4-11). During hospitalisation, 443 (25%) had a SpO2 \< 94% at least once, 237 (13%) received oxygen and 266 (15%) took corticosteroids. Mortality was 5% overall, and 1%, 5% and 14% in patients aged \<40, 40-59 and $geq$60 years, respectively. In multivariable analysis, the risk of death was higher in men (aOR 2.0, 95% CI 1.1; 3.6), people aged $geq$60 years (aOR 2.9, 95% CI 1.7; 4.8) and those with chronic hypertension (aOR 2.1, 95% CI 1.2; 3.4). CONCLUSION: COVID-19 is as severe in Africa as elsewhere, and there must be more vigilance for common risk factors such as older age and hypertension.}, note = {Copyright © 2021 The Authors. Published by Elsevier Ltd.. All rights reserved. PMID: 34000419 PMCID: PMC8120805}, keywords = {Adult, Aged, Burkina Faso/epidemiology, Comorbidities, COVID-19, Female, Hospitalization, Humans, Male, Mortality, Prospective Studies, Referral and Consultation, SARS-Cov-2, sub-Saharan Africa}, pubstate = {published}, tppubtype = {article} } Close OBJECTIVES: The overall death toll from COVID-19 in Africa is reported to be low but there is little individual-level evidence on the severity of the disease. This study examined the clinical spectrum and outcome of patients monitored in COVID-19 care centres (CCCs) in two West-African countries. METHODS: Burkina Faso and Guinea set up referral CCCs to hospitalise all symptomatic SARS-CoV-2 carriers, regardless of the severity of their symptoms. Data collected from hospitalised patients by November 2020 are presented. RESULT: A total of 1,805 patients (64% men, median age 41 years) were admitted with COVID-19. Symptoms lasted for a median of 7 days (IQR 4-11). During hospitalisation, 443 (25%) had a SpO2 < 94% at least once, 237 (13%) received oxygen and 266 (15%) took corticosteroids. Mortality was 5% overall, and 1%, 5% and 14% in patients aged <40, 40-59 and $geq$60 years, respectively. In multivariable analysis, the risk of death was higher in men (aOR 2.0, 95% CI 1.1; 3.6), people aged $geq$60 years (aOR 2.9, 95% CI 1.7; 4.8) and those with chronic hypertension (aOR 2.1, 95% CI 1.2; 3.4). CONCLUSION: COVID-19 is as severe in Africa as elsewhere, and there must be more vigilance for common risk factors such as older age and hypertension. Close doi:10.1016/j.ijid.2021.05.024 Close
	Mariken Wit, Matthew Cairns, Yves Daniel Compaoré, Issaka Sagara, Irene Kuepfer, Issaka Zongo, Amadou Barry, Modibo Diarra, Amadou Tapily, Samba Coumare, Ismaila Thera, Frederic Nikiema, R Serge Yerbanga, Rosemonde M Guissou, Halidou Tinto, Alassane Dicko, Daniel Chandramohan, Brian Greenwood, Jean Bosco Ouedraogo Nutritional status in young children prior to the malaria transmission season in Burkina Faso and Mali, and its impact on the incidence of clinical malaria (Journal Article) In: Malar. J., vol. 20, no. 1, pp. 274, 2021, ISSN: 1475-2875, (PMID: 34158054 PMCID: PMC8220741). (Abstract \| Links \| BibTeX \| Tags: Acute malnutrition, Antimalarials/administration & dosage, Azithromycin/administration & dosage, Burkina Faso, Burkina Faso/epidemiology, Child, Chronic malnutrition, Female, Humans, Incidence, Infant, Malaria, Malaria/epidemiology/transmission, Male, Nutritional Status, Preschool, seasonal malaria chemoprevention, Seasons) Close @article{De_Wit2021-yi, title = {Nutritional status in young children prior to the malaria transmission season in Burkina Faso and Mali, and its impact on the incidence of clinical malaria}, author = {Mariken Wit and Matthew Cairns and Yves Daniel Compaor\'{e} and Issaka Sagara and Irene Kuepfer and Issaka Zongo and Amadou Barry and Modibo Diarra and Amadou Tapily and Samba Coumare and Ismaila Thera and Frederic Nikiema and R Serge Yerbanga and Rosemonde M Guissou and Halidou Tinto and Alassane Dicko and Daniel Chandramohan and Brian Greenwood and Jean Bosco Ouedraogo}, doi = {10.1186/s12936-021-03802-2}, issn = {1475-2875}, year = {2021}, date = {2021-06-22}, urldate = {2021-06-22}, journal = {Malar. J.}, volume = {20}, number = {1}, pages = {274}, publisher = {Springer Science and Business Media LLC}, abstract = {BACKGROUND: Malaria and malnutrition remain major problems in Sahel countries, especially in young children. The direct effect of malnutrition on malaria remains poorly understood, and may have important implications for malaria control. In this study, nutritional status and the association between malnutrition and subsequent incidence of symptomatic malaria were examined in children in Burkina Faso and Mali who received either azithromycin or placebo, alongside seasonal malaria chemoprevention. METHODS: Mid-upper arm circumference (MUAC) was measured in all 20,185 children who attended a screening visit prior to the malaria transmission season in 2015. Prior to the 2016 malaria season, weight, height and MUAC were measured among 4149 randomly selected children. Height-for-age, weight-for-age, weight-for-height, and MUAC-for-age were calculated as indicators of nutritional status. Malaria incidence was measured during the following rainy seasons. Multivariable random effects Poisson models were created for each nutritional indicator to study the effect of malnutrition on clinical malaria incidence for each country. RESULTS: In both 2015 and 2016, nutritional status prior to the malaria season was poor. The most prevalent form of malnutrition in Burkina Faso was being underweight (30.5%; 95% CI 28.6-32.6), whereas in Mali stunting was most prevalent (27.5%; 95% CI 25.6-29.5). In 2016, clinical malaria incidence was 675 per 1000 person-years (95% CI 613-744) in Burkina Faso, and 1245 per 1000 person-years (95% CI 1152-1347) in Mali. There was some evidence that severe stunting was associated with lower incidence of malaria in Mali (RR 0.81; 95% CI 0.64-1.02; p = 0.08), but this association was not seen in Burkina Faso. Being moderately underweight tended to be associated with higher incidence of clinical malaria in Burkina Faso (RR 1.27; 95% CI 0.98-1.64; p = 0.07), while this was the case in Mali for moderate wasting (RR 1.27; 95% CI 0.98-1.64; p = 0.07). However, these associations were not observed in severely affected children, nor consistent between countries. MUAC-for-age was not associated with malaria risk. CONCLUSIONS: Both malnutrition and malaria were common in the study areas, high despite high coverage of seasonal malaria chemoprevention and long-lasting insecticidal nets. However, no strong or consistent evidence was found for an association between any of the nutritional indicators and the subsequent incidence of clinical malaria.}, note = {PMID: 34158054 PMCID: PMC8220741}, keywords = {Acute malnutrition, Antimalarials/administration \& dosage, Azithromycin/administration \& dosage, Burkina Faso, Burkina Faso/epidemiology, Child, Chronic malnutrition, Female, Humans, Incidence, Infant, Malaria, Malaria/epidemiology/transmission, Male, Nutritional Status, Preschool, seasonal malaria chemoprevention, Seasons}, pubstate = {published}, tppubtype = {article} } Close BACKGROUND: Malaria and malnutrition remain major problems in Sahel countries, especially in young children. The direct effect of malnutrition on malaria remains poorly understood, and may have important implications for malaria control. In this study, nutritional status and the association between malnutrition and subsequent incidence of symptomatic malaria were examined in children in Burkina Faso and Mali who received either azithromycin or placebo, alongside seasonal malaria chemoprevention. METHODS: Mid-upper arm circumference (MUAC) was measured in all 20,185 children who attended a screening visit prior to the malaria transmission season in 2015. Prior to the 2016 malaria season, weight, height and MUAC were measured among 4149 randomly selected children. Height-for-age, weight-for-age, weight-for-height, and MUAC-for-age were calculated as indicators of nutritional status. Malaria incidence was measured during the following rainy seasons. Multivariable random effects Poisson models were created for each nutritional indicator to study the effect of malnutrition on clinical malaria incidence for each country. RESULTS: In both 2015 and 2016, nutritional status prior to the malaria season was poor. The most prevalent form of malnutrition in Burkina Faso was being underweight (30.5%; 95% CI 28.6-32.6), whereas in Mali stunting was most prevalent (27.5%; 95% CI 25.6-29.5). In 2016, clinical malaria incidence was 675 per 1000 person-years (95% CI 613-744) in Burkina Faso, and 1245 per 1000 person-years (95% CI 1152-1347) in Mali. There was some evidence that severe stunting was associated with lower incidence of malaria in Mali (RR 0.81; 95% CI 0.64-1.02; p = 0.08), but this association was not seen in Burkina Faso. Being moderately underweight tended to be associated with higher incidence of clinical malaria in Burkina Faso (RR 1.27; 95% CI 0.98-1.64; p = 0.07), while this was the case in Mali for moderate wasting (RR 1.27; 95% CI 0.98-1.64; p = 0.07). However, these associations were not observed in severely affected children, nor consistent between countries. MUAC-for-age was not associated with malaria risk. CONCLUSIONS: Both malnutrition and malaria were common in the study areas, high despite high coverage of seasonal malaria chemoprevention and long-lasting insecticidal nets. However, no strong or consistent evidence was found for an association between any of the nutritional indicators and the subsequent incidence of clinical malaria. Close doi:10.1186/s12936-021-03802-2 Close
	Paul Sondo, Biebo Bihoun, Bérenger Kabore, Marc Christian Tahita, Karim Derra, Toussaint Rouamba, Seydou Nakanabo Diallo, Adama Kazienga, Hamidou Ilboudo, Innocent Valea, Zekiba Tarnagda, Hermann Sorgho, Thierry Lefevre, Halidou Tinto Polymorphisms in Plasmodium falciparum parasites and mutations in the resistance genes Pfcrt and Pfmdr1 in Nanoro area, Burkina Faso. (Journal Article) In: Pan Afr. Med. J., vol. 39, pp. 118, 2021, ISSN: 1937-8688, (Copyright: Paul Sondo et al. PMID: 34512854 PMCID: PMC8396377). (Abstract \| Links \| BibTeX \| Tags: Antimalarials/pharmacology, Burkina Faso, Drug Resistance, Falciparum/drug therapy/parasitology, GeneticRestriction Fragment Length, Genotype, Humans, Malaria, Membrane Transport Proteins/genetics, msp1, msp2, Multidrug Resistance-Associated Proteins/genetics, Mutation, Pfcrt, Pfmdr1, Plasmodium falciparum, Plasmodium falciparum/drug effects/genetics/isolation & purification, Polymerase Chain Reaction, Polymorphism, Protozoan Proteins/genetics) Close @article{Sondo2021-qe, title = {Polymorphisms in Plasmodium falciparum parasites and mutations in the resistance genes Pfcrt and Pfmdr1 in Nanoro area, Burkina Faso.}, author = {Paul Sondo and Biebo Bihoun and B\'{e}renger Kabore and Marc Christian Tahita and Karim Derra and Toussaint Rouamba and Seydou Nakanabo Diallo and Adama Kazienga and Hamidou Ilboudo and Innocent Valea and Zekiba Tarnagda and Hermann Sorgho and Thierry Lefevre and Halidou Tinto}, doi = {10.11604/pamj.2021.39.118.26959}, issn = {1937-8688}, year = {2021}, date = {2021-06-10}, urldate = {2021-06-10}, journal = {Pan Afr. Med. J.}, volume = {39}, pages = {118}, publisher = {Pan African Medical Journal}, abstract = {Introduction: from a genetic point of view P. falciparumis extremely polymorphic. There is a variety of parasite strains infesting individuals living in malaria endemic areas. The purpose of this study is to investigate the relationship between polymorphisms in Plasmodium falciparum parasites and Pfcrt and Pfmdr1 gene mutations in Nanoro area, Burkina Faso. Methods: blood samples from plasmodium carriers residing in the Nanoro Health District were genotyped using nested PCR. Parasite gene mutations associated with resistance to antimalarial drugs were detected by PCR-RFLP. Results: samples of 672 patients were successfully genotyped. No msp1and msp2allelic families exhibited an increase in developing mutations in resistance genes. However, mutant strains of these genes were present at greater levels in monoclonal infections than in multi-clonal infections. Conclusion: this study provides an overview of the relationship between polymorphisms in Plasmodium falciparum parasites and mutations in resistance genes. These data will undoubtedly contribute to improving knowledge of the parasite´s biology and its mechanisms of resistance to antimalarial drugs.}, note = {Copyright: Paul Sondo et al. PMID: 34512854 PMCID: PMC8396377}, keywords = {Antimalarials/pharmacology, Burkina Faso, Drug Resistance, Falciparum/drug therapy/parasitology, GeneticRestriction Fragment Length, Genotype, Humans, Malaria, Membrane Transport Proteins/genetics, msp1, msp2, Multidrug Resistance-Associated Proteins/genetics, Mutation, Pfcrt, Pfmdr1, Plasmodium falciparum, Plasmodium falciparum/drug effects/genetics/isolation \& purification, Polymerase Chain Reaction, Polymorphism, Protozoan Proteins/genetics}, pubstate = {published}, tppubtype = {article} } Close Introduction: from a genetic point of view P. falciparumis extremely polymorphic. There is a variety of parasite strains infesting individuals living in malaria endemic areas. The purpose of this study is to investigate the relationship between polymorphisms in Plasmodium falciparum parasites and Pfcrt and Pfmdr1 gene mutations in Nanoro area, Burkina Faso. Methods: blood samples from plasmodium carriers residing in the Nanoro Health District were genotyped using nested PCR. Parasite gene mutations associated with resistance to antimalarial drugs were detected by PCR-RFLP. Results: samples of 672 patients were successfully genotyped. No msp1and msp2allelic families exhibited an increase in developing mutations in resistance genes. However, mutant strains of these genes were present at greater levels in monoclonal infections than in multi-clonal infections. Conclusion: this study provides an overview of the relationship between polymorphisms in Plasmodium falciparum parasites and mutations in resistance genes. These data will undoubtedly contribute to improving knowledge of the parasite´s biology and its mechanisms of resistance to antimalarial drugs. Close doi:10.11604/pamj.2021.39.118.26959 Close
	Annelies Post, Berenger Kaboré, Mike Berendsen, Salou Diallo, Ousmane Traore, Rob J W Arts, Mihai G Netea, Leo A B Joosten, Halidou Tinto, Jan Jacobs, Quirijn Mast, André Ven Altered ex-vivo cytokine responses in children with asymptomatic Plasmodium falciparum infection in Burkina Faso: An additional argument to treat asymptomatic malaria? (Journal Article) In: Front. Immunol., vol. 12, pp. 614817, 2021, ISSN: 1664-3224, (Copyright © 2021 Post, Kaboré, Berendsen, Diallo, Traore, Arts, Netea, Joosten, Tinto, Jacobs, de Mast and van der Ven. PMID: 34177883 PMCID: PMC8220162). (Abstract \| Links \| BibTeX \| Tags: Asymptomatic Diseases, asymptomatic malaria, bacteraemia, Bacteremia, bloodstream infection, Burkina Faso/epidemiology, Cells, Child, Cultured, Cytokines/metabolism, Endemic Diseases, Female, Humans, Infant, iNTS, Lipopolysaccharides/immunology, Malaria/epidemiology/immunology, Male, Parasite Load, Plasmodium falciparum/physiology, Preschool, Salmonella) Close @article{Post2021-oo, title = {Altered ex-vivo cytokine responses in children with asymptomatic Plasmodium falciparum infection in Burkina Faso: An additional argument to treat asymptomatic malaria?}, author = {Annelies Post and Berenger Kabor\'{e} and Mike Berendsen and Salou Diallo and Ousmane Traore and Rob J W Arts and Mihai G Netea and Leo A B Joosten and Halidou Tinto and Jan Jacobs and Quirijn Mast and Andr\'{e} Ven}, doi = {10.3389/fimmu.2021.614817}, issn = {1664-3224}, year = {2021}, date = {2021-06-09}, urldate = {2021-06-09}, journal = {Front. Immunol.}, volume = {12}, pages = {614817}, publisher = {Frontiers Media SA}, abstract = {Introduction: Patients with clinical malaria have an increased risk for bacterial bloodstream infections. We hypothesized that asymptomatic malaria parasitemia increases susceptibility for bacterial infections through an effect on the innate immune system. We measured circulating cytokine levels and ex-vivo cytokine production capacity in asymptomatic malaria and compared with controls. Methods: Data were collected from asymptomatic participants \<5 years old with and without positive malaria microscopy, as well as from hospitalized patients \<5 years old with clinical malaria, bacteremia, or malaria/bacteremia co-infections in a malaria endemic region of Burkina Faso. Circulating cytokines (TNF-$alpha$, IFN-$gamma$, IL-6, IL-10) were measured using multiplex assays. Whole blood from asymptomatic participants with and without positive malaria microscopy were ex-vivo stimulated with S. aureus, E. coli LPS and Salmonella Typhimurium; cytokine concentrations (TNF-$alpha$, IFN-$gamma$, IL-1$beta$, IL-6, IL-10) were measured on supernatants using ELISA. Results: Included were children with clinical malaria (n=118), bacteremia (n=22), malaria and bacteremia co-infection (n=9), asymptomatic malaria (n=125), and asymptomatic controls (n=237). Children with either clinical or asymptomatic malaria had higher plasma cytokine concentrations than controls. Cytokine concentrations correlated positively with malaria parasite density with the strongest correlation for IL-10 in both asymptomatic (r=0.63) and clinical malaria (r=0.53). Patients with bacteremia had lower circulating IL-10, TNF-$alpha$ and IFN-$gamma$ and higher IL-6 concentrations, compared to clinical malaria. Ex-vivo whole blood cytokine production to LPS and S. aureus was significantly lower in asymptomatic malaria compared to controls. Whole blood IFN-$gamma$ and IL-10 production in response to Salmonella was also lower in asymptomatic malaria. Interpretation: In children with asymptomatic malaria, cytokine responses upon ex-vivo bacterial stimulation are downregulated. Further studies are needed to explore if the suggested impaired innate immune response to bacterial pathogens also translates into impaired control of pathogens such as Salmonella spp.}, note = {Copyright © 2021 Post, Kabor\'{e}, Berendsen, Diallo, Traore, Arts, Netea, Joosten, Tinto, Jacobs, de Mast and van der Ven. PMID: 34177883 PMCID: PMC8220162}, keywords = {Asymptomatic Diseases, asymptomatic malaria, bacteraemia, Bacteremia, bloodstream infection, Burkina Faso/epidemiology, Cells, Child, Cultured, Cytokines/metabolism, Endemic Diseases, Female, Humans, Infant, iNTS, Lipopolysaccharides/immunology, Malaria/epidemiology/immunology, Male, Parasite Load, Plasmodium falciparum/physiology, Preschool, Salmonella}, pubstate = {published}, tppubtype = {article} } Close Introduction: Patients with clinical malaria have an increased risk for bacterial bloodstream infections. We hypothesized that asymptomatic malaria parasitemia increases susceptibility for bacterial infections through an effect on the innate immune system. We measured circulating cytokine levels and ex-vivo cytokine production capacity in asymptomatic malaria and compared with controls. Methods: Data were collected from asymptomatic participants <5 years old with and without positive malaria microscopy, as well as from hospitalized patients <5 years old with clinical malaria, bacteremia, or malaria/bacteremia co-infections in a malaria endemic region of Burkina Faso. Circulating cytokines (TNF-$alpha$, IFN-$gamma$, IL-6, IL-10) were measured using multiplex assays. Whole blood from asymptomatic participants with and without positive malaria microscopy were ex-vivo stimulated with S. aureus, E. coli LPS and Salmonella Typhimurium; cytokine concentrations (TNF-$alpha$, IFN-$gamma$, IL-1$beta$, IL-6, IL-10) were measured on supernatants using ELISA. Results: Included were children with clinical malaria (n=118), bacteremia (n=22), malaria and bacteremia co-infection (n=9), asymptomatic malaria (n=125), and asymptomatic controls (n=237). Children with either clinical or asymptomatic malaria had higher plasma cytokine concentrations than controls. Cytokine concentrations correlated positively with malaria parasite density with the strongest correlation for IL-10 in both asymptomatic (r=0.63) and clinical malaria (r=0.53). Patients with bacteremia had lower circulating IL-10, TNF-$alpha$ and IFN-$gamma$ and higher IL-6 concentrations, compared to clinical malaria. Ex-vivo whole blood cytokine production to LPS and S. aureus was significantly lower in asymptomatic malaria compared to controls. Whole blood IFN-$gamma$ and IL-10 production in response to Salmonella was also lower in asymptomatic malaria. Interpretation: In children with asymptomatic malaria, cytokine responses upon ex-vivo bacterial stimulation are downregulated. Further studies are needed to explore if the suggested impaired innate immune response to bacterial pathogens also translates into impaired control of pathogens such as Salmonella spp. Close doi:10.3389/fimmu.2021.614817 Close
	Paul Sondo, Marc Christian Tahita, Toussaint Rouamba, Karim Derra, Bérenger Kaboré, Cheick Sa"id Compaoré, Florence Ouédraogo, Eli Rouamba, Hamidou Ilboudo, Estelle A"issa Bambara, Macaire Nana, Edmond Yabré Sawadogo, Hermann Sorgho, Athanase Mwinessobaonfou Somé, Innocent Valéa, Prabin Dahal, Maminata Traoré/Coulibaly, Halidou Tinto Assessment of a combined strategy of seasonal malaria chemoprevention and supplementation with vitamin A, zinc and Plumpy’Doz™ to prevent malaria and malnutrition in children under 5 years old in Burkina Faso: a randomized open-label trial (SMC-NUT) (Journal Article) In: Trials, vol. 22, no. 1, pp. 360, 2021, ISSN: 1745-6215, (PMID: 34030705 PMCID: PMC8142067). (Abstract \| Links \| BibTeX \| Tags: Antimalarials/adverse effects, Burkina Faso/epidemiology, Chemoprevention, Child, Child Nutrition Disorders, Dietary Supplements, Humans, Infant, Malaria, Malaria/diagnosis/epidemiology/prevention & control, Malnutrition, Malnutrition/diagnosis/drug therapy/prevention & control, Pharmaceutical Preparations, Plumpy’Doz™, Preschool, Randomized controlled trial, Seasonal chemoprevention, Seasons, Vitamin A, Vitamin A/adverse effects, Zinc) Close @article{Sondo2021-kc, title = {Assessment of a combined strategy of seasonal malaria chemoprevention and supplementation with vitamin A, zinc and Plumpy'Doz™ to prevent malaria and malnutrition in children under 5 years old in Burkina Faso: a randomized open-label trial (SMC-NUT)}, author = {Paul Sondo and Marc Christian Tahita and Toussaint Rouamba and Karim Derra and B\'{e}renger Kabor\'{e} and Cheick Sa"id Compaor\'{e} and Florence Ou\'{e}draogo and Eli Rouamba and Hamidou Ilboudo and Estelle A"issa Bambara and Macaire Nana and Edmond Yabr\'{e} Sawadogo and Hermann Sorgho and Athanase Mwinessobaonfou Som\'{e} and Innocent Val\'{e}a and Prabin Dahal and Maminata Traor\'{e}/Coulibaly and Halidou Tinto}, doi = {10.1186/s13063-021-05320-7}, issn = {1745-6215}, year = {2021}, date = {2021-05-24}, urldate = {2021-05-24}, journal = {Trials}, volume = {22}, number = {1}, pages = {360}, publisher = {Springer Science and Business Media LLC}, abstract = {BACKGROUND: Malaria and malnutrition represent major public health concerns worldwide especially in Sub-Sahara Africa. Despite implementation of seasonal malaria chemoprophylaxis (SMC), an intervention aimed at reducing malaria incidence among children aged 3-59 months, the burden of malaria and associated mortality among children below age 5 years remains high in Burkina Faso. Malnutrition, in particular micronutrient deficiency, appears to be one of the potential factors that can negatively affect the effectiveness of SMC. Treating micronutrient deficiencies is known to reduce the incidence of malaria in highly prevalent malaria zone such as rural settings. Therefore, we hypothesized that a combined strategy of SMC together with a daily oral nutrients supplement will enhance the immune response and decrease the incidence of malaria and malnutrition among children under SMC coverage. METHODS: Children (6-59 months) under SMC coverage receiving vitamin A supplementation will be randomly assigned to one of the three study arms (a) SMC + vitamin A alone, (b) SMC + vitamin A + zinc, or (c) SMC + vitamin A + Plumpy'Doz™ using 1:1:1 allocation ratio. After each SMC monthly distribution, children will be visited at home to confirm drug administration and followed-up for 1 year. Anthropometric indicators will be recorded at each visit and blood samples will be collected for microscopy slides, haemoglobin measurement, and spotted onto filter paper for further PCR analyses. The primary outcome measure is the incidence of malaria in each arm. Secondary outcome measures will include mid-upper arm circumference and weight gain from baseline measurements, coverage and compliance to SMC, occurrence of adverse events (AEs), and prevalence of molecular markers of antimalarial resistance comprising Pfcrt, Pfmdr1, Pfdhfr, and Pfdhps. DISCUSSION: This study will demonstrate an integrated strategy of malaria and malnutrition programmes in order to mutualize resources for best impact. By relying on existing strategies, the policy implementation of this joint intervention will be scalable at country and regional levels. TRIAL REGISTRATION: ClinicalTrials.gov NCT04238845 . Registered on 23 January 2020 https://clinicaltrials.gov/ct2/show/NCT04238845.}, note = {PMID: 34030705 PMCID: PMC8142067}, keywords = {Antimalarials/adverse effects, Burkina Faso/epidemiology, Chemoprevention, Child, Child Nutrition Disorders, Dietary Supplements, Humans, Infant, Malaria, Malaria/diagnosis/epidemiology/prevention \& control, Malnutrition, Malnutrition/diagnosis/drug therapy/prevention \& control, Pharmaceutical Preparations, Plumpy’Doz™, Preschool, Randomized controlled trial, Seasonal chemoprevention, Seasons, Vitamin A, Vitamin A/adverse effects, Zinc}, pubstate = {published}, tppubtype = {article} } Close BACKGROUND: Malaria and malnutrition represent major public health concerns worldwide especially in Sub-Sahara Africa. Despite implementation of seasonal malaria chemoprophylaxis (SMC), an intervention aimed at reducing malaria incidence among children aged 3-59 months, the burden of malaria and associated mortality among children below age 5 years remains high in Burkina Faso. Malnutrition, in particular micronutrient deficiency, appears to be one of the potential factors that can negatively affect the effectiveness of SMC. Treating micronutrient deficiencies is known to reduce the incidence of malaria in highly prevalent malaria zone such as rural settings. Therefore, we hypothesized that a combined strategy of SMC together with a daily oral nutrients supplement will enhance the immune response and decrease the incidence of malaria and malnutrition among children under SMC coverage. METHODS: Children (6-59 months) under SMC coverage receiving vitamin A supplementation will be randomly assigned to one of the three study arms (a) SMC + vitamin A alone, (b) SMC + vitamin A + zinc, or (c) SMC + vitamin A + Plumpy’Doz™ using 1:1:1 allocation ratio. After each SMC monthly distribution, children will be visited at home to confirm drug administration and followed-up for 1 year. Anthropometric indicators will be recorded at each visit and blood samples will be collected for microscopy slides, haemoglobin measurement, and spotted onto filter paper for further PCR analyses. The primary outcome measure is the incidence of malaria in each arm. Secondary outcome measures will include mid-upper arm circumference and weight gain from baseline measurements, coverage and compliance to SMC, occurrence of adverse events (AEs), and prevalence of molecular markers of antimalarial resistance comprising Pfcrt, Pfmdr1, Pfdhfr, and Pfdhps. DISCUSSION: This study will demonstrate an integrated strategy of malaria and malnutrition programmes in order to mutualize resources for best impact. By relying on existing strategies, the policy implementation of this joint intervention will be scalable at country and regional levels. TRIAL REGISTRATION: ClinicalTrials.gov NCT04238845 . Registered on 23 January 2020 https://clinicaltrials.gov/ct2/show/NCT04238845. Close doi:10.1186/s13063-021-05320-7 Close
	Joel D Bognini, Sekou Samadoulougou, Mady Ouedraogo, Tiga David Kangoye, Carine Van Malderen, Halidou Tinto, Fati Kirakoya-Samadoulougou Socioeconomic inequalities in curative healthcare-seeking for children under five before and after the free healthcare initiative in Sierra Leone: analysis of population-based survey data (Journal Article) In: Int. J. Equity Health, vol. 20, no. 1, pp. 124, 2021, ISSN: 1475-9276, (PMID: 34020665 PMCID: PMC8140517). (Abstract \| Links \| BibTeX \| Tags: Adolescent, Adult, Child, Children under five, Delivery of Health Care/economics, Female, Health Care Surveys, Healthcare Disparities/economics/statistics & numerical data, Healthcare utilization, Humans, Infant, Male, Parents/psychology, Patient Acceptance of Health Care/statistics & numerical data, Preschool, Sierra Leone, Socioeconomic Factors, Young Adult) Close @article{Bognini2021-mk, title = {Socioeconomic inequalities in curative healthcare-seeking for children under five before and after the free healthcare initiative in Sierra Leone: analysis of population-based survey data}, author = {Joel D Bognini and Sekou Samadoulougou and Mady Ouedraogo and Tiga David Kangoye and Carine Van Malderen and Halidou Tinto and Fati Kirakoya-Samadoulougou}, doi = {10.1186/s12939-021-01474-7}, issn = {1475-9276}, year = {2021}, date = {2021-05-21}, urldate = {2021-05-21}, journal = {Int. J. Equity Health}, volume = {20}, number = {1}, pages = {124}, publisher = {Springer Science and Business Media LLC}, abstract = {BACKGROUND: Socioeconomic inequalities between and within countries lead to disparities in the use of health services. These disparities could lead to child mortality in children under 5 years by depriving them of healthcare. Therefore, initiatives to remove healthcare fees such as the Free Healthcare Initiative (FHCI) adopted in Sierra Leone can contribute to reducing these inequities in healthcare-seeking for children. This study aimed to assess the socioeconomic inequalities in healthcare-seeking for children under 5 years of age before and after the implementation of the FHCI. METHODS: Data were included on 1207, 2815, 1633, and 1476 children under 5 years of age with fever from the 2008, 2013, 2016, and 2019 nationwide surveys, respectively. Concentration curves were drawn for the period before (2008) and after (2013-2019) the implementation of the FHCI to assess socioeconomic inequalities in healthcare-seeking. Finally, Erreyger's corrected concentration indices were calculated to understand the magnitude of these inequalities. RESULTS: Before the implementation of the FHCI, there were inequalities in healthcare-seeking for children under five (Erreyger's corrected concentration index (CI) = 0.168, standard error (SE) = 0.049; p \< 0.001) in favor of the wealthy households. These inequalities decreased after the implementation of the FHCI (CI = 0.061, SE = 0.033; p = 0.06 in 2013, CI = 0.039, SE = 0.04; p = 0.32 in 2016, and CI = - 0.0005, SE = 0.362; p = 0.98 in 2019). Furthermore, before the implementation of the FHCI, a significant pro-rich inequality in the districts of Kenema (CI = 0.117, SE = 0.168, p = 0.021), Kono (CI = 0.175, SE = 0.078, p = 0.028) and Western Area Urban (CI = 0.070, SE = 0.032, p = 0.031) has been observed. After the implementation of the FHCI in 2019, these disparities were reduced, 11 of the 14 districts had a CI around the value of equality, and only in 2 districts the pro-rich inequality were significant (Western Area Urban (CI = 0.035, SE = 0.016, p = 0.039) and Western Area Rural (CI = 0.066, SE = 0.030, p = 0.027)). CONCLUSION: The results of this study demonstrated that socio-economic inequalities in healthcare-seeking for children have been considerably reduced after the FHCI in Sierra Leone. To further reduce these inequalities, policy actions can focus on the increase of availability of health services in the districts where the healthcare-seeking remained pro-rich.}, note = {PMID: 34020665 PMCID: PMC8140517}, keywords = {Adolescent, Adult, Child, Children under five, Delivery of Health Care/economics, Female, Health Care Surveys, Healthcare Disparities/economics/statistics \& numerical data, Healthcare utilization, Humans, Infant, Male, Parents/psychology, Patient Acceptance of Health Care/statistics \& numerical data, Preschool, Sierra Leone, Socioeconomic Factors, Young Adult}, pubstate = {published}, tppubtype = {article} } Close BACKGROUND: Socioeconomic inequalities between and within countries lead to disparities in the use of health services. These disparities could lead to child mortality in children under 5 years by depriving them of healthcare. Therefore, initiatives to remove healthcare fees such as the Free Healthcare Initiative (FHCI) adopted in Sierra Leone can contribute to reducing these inequities in healthcare-seeking for children. This study aimed to assess the socioeconomic inequalities in healthcare-seeking for children under 5 years of age before and after the implementation of the FHCI. METHODS: Data were included on 1207, 2815, 1633, and 1476 children under 5 years of age with fever from the 2008, 2013, 2016, and 2019 nationwide surveys, respectively. Concentration curves were drawn for the period before (2008) and after (2013-2019) the implementation of the FHCI to assess socioeconomic inequalities in healthcare-seeking. Finally, Erreyger’s corrected concentration indices were calculated to understand the magnitude of these inequalities. RESULTS: Before the implementation of the FHCI, there were inequalities in healthcare-seeking for children under five (Erreyger’s corrected concentration index (CI) = 0.168, standard error (SE) = 0.049; p < 0.001) in favor of the wealthy households. These inequalities decreased after the implementation of the FHCI (CI = 0.061, SE = 0.033; p = 0.06 in 2013, CI = 0.039, SE = 0.04; p = 0.32 in 2016, and CI = - 0.0005, SE = 0.362; p = 0.98 in 2019). Furthermore, before the implementation of the FHCI, a significant pro-rich inequality in the districts of Kenema (CI = 0.117, SE = 0.168, p = 0.021), Kono (CI = 0.175, SE = 0.078, p = 0.028) and Western Area Urban (CI = 0.070, SE = 0.032, p = 0.031) has been observed. After the implementation of the FHCI in 2019, these disparities were reduced, 11 of the 14 districts had a CI around the value of equality, and only in 2 districts the pro-rich inequality were significant (Western Area Urban (CI = 0.035, SE = 0.016, p = 0.039) and Western Area Rural (CI = 0.066, SE = 0.030, p = 0.027)). CONCLUSION: The results of this study demonstrated that socio-economic inequalities in healthcare-seeking for children have been considerably reduced after the FHCI in Sierra Leone. To further reduce these inequalities, policy actions can focus on the increase of availability of health services in the districts where the healthcare-seeking remained pro-rich. Close doi:10.1186/s12939-021-01474-7 Close
	Yeka Adoke, Rella Zoleko-Manego, Serge Ouoba, Alfred B Tiono, Grace Kaguthi, Juv^encio Eduardo Bonzela, Tran Thanh Duong, Alain Nahum, Marielle Bouyou-Akotet, Bernhards Ogutu, Alphonse Ouedraogo, Fiona Macintyre, Andreas Jessel, Bart Laurijssens, Mohammed H Cherkaoui-Rbati, Cathy Cantalloube, Anne Claire Marrast, Rapha"el Bejuit, David White, Timothy N C Wells, Florian Wartha, Didier Leroy, Afizi Kibuuka, Ghyslain Mombo-Ngoma, Daouda Ouattara, Ir`ene Mugenya, Bui Quang Phuc, Francis Bohissou, Denise P Mawili-Mboumba, Fredrick Olewe, Issiaka Soulama, Halidou Tinto, FALCI Study Group A randomized, double-blind, phase 2b study to investigate the efficacy, safety, tolerability and pharmacokinetics of a single-dose regimen of ferroquine with artefenomel in adults and children with uncomplicated Plasmodium falciparum malaria (Journal Article) In: Malar. J., vol. 20, no. 1, pp. 222, 2021, ISSN: 1475-2875, (PMID: 34011358 PMCID: PMC8135182). (Abstract \| Links \| BibTeX \| Tags: Adamantane/administration & dosage/analogs & derivatives, Adolescent, Adult, Aged, Aminoquinolines/administration & dosage, Benin, Burkina Faso, C580Y, Child, Combination treatment, Double-Blind Method, Drug Combinations, Exposure–response, Falciparum/prevention & control, Female, Ferroquine, Ferrous Compounds/administration & dosage, Gabon, Humans, Infant, Kelch-13 mutation, Kenya, Malaria, Male, Metallocenes/administration & dosage, Middle Aged, Mozambique, Parasite clearance, Peroxides/administration & dosage, Pharmacokinetics/pharmacodynamics, Plasmodium falciparum/drug effects, Preschool, resistance, Uganda, Vietnam, Vomiting, Young Adult) Close @article{Adoke2021-el, title = {A randomized, double-blind, phase 2b study to investigate the efficacy, safety, tolerability and pharmacokinetics of a single-dose regimen of ferroquine with artefenomel in adults and children with uncomplicated Plasmodium falciparum malaria}, author = {Yeka Adoke and Rella Zoleko-Manego and Serge Ouoba and Alfred B Tiono and Grace Kaguthi and Juv^encio Eduardo Bonzela and Tran Thanh Duong and Alain Nahum and Marielle Bouyou-Akotet and Bernhards Ogutu and Alphonse Ouedraogo and Fiona Macintyre and Andreas Jessel and Bart Laurijssens and Mohammed H Cherkaoui-Rbati and Cathy Cantalloube and Anne Claire Marrast and Rapha"el Bejuit and David White and Timothy N C Wells and Florian Wartha and Didier Leroy and Afizi Kibuuka and Ghyslain Mombo-Ngoma and Daouda Ouattara and Ir`ene Mugenya and Bui Quang Phuc and Francis Bohissou and Denise P Mawili-Mboumba and Fredrick Olewe and Issiaka Soulama and Halidou Tinto and FALCI Study Group}, doi = {10.1186/s12936-021-03749-4}, issn = {1475-2875}, year = {2021}, date = {2021-05-19}, urldate = {2021-05-19}, journal = {Malar. J.}, volume = {20}, number = {1}, pages = {222}, publisher = {Springer Science and Business Media LLC}, abstract = {BACKGROUND: For uncomplicated Plasmodium falciparum malaria, highly efficacious single-dose treatments are expected to increase compliance and improve treatment outcomes, and thereby may slow the development of resistance. The efficacy and safety of a single-dose combination of artefenomel (800 mg) plus ferroquine (400/600/900/1200 mg doses) for the treatment of uncomplicated P. falciparum malaria were evaluated in Africa (focusing on children $\leq$ 5 years) and Asia. METHODS: The study was a randomized, double-blind, single-dose, multi-arm clinical trial in patients aged \> 6 months to 5 years and 20 Asian patients. None of the treatment arms met the target efficacy criterion for PCR-adjusted ACPR at Day 28 (lower limit of 95% confidence interval [CI] \> 90%). PCR-adjusted ACPR at Day 28 [95% CI] in the PP Set ranged from 78.4% [64.7; 88.7%] to 91.7% [81.6; 97.2%] for the 400 mg to 1200 mg ferroquine dose. Efficacy rates were low in Vietnamese patients, ranging from 20 to 40%. A clear relationship was found between drug exposure (artefenomel and ferroquine concentrations at Day 7) and efficacy (primary endpoint), with higher concentrations of both drugs resulting in higher efficacy. Six distinct kelch-13 mutations were detected in parasite isolates from 10/272 African patients (with 2 mutations known to be associated with artemisinin resistance) and 18/20 Asian patients (all C580Y mutation). Vomiting within 6 h of initial artefenomel administration was common (24.6%) and associated with lower drug exposures. CONCLUSION: The efficacy of artefenomel/ferroquine combination was suboptimal in African children aged $\leq$ 5 years, the population of interest, and vomiting most likely had a negative impact on efficacy. Trial registration ClinicalTrials.gov, NCT02497612. Registered 14 Jul 2015, https://clinicaltrials.gov/ct2/show/NCT02497612?term=NCT02497612\&draw=2\&rank=1.}, note = {PMID: 34011358 PMCID: PMC8135182}, keywords = {Adamantane/administration \& dosage/analogs \& derivatives, Adolescent, Adult, Aged, Aminoquinolines/administration \& dosage, Benin, Burkina Faso, C580Y, Child, Combination treatment, Double-Blind Method, Drug Combinations, Exposure\textendashresponse, Falciparum/prevention \& control, Female, Ferroquine, Ferrous Compounds/administration \& dosage, Gabon, Humans, Infant, Kelch-13 mutation, Kenya, Malaria, Male, Metallocenes/administration \& dosage, Middle Aged, Mozambique, Parasite clearance, Peroxides/administration \& dosage, Pharmacokinetics/pharmacodynamics, Plasmodium falciparum/drug effects, Preschool, resistance, Uganda, Vietnam, Vomiting, Young Adult}, pubstate = {published}, tppubtype = {article} } Close BACKGROUND: For uncomplicated Plasmodium falciparum malaria, highly efficacious single-dose treatments are expected to increase compliance and improve treatment outcomes, and thereby may slow the development of resistance. The efficacy and safety of a single-dose combination of artefenomel (800 mg) plus ferroquine (400/600/900/1200 mg doses) for the treatment of uncomplicated P. falciparum malaria were evaluated in Africa (focusing on children $łeq$ 5 years) and Asia. METHODS: The study was a randomized, double-blind, single-dose, multi-arm clinical trial in patients aged > 6 months to 5 years and 20 Asian patients. None of the treatment arms met the target efficacy criterion for PCR-adjusted ACPR at Day 28 (lower limit of 95% confidence interval [CI] > 90%). PCR-adjusted ACPR at Day 28 [95% CI] in the PP Set ranged from 78.4% [64.7; 88.7%] to 91.7% [81.6; 97.2%] for the 400 mg to 1200 mg ferroquine dose. Efficacy rates were low in Vietnamese patients, ranging from 20 to 40%. A clear relationship was found between drug exposure (artefenomel and ferroquine concentrations at Day 7) and efficacy (primary endpoint), with higher concentrations of both drugs resulting in higher efficacy. Six distinct kelch-13 mutations were detected in parasite isolates from 10/272 African patients (with 2 mutations known to be associated with artemisinin resistance) and 18/20 Asian patients (all C580Y mutation). Vomiting within 6 h of initial artefenomel administration was common (24.6%) and associated with lower drug exposures. CONCLUSION: The efficacy of artefenomel/ferroquine combination was suboptimal in African children aged $łeq$ 5 years, the population of interest, and vomiting most likely had a negative impact on efficacy. Trial registration ClinicalTrials.gov, NCT02497612. Registered 14 Jul 2015, https://clinicaltrials.gov/ct2/show/NCT02497612?term=NCT02497612&draw=2&rank=1. Close doi:10.1186/s12936-021-03749-4 Close
	Mehreen S Datoo, Magloire H Natama, Athanase Somé, Ousmane Traoré, Toussaint Rouamba, Duncan Bellamy, Prisca Yameogo, Daniel Valia, Moubarak Tegneri, Florence Ouedraogo, Rachidatou Soma, Seydou Sawadogo, Faizatou Sorgho, Karim Derra, Eli Rouamba, Benedict Orindi, Fernando Ramos Lopez, Amy Flaxman, Federica Cappuccini, Reshma Kailath, Sean Elias, Ekta Mukhopadhyay, Andres Noe, Matthew Cairns, Alison Lawrie, Rachel Roberts, Innocent Valéa, Hermann Sorgho, Nicola Williams, Gregory Glenn, Louis Fries, Jenny Reimer, Katie J Ewer, Umesh Shaligram, Adrian V S Hill, Halidou Tinto Efficacy of a low-dose candidate malaria vaccine, R21 in adjuvant Matrix-M, with seasonal administration to children in Burkina Faso: a randomised controlled trial (Journal Article) In: Lancet, vol. 397, no. 10287, pp. 1809–1818, 2021, ISSN: 1474-547X 0140-6736, (Copyright © 2021 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license. Published by Elsevier Ltd.. All rights reserved. PMID: 33964223 PMCID: PMC8121760). (Abstract \| Links \| BibTeX \| Tags: Adjuvants, Burkina Faso, Double-Blind Method, Falciparum/prevention & control, Female, Hepatitis B Surface Antigens, Humans, Immunogenicity, Immunologic/administration & dosage, Infant, Malaria, Malaria Vaccines/therapeutic use, Malaria/prevention & control, Male, Nanoparticles/administration & dosage, Proportional Hazards Models, Protozoan Proteins/immunology, Saponins/administration & dosage, Treatment Outcome, Vaccine, Vaccines, Virus-Like Particle/therapeutic use) Close @article{Datoo2021-dk, title = {Efficacy of a low-dose candidate malaria vaccine, R21 in adjuvant Matrix-M, with seasonal administration to children in Burkina Faso: a randomised controlled trial}, author = {Mehreen S Datoo and Magloire H Natama and Athanase Som\'{e} and Ousmane Traor\'{e} and Toussaint Rouamba and Duncan Bellamy and Prisca Yameogo and Daniel Valia and Moubarak Tegneri and Florence Ouedraogo and Rachidatou Soma and Seydou Sawadogo and Faizatou Sorgho and Karim Derra and Eli Rouamba and Benedict Orindi and Fernando Ramos Lopez and Amy Flaxman and Federica Cappuccini and Reshma Kailath and Sean Elias and Ekta Mukhopadhyay and Andres Noe and Matthew Cairns and Alison Lawrie and Rachel Roberts and Innocent Val\'{e}a and Hermann Sorgho and Nicola Williams and Gregory Glenn and Louis Fries and Jenny Reimer and Katie J Ewer and Umesh Shaligram and Adrian V S Hill and Halidou Tinto}, doi = {10.1016/S0140-6736(21)00943-0}, issn = {1474-547X 0140-6736}, year = {2021}, date = {2021-05-15}, urldate = {2021-05-15}, journal = {Lancet}, volume = {397}, number = {10287}, pages = {1809--1818}, publisher = {Elsevier BV}, abstract = {BACKGROUND: Stalled progress in controlling Plasmodium falciparum malaria highlights the need for an effective and deployable vaccine. RTS,S/AS01, the most effective malaria vaccine candidate to date, demonstrated 56% efficacy over 12 months in African children. We therefore assessed a new candidate vaccine for safety and efficacy. METHODS: In this double-blind, randomised, controlled, phase 2b trial, the low-dose circumsporozoite protein-based vaccine R21, with two different doses of adjuvant Matrix-M (MM), was given to children aged 5-17 months in Nanoro, Burkina Faso-a highly seasonal malaria transmission setting. Three vaccinations were administered at 4-week intervals before the malaria season, with a fourth dose 1 year later. All vaccines were administered intramuscularly into the thigh. Group 1 received 5 $mu$g R21 plus 25 $mu$g MM, group 2 received 5 $mu$g R21 plus 50 $mu$g MM, and group 3, the control group, received rabies vaccinations. Children were randomly assigned (1:1:1) to groups 1-3. An independent statistician generated a random allocation list, using block randomisation with variable block sizes, which was used to assign participants. Participants, their families, and the local study team were all masked to group allocation. Only the pharmacists preparing the vaccine were unmasked to group allocation. Vaccine safety, immunogenicity, and efficacy were evaluated over 1 year. The primary objective assessed protective efficacy of R21 plus MM (R21/MM) from 14 days after the third vaccination to 6 months. Primary analyses of vaccine efficacy were based on a modified intention-to-treat population, which included all participants who received three vaccinations, allowing for inclusion of participants who received the wrong vaccine at any timepoint. This trial is registered with ClinicalTrials.gov, NCT03896724. FINDINGS: From May 7 to June 13, 2019, 498 children aged 5-17 months were screened, and 48 were excluded. 450 children were enrolled and received at least one vaccination. 150 children were allocated to group 1, 150 children were allocated to group 2, and 150 children were allocated to group 3. The final vaccination of the primary series was administered on Aug 7, 2019. R21/MM had a favourable safety profile and was well tolerated. The majority of adverse events were mild, with the most common event being fever. None of the seven serious adverse events were attributed to the vaccine. At the 6-month primary efficacy analysis, 43 (29%) of 146 participants in group 1, 38 (26%) of 146 participants in group 2, and 105 (71%) of 147 participants in group 3 developed clinical malaria. Vaccine efficacy was 74% (95% CI 63-82) in group 1 and 77% (67-84) in group 2 at 6 months. At 1 year, vaccine efficacy remained high, at 77% (67-84) in group 1. Participants vaccinated with R21/MM showed high titres of malaria-specific anti-Asn-Ala-Asn-Pro (NANP) antibodies 28 days after the third vaccination, which were almost doubled with the higher adjuvant dose. Titres waned but were boosted to levels similar to peak titres after the primary series of vaccinations after a fourth dose administered 1 year later. INTERPRETATION: R21/MM appears safe and very immunogenic in African children, and shows promising high-level efficacy. FUNDING: The European \& Developing Countries Clinical Trials Partnership, Wellcome Trust, and National Institute for Health Research Oxford Biomedical Research Centre.}, note = {Copyright © 2021 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license. Published by Elsevier Ltd.. All rights reserved. PMID: 33964223 PMCID: PMC8121760}, keywords = {Adjuvants, Burkina Faso, Double-Blind Method, Falciparum/prevention \& control, Female, Hepatitis B Surface Antigens, Humans, Immunogenicity, Immunologic/administration \& dosage, Infant, Malaria, Malaria Vaccines/therapeutic use, Malaria/prevention \& control, Male, Nanoparticles/administration \& dosage, Proportional Hazards Models, Protozoan Proteins/immunology, Saponins/administration \& dosage, Treatment Outcome, Vaccine, Vaccines, Virus-Like Particle/therapeutic use}, pubstate = {published}, tppubtype = {article} } Close BACKGROUND: Stalled progress in controlling Plasmodium falciparum malaria highlights the need for an effective and deployable vaccine. RTS,S/AS01, the most effective malaria vaccine candidate to date, demonstrated 56% efficacy over 12 months in African children. We therefore assessed a new candidate vaccine for safety and efficacy. METHODS: In this double-blind, randomised, controlled, phase 2b trial, the low-dose circumsporozoite protein-based vaccine R21, with two different doses of adjuvant Matrix-M (MM), was given to children aged 5-17 months in Nanoro, Burkina Faso-a highly seasonal malaria transmission setting. Three vaccinations were administered at 4-week intervals before the malaria season, with a fourth dose 1 year later. All vaccines were administered intramuscularly into the thigh. Group 1 received 5 $mu$g R21 plus 25 $mu$g MM, group 2 received 5 $mu$g R21 plus 50 $mu$g MM, and group 3, the control group, received rabies vaccinations. Children were randomly assigned (1:1:1) to groups 1-3. An independent statistician generated a random allocation list, using block randomisation with variable block sizes, which was used to assign participants. Participants, their families, and the local study team were all masked to group allocation. Only the pharmacists preparing the vaccine were unmasked to group allocation. Vaccine safety, immunogenicity, and efficacy were evaluated over 1 year. The primary objective assessed protective efficacy of R21 plus MM (R21/MM) from 14 days after the third vaccination to 6 months. Primary analyses of vaccine efficacy were based on a modified intention-to-treat population, which included all participants who received three vaccinations, allowing for inclusion of participants who received the wrong vaccine at any timepoint. This trial is registered with ClinicalTrials.gov, NCT03896724. FINDINGS: From May 7 to June 13, 2019, 498 children aged 5-17 months were screened, and 48 were excluded. 450 children were enrolled and received at least one vaccination. 150 children were allocated to group 1, 150 children were allocated to group 2, and 150 children were allocated to group 3. The final vaccination of the primary series was administered on Aug 7, 2019. R21/MM had a favourable safety profile and was well tolerated. The majority of adverse events were mild, with the most common event being fever. None of the seven serious adverse events were attributed to the vaccine. At the 6-month primary efficacy analysis, 43 (29%) of 146 participants in group 1, 38 (26%) of 146 participants in group 2, and 105 (71%) of 147 participants in group 3 developed clinical malaria. Vaccine efficacy was 74% (95% CI 63-82) in group 1 and 77% (67-84) in group 2 at 6 months. At 1 year, vaccine efficacy remained high, at 77% (67-84) in group 1. Participants vaccinated with R21/MM showed high titres of malaria-specific anti-Asn-Ala-Asn-Pro (NANP) antibodies 28 days after the third vaccination, which were almost doubled with the higher adjuvant dose. Titres waned but were boosted to levels similar to peak titres after the primary series of vaccinations after a fourth dose administered 1 year later. INTERPRETATION: R21/MM appears safe and very immunogenic in African children, and shows promising high-level efficacy. FUNDING: The European & Developing Countries Clinical Trials Partnership, Wellcome Trust, and National Institute for Health Research Oxford Biomedical Research Centre. Close doi:10.1016/S0140-6736(21)00943-0 Close
	Toussaint Rouamba, Sékou Samadoulougou, Mady Ouédraogo, Hervé Hien, Halidou Tinto, Fati Kirakoya-Samadoulougou Asymptomatic malaria and anaemia among pregnant women during high and low malaria transmission seasons in Burkina Faso: household-based cross-sectional surveys in Burkina Faso, 2013 and 2017 (Journal Article) In: Malar. J., vol. 20, no. 1, pp. 211, 2021, ISSN: 1475-2875. (Abstract \| Links \| BibTeX \| Tags: Adult, Anemia/epidemiology/parasitology, Asymptomatic carriage, Asymptomatic Infections/epidemiology, Burkina Faso/epidemiology, Community, Cross-Sectional Studies, Female, Haemoglobin, Humans, Malaria/epidemiology/parasitology, Parasitic/epidemiology/parasitology, Plasmodium, Pregnancy, Pregnancy Complications, Pregnant, Pregnant Women, Prevalence, Young Adult) Close @article{Rouamba2021-gn, title = {Asymptomatic malaria and anaemia among pregnant women during high and low malaria transmission seasons in Burkina Faso: household-based cross-sectional surveys in Burkina Faso, 2013 and 2017}, author = {Toussaint Rouamba and S\'{e}kou Samadoulougou and Mady Ou\'{e}draogo and Herv\'{e} Hien and Halidou Tinto and Fati Kirakoya-Samadoulougou}, doi = {10.1186/s12936-021-03703-4}, issn = {1475-2875}, year = {2021}, date = {2021-05-01}, urldate = {2021-05-01}, journal = {Malar. J.}, volume = {20}, number = {1}, pages = {211}, publisher = {Springer Science and Business Media LLC}, abstract = {BACKGROUND: Malaria in endemic countries is often asymptomatic during pregnancy, but it has substantial consequences for both the mother and her unborn baby. During pregnancy, anaemia is an important consequence of malaria infection. In Burkina Faso, the intensity of malaria varies according to the season, albeit the prevalence of malaria and anaemia as well as their risk factors, during high and low malaria transmission seasons is underexplored at the household level. METHODS: Data of 1751 pregnant women from October 2013 to March 2014 and 1931 pregnant women from April 2017 to June 2017 were drawn from two cross-sectional household surveys conducted in 24 health districts of Burkina Faso. Pregnant women were tested for malaria in their household after consenting. Asymptomatic carriage was defined as a positive result from malaria rapid diagnostic tests in the absence of clinical symptoms of malaria. Anaemia was defined as haemoglobin level less than 11 g/dL in the first and third trimester and less than 10.5 g/dL in the second trimester of pregnancy. RESULTS: Prevalence of asymptomatic malaria in pregnancy was estimated at 23.9% (95% CI 20.2-28.0) during the high transmission season (October-November) in 2013. During the low transmission season, it was 12.7% (95% CI 10.9-14.7) between December and March in 2013-2014 and halved (6.4%; 95% CI 5.3-7.6) between April and June 2017. Anaemia prevalence was estimated at 59.4% (95% CI 54.8-63.8) during the high transmission season in 2013. During the low transmission season, it was 50.6% (95% CI 47.7-53.4) between December and March 2013-2014 and 65.0% (95% CI 62.8-67.2) between April and June, 2017. CONCLUSION: This study revealed that the prevalence of malaria asymptomatic carriage and anaemia among pregnant women at the community level remain high throughout the year. Thus, more efforts are needed to increase prevention measures such as IPTp-SP coverage in order to reduce anaemia and contribute to preventing low birth weight and poor pregnancy outcomes.}, keywords = {Adult, Anemia/epidemiology/parasitology, Asymptomatic carriage, Asymptomatic Infections/epidemiology, Burkina Faso/epidemiology, Community, Cross-Sectional Studies, Female, Haemoglobin, Humans, Malaria/epidemiology/parasitology, Parasitic/epidemiology/parasitology, Plasmodium, Pregnancy, Pregnancy Complications, Pregnant, Pregnant Women, Prevalence, Young Adult}, pubstate = {published}, tppubtype = {article} } Close BACKGROUND: Malaria in endemic countries is often asymptomatic during pregnancy, but it has substantial consequences for both the mother and her unborn baby. During pregnancy, anaemia is an important consequence of malaria infection. In Burkina Faso, the intensity of malaria varies according to the season, albeit the prevalence of malaria and anaemia as well as their risk factors, during high and low malaria transmission seasons is underexplored at the household level. METHODS: Data of 1751 pregnant women from October 2013 to March 2014 and 1931 pregnant women from April 2017 to June 2017 were drawn from two cross-sectional household surveys conducted in 24 health districts of Burkina Faso. Pregnant women were tested for malaria in their household after consenting. Asymptomatic carriage was defined as a positive result from malaria rapid diagnostic tests in the absence of clinical symptoms of malaria. Anaemia was defined as haemoglobin level less than 11 g/dL in the first and third trimester and less than 10.5 g/dL in the second trimester of pregnancy. RESULTS: Prevalence of asymptomatic malaria in pregnancy was estimated at 23.9% (95% CI 20.2-28.0) during the high transmission season (October-November) in 2013. During the low transmission season, it was 12.7% (95% CI 10.9-14.7) between December and March in 2013-2014 and halved (6.4%; 95% CI 5.3-7.6) between April and June 2017. Anaemia prevalence was estimated at 59.4% (95% CI 54.8-63.8) during the high transmission season in 2013. During the low transmission season, it was 50.6% (95% CI 47.7-53.4) between December and March 2013-2014 and 65.0% (95% CI 62.8-67.2) between April and June, 2017. CONCLUSION: This study revealed that the prevalence of malaria asymptomatic carriage and anaemia among pregnant women at the community level remain high throughout the year. Thus, more efforts are needed to increase prevention measures such as IPTp-SP coverage in order to reduce anaemia and contribute to preventing low birth weight and poor pregnancy outcomes. Close doi:10.1186/s12936-021-03703-4 Close
	Massa Dit Achille Bonko, Palpouguini Lompo, Marc Christian Tahita, Francois Kiemde, Ibrahima Karama, Athanase M Somé, Petra F Mens, Sandra Menting, Halidou Tinto, Henk D F H Schallig Antibiotic susceptibility of Staphylococcus aureus and Streptococcus pneumoniae isolates from the nasopharynx of febrile children under 5 years in Nanoro, Burkina Faso (Journal Article) In: Antibiotics (Basel), vol. 10, no. 4, 2021, ISSN: 2079-6382, (PMID: 33920987 PMCID: PMC8071235). (Abstract \| Links \| BibTeX \| Tags: antibiotics, children; nasopharynx, resistance, Staphylococcus aureus, Streptococcus pneumoniae) Close @article{Bonko2021-kv, title = {Antibiotic susceptibility of Staphylococcus aureus and Streptococcus pneumoniae isolates from the nasopharynx of febrile children under 5 years in Nanoro, Burkina Faso}, author = {Massa Dit Achille Bonko and Palpouguini Lompo and Marc Christian Tahita and Francois Kiemde and Ibrahima Karama and Athanase M Som\'{e} and Petra F Mens and Sandra Menting and Halidou Tinto and Henk D F H Schallig}, doi = {10.3390/antibiotics10040444}, issn = {2079-6382}, year = {2021}, date = {2021-04-15}, urldate = {2021-04-15}, journal = {Antibiotics (Basel)}, volume = {10}, number = {4}, abstract = {(1) Background: nasopharynx colonization by resistant Staphylococcus aureus and Streptococcus pneumoniae can lead to serious diseases. Emerging resistance to antibiotics commonly used to treat infections due to these pathogens poses a serious threat to the health system. The present study aimed to determine the antibiotic susceptibility of S. aureus and S. pneumoniae isolates from the febrile children's nasopharynx under 5 years in Nanoro (Burkina Faso). (2) Methods: bacterial isolates were identified from nasopharyngeal swabs prospectively collected from 629 febrile children. Antibiotic susceptibility of S. aureus and S. pneumoniae isolates was assessed by Kirby-Bauer method and results were interpreted according to the Clinical and Laboratory Standard Institute guidelines. (3) Results: bacterial colonization was confirmed in 154 (24.5%) of children of whom 96.1% carried S. aureus, 3.2% had S. pneumoniae, and 0.6% carried both bacteria. S. aureus isolates showed alarming resistance to penicillin (96.0%) and S. pneumoniae was highly resistant to tetracycline (100%) and trimethoprim-sulfamethoxazole (83.3%), and moderately resistant to penicillin (50.0%). Furthermore, 4.0% of S. aureus identified were methicillin resistant. (4) Conclusion: this study showed concerning resistance rates to antibiotics to treat suspected bacterial respiratory tract infections. The work highlights the necessity to implement continuous antibiotic resistance surveillance.}, note = {PMID: 33920987 PMCID: PMC8071235}, keywords = {antibiotics, children; nasopharynx, resistance, Staphylococcus aureus, Streptococcus pneumoniae}, pubstate = {published}, tppubtype = {article} } Close (1) Background: nasopharynx colonization by resistant Staphylococcus aureus and Streptococcus pneumoniae can lead to serious diseases. Emerging resistance to antibiotics commonly used to treat infections due to these pathogens poses a serious threat to the health system. The present study aimed to determine the antibiotic susceptibility of S. aureus and S. pneumoniae isolates from the febrile children’s nasopharynx under 5 years in Nanoro (Burkina Faso). (2) Methods: bacterial isolates were identified from nasopharyngeal swabs prospectively collected from 629 febrile children. Antibiotic susceptibility of S. aureus and S. pneumoniae isolates was assessed by Kirby-Bauer method and results were interpreted according to the Clinical and Laboratory Standard Institute guidelines. (3) Results: bacterial colonization was confirmed in 154 (24.5%) of children of whom 96.1% carried S. aureus, 3.2% had S. pneumoniae, and 0.6% carried both bacteria. S. aureus isolates showed alarming resistance to penicillin (96.0%) and S. pneumoniae was highly resistant to tetracycline (100%) and trimethoprim-sulfamethoxazole (83.3%), and moderately resistant to penicillin (50.0%). Furthermore, 4.0% of S. aureus identified were methicillin resistant. (4) Conclusion: this study showed concerning resistance rates to antibiotics to treat suspected bacterial respiratory tract infections. The work highlights the necessity to implement continuous antibiotic resistance surveillance. Close doi:10.3390/antibiotics10040444 Close
	Sabine Gies, Stephen A Roberts, Salou Diallo, Olga M Lompo, Halidou Tinto, Bernard J Brabin Risk of malaria in young children after periconceptional iron supplementation (Journal Article) In: Matern. Child Nutr., vol. 17, no. 2, pp. e13106, 2021, ISSN: 1740-8709 1740-8695, (© 2020 The Authors. Maternal & Child Nutrition published by John Wiley & Sons Ltd. PMID: 33236840 PMCID: PMC7988873). (Abstract \| Links \| BibTeX \| Tags: Burkina Faso, child iron, Dietary Supplements/analysis, Female, Folic Acid, Humans, Infant, Malaria, Newborn, periconceptional, placenta, Pregnancy, Premature Birth, Preschool) Close @article{Gies2021-aw, title = {Risk of malaria in young children after periconceptional iron supplementation}, author = {Sabine Gies and Stephen A Roberts and Salou Diallo and Olga M Lompo and Halidou Tinto and Bernard J Brabin}, doi = {10.1111/mcn.13106}, issn = {1740-8709 1740-8695}, year = {2021}, date = {2021-04-01}, urldate = {2021-04-01}, journal = {Matern. Child Nutr.}, volume = {17}, number = {2}, pages = {e13106}, publisher = {Wiley}, abstract = {This study in Burkina Faso investigated whether offspring of young mothers who had received weekly periconceptional iron supplementation in a randomised controlled trial were at increased risk of malaria. A child safety survey was undertaken in the peak month of malaria transmission towards the end of the trial to assess child iron biomarkers, nutritional status, anaemia and malaria outcomes. Antenatal iron biomarkers, preterm birth, fetal growth restriction and placental pathology for malaria and chorioamnionitis were assessed. Data were available for 180 babies surviving to the time of the survey when their median age was 9 months. Prevalence of maternal iron deficiency in the last trimester based on low body iron stores was 16%. Prevalence of active placental malaria infection was 24.8%, past infection 59% and chorioamnionitis 55.6%. Babies of iron supplemented women had lower median gestational age. Four out of five children ≥ 6 months were iron deficient, and 98% were anaemic. At 4 months malaria prevalence was 45%. Child iron biomarkers, anaemia and malaria outcomes did not differ by trial arm. Factors associated with childhood parasitaemia were third trimester C-reactive protein level (OR 2.1; 95% CI 1.1-3.9), active placental malaria (OR 5.8; 1.0-32.5, P = 0.042) and child body iron stores (OR 1.13; 1.04-1.23, P = 0.002). Chorioamnionitis was associated with reduced risk of child parasitaemia (OR 0.4; 0.1-1.0, P = 0.038). Periconceptional iron supplementation of young women did not alter body iron stores of their children. Higher child body iron stores and placental malaria increased risk of childhood parasitaemia.}, note = {© 2020 The Authors. Maternal \& Child Nutrition published by John Wiley \& Sons Ltd. PMID: 33236840 PMCID: PMC7988873}, keywords = {Burkina Faso, child iron, Dietary Supplements/analysis, Female, Folic Acid, Humans, Infant, Malaria, Newborn, periconceptional, placenta, Pregnancy, Premature Birth, Preschool}, pubstate = {published}, tppubtype = {article} } Close This study in Burkina Faso investigated whether offspring of young mothers who had received weekly periconceptional iron supplementation in a randomised controlled trial were at increased risk of malaria. A child safety survey was undertaken in the peak month of malaria transmission towards the end of the trial to assess child iron biomarkers, nutritional status, anaemia and malaria outcomes. Antenatal iron biomarkers, preterm birth, fetal growth restriction and placental pathology for malaria and chorioamnionitis were assessed. Data were available for 180 babies surviving to the time of the survey when their median age was 9 months. Prevalence of maternal iron deficiency in the last trimester based on low body iron stores was 16%. Prevalence of active placental malaria infection was 24.8%, past infection 59% and chorioamnionitis 55.6%. Babies of iron supplemented women had lower median gestational age. Four out of five children ≥ 6 months were iron deficient, and 98% were anaemic. At 4 months malaria prevalence was 45%. Child iron biomarkers, anaemia and malaria outcomes did not differ by trial arm. Factors associated with childhood parasitaemia were third trimester C-reactive protein level (OR 2.1; 95% CI 1.1-3.9), active placental malaria (OR 5.8; 1.0-32.5, P = 0.042) and child body iron stores (OR 1.13; 1.04-1.23, P = 0.002). Chorioamnionitis was associated with reduced risk of child parasitaemia (OR 0.4; 0.1-1.0, P = 0.038). Periconceptional iron supplementation of young women did not alter body iron stores of their children. Higher child body iron stores and placental malaria increased risk of childhood parasitaemia. Close doi:10.1111/mcn.13106 Close
	Engelbert A Nonterah, Michiel L Bots, Abraham Oduro, Godfred Agongo, Cassandra C Soo, Lisa K Micklesfield, Felistas Mashinya, Palwendé R Boua, Shukri F Mohamed, Alisha N Wade, Catherine Kyobutungi, Halidou Tinto, Shane A Norris, Stephen M Tollman, Mich`ele Ramsay, Diederick E Grobbee, Kerstin Klipstein-Grobusch, Nigel J Crowther, AWI-Gen, H3Africa Consortium Adiposity phenotypes and subclinical atherosclerosis in adults from sub-Saharan Africa: An H3Africa AWI-gen study (Journal Article) In: Glob. Heart, vol. 16, no. 1, pp. 19, 2021, ISSN: 2211-8179 2211-8160, (Copyright: © 2021 The Author(s). PMID: 33833943 PMCID: PMC7977036). (Abstract \| Links \| BibTeX \| Tags: adiposity, Adult, Body Mass Index, cardiovascular disease, Carotid intima-media thickness, Cross-Sectional Studies, Female, Ghana, Humans, Male, Middle Aged, obesity, Obesity/complications/epidemiology, Phenotype, Risk Factors, sub-Saharan Africa, subclinical atherosclerosis) Close @article{Nonterah2021-pc, title = {Adiposity phenotypes and subclinical atherosclerosis in adults from sub-Saharan Africa: An H3Africa AWI-gen study}, author = {Engelbert A Nonterah and Michiel L Bots and Abraham Oduro and Godfred Agongo and Cassandra C Soo and Lisa K Micklesfield and Felistas Mashinya and Palwend\'{e} R Boua and Shukri F Mohamed and Alisha N Wade and Catherine Kyobutungi and Halidou Tinto and Shane A Norris and Stephen M Tollman and Mich`ele Ramsay and Diederick E Grobbee and Kerstin Klipstein-Grobusch and Nigel J Crowther and AWI-Gen and H3Africa Consortium}, doi = {10.5334/gh.863}, issn = {2211-8179 2211-8160}, year = {2021}, date = {2021-03-19}, urldate = {2021-03-19}, journal = {Glob. Heart}, volume = {16}, number = {1}, pages = {19}, publisher = {Ubiquity Press, Ltd.}, abstract = {Background: Obesity and adipose tissue distribution contribute to an increased risk of cardiovascular disease (CVD) by promoting atherosclerosis. This association has been poorly studied in sub-Saharan Africa (SSA) despite the rising prevalence of cardiovascular disease. Objectives: We determined the association between various adiposity phenotypes and carotid intima-media thickness (CIMT), a proxy of subclinical atherosclerosis, in a large SSA population. Methods: A population-based cross-sectional study was performed from 2013-2016 in Burkina Faso, Ghana, Kenya and South Africa. Body mass index (BMI), waist (WC), hip circumferences (HC), visceral (VAT) and subcutaneous adipose tissue (SCAT) using B-mode ultrasound were measured. Ultrasonography of left and right far wall CIMT of the common carotid artery was used as an indicator of subclinical atherosclerosis. Individual participant data meta-analyses were used to determine the associations between adiposity phenotypes and CIMT in the pooled sample while adjusted multivariable linear regression analyses were used for site specific analyses. Results: Data were obtained from 9,010 adults (50.3% women and a mean age of 50$pm$ 6years). Men had higher levels of visceral fat than women while women had higher BMI, waist and hip circumference and subcutaneous fat than men at all sites except Burkina Faso. In the pooled analyses, BMI ($beta$-value [95% CIs]: 19.5 [16.8, 22.3] $mu$m) showed the strongest relationship with CIMT followed by VAT (5.86 [4.65, 7.07] $mu$m), SCAT (5.00 [2.85, 7.15] $mu$m), WC (1.27 [1.09, 1.44] $mu$m) and HC (1.23 [1.04, 1.42] $mu$m). Stronger associations were observed in men than in women. Conclusion: Obesity within SSA will likely result in higher levels of atherosclerosis and promote the occurrence of cardio- and cerebrovascular events, especially in males, unless addressed through primary prevention of obesity in both rural and urban communities across Africa. The inverse association of VAT with CIMT in Burkina Faso and Ghana requires further investigation. Highlights: All adiposity phenotypes were positively associated with common carotid intima-media thickness (CIMT) in the entire cohort (pooled analyses).BMI had the strongest association with CIMT compared to other phenotypes.The magnitude of association between adiposity phenotypes and CIMT was higher in men than in women.Subcutaneous adipose tissue was inversely associated with CIMT only in women.An unexpected finding was the inverse association of visceral adipose tissue with CIMT in Burkina Faso and Ghana.}, note = {Copyright: © 2021 The Author(s). PMID: 33833943 PMCID: PMC7977036}, keywords = {adiposity, Adult, Body Mass Index, cardiovascular disease, Carotid intima-media thickness, Cross-Sectional Studies, Female, Ghana, Humans, Male, Middle Aged, obesity, Obesity/complications/epidemiology, Phenotype, Risk Factors, sub-Saharan Africa, subclinical atherosclerosis}, pubstate = {published}, tppubtype = {article} } Close Background: Obesity and adipose tissue distribution contribute to an increased risk of cardiovascular disease (CVD) by promoting atherosclerosis. This association has been poorly studied in sub-Saharan Africa (SSA) despite the rising prevalence of cardiovascular disease. Objectives: We determined the association between various adiposity phenotypes and carotid intima-media thickness (CIMT), a proxy of subclinical atherosclerosis, in a large SSA population. Methods: A population-based cross-sectional study was performed from 2013-2016 in Burkina Faso, Ghana, Kenya and South Africa. Body mass index (BMI), waist (WC), hip circumferences (HC), visceral (VAT) and subcutaneous adipose tissue (SCAT) using B-mode ultrasound were measured. Ultrasonography of left and right far wall CIMT of the common carotid artery was used as an indicator of subclinical atherosclerosis. Individual participant data meta-analyses were used to determine the associations between adiposity phenotypes and CIMT in the pooled sample while adjusted multivariable linear regression analyses were used for site specific analyses. Results: Data were obtained from 9,010 adults (50.3% women and a mean age of 50$pm$ 6years). Men had higher levels of visceral fat than women while women had higher BMI, waist and hip circumference and subcutaneous fat than men at all sites except Burkina Faso. In the pooled analyses, BMI ($beta$-value [95% CIs]: 19.5 [16.8, 22.3] $mu$m) showed the strongest relationship with CIMT followed by VAT (5.86 [4.65, 7.07] $mu$m), SCAT (5.00 [2.85, 7.15] $mu$m), WC (1.27 [1.09, 1.44] $mu$m) and HC (1.23 [1.04, 1.42] $mu$m). Stronger associations were observed in men than in women. Conclusion: Obesity within SSA will likely result in higher levels of atherosclerosis and promote the occurrence of cardio- and cerebrovascular events, especially in males, unless addressed through primary prevention of obesity in both rural and urban communities across Africa. The inverse association of VAT with CIMT in Burkina Faso and Ghana requires further investigation. Highlights: All adiposity phenotypes were positively associated with common carotid intima-media thickness (CIMT) in the entire cohort (pooled analyses).BMI had the strongest association with CIMT compared to other phenotypes.The magnitude of association between adiposity phenotypes and CIMT was higher in men than in women.Subcutaneous adipose tissue was inversely associated with CIMT only in women.An unexpected finding was the inverse association of visceral adipose tissue with CIMT in Burkina Faso and Ghana. Close doi:10.5334/gh.863 Close
	Palpouguini Lompo, Marc Christian Tahita, Hermann Sorgho, William Kaboré, Adama Kazienga, Ashmed Cheick Bachirou Nana, Hamtandi Magloire Natama, Isidore Juste Ouindgueta Bonkoungou, Nicolas Barro, Halidou Tinto Pathogens associated with acute diarrhea, and comorbidity with malaria among children under five years old in rural Burkina Faso (Journal Article) In: Pan Afr. Med. J., vol. 38, pp. 259, 2021, ISSN: 1937-8688, (Copyright: Palpouguini Lompo et al. PMID: 34104307 PMCID: PMC8164431). (Abstract \| Links \| BibTeX \| Tags: Abdominal Pain/epidemiology, Acute Disease, bacteria, Burkina Faso, Burkina Faso/epidemiology, Child, Comorbidity, Diarrhea, Diarrhea/epidemiology/microbiology, Female, Fever/epidemiology, Giardiasis/epidemiology, Humans, Infant, infectious, Malaria, Malaria/epidemiology, Male, parasite, pathogens, Preschool, Prevalence, Risk Factors, rotavirus, Rotavirus Infections/epidemiology, Rural Population, Seasons, Vomiting/epidemiology) Close @article{Lompo2021-sk, title = {Pathogens associated with acute diarrhea, and comorbidity with malaria among children under five years old in rural Burkina Faso}, author = {Palpouguini Lompo and Marc Christian Tahita and Hermann Sorgho and William Kabor\'{e} and Adama Kazienga and Ashmed Cheick Bachirou Nana and Hamtandi Magloire Natama and Isidore Juste Ouindgueta Bonkoungou and Nicolas Barro and Halidou Tinto}, doi = {10.11604/pamj.2021.38.259.15864}, issn = {1937-8688}, year = {2021}, date = {2021-03-01}, urldate = {2021-03-01}, journal = {Pan Afr. Med. J.}, volume = {38}, pages = {259}, publisher = {Pan African Medical Journal}, abstract = {INTRODUCTION: acute diarrhea in children under five years is a public health problem in developing countries and particularly in malaria-endemic areas where both diseases co-exist. The present study examined the etiology of childhood diarrhea and its comorbidity with malaria in a rural area of Burkina Faso. METHODS: conventional culture techniques, direct stools examination, and viruses´ detection by rapid tests were performed on the fresh stools and microscopy was used to diagnose malaria. Some risk factors were also assessed. RESULTS: on a total of 191 samples collected, at least one pathogen was identified in 89 cases (46.6%). The proportions of pathogens found on the 89 positive stool samples were parasites 51.69% (46 cases), viruses 39.33% (35 cases), and bacteria 14.61% (13 cases), respectively. The relationship between malaria and infectious diarrhea was significant in viral and parasites causes (p=0.005 and 0.043 respectively). Fever, vomiting and abdominal pain were the major symptoms associated with diarrhea, with 71.51%, 31.72% and 23.66% respectively. The highest viral diarrhea prevalence was reported during the dry season (OR=5.29, 95% CI: 1.74 - 16.07, p=0.001) while parasite diarrhea was more encountered during the rainy season (OR=0.41, 95% CI: 0.33 - 0.87, p=0.011). CONCLUSION: Giardia spp and rotavirus were the leading cause of acute diarrhea in Nanoro, Burkina Faso with a predominance of rotavirus in children less than 2 years. Parasite and viral diarrhea were the most pathogens associated with malaria. However, the high rate of negative stool samples suggests the need to determine other enteric microorganisms.}, note = {Copyright: Palpouguini Lompo et al. PMID: 34104307 PMCID: PMC8164431}, keywords = {Abdominal Pain/epidemiology, Acute Disease, bacteria, Burkina Faso, Burkina Faso/epidemiology, Child, Comorbidity, Diarrhea, Diarrhea/epidemiology/microbiology, Female, Fever/epidemiology, Giardiasis/epidemiology, Humans, Infant, infectious, Malaria, Malaria/epidemiology, Male, parasite, pathogens, Preschool, Prevalence, Risk Factors, rotavirus, Rotavirus Infections/epidemiology, Rural Population, Seasons, Vomiting/epidemiology}, pubstate = {published}, tppubtype = {article} } Close INTRODUCTION: acute diarrhea in children under five years is a public health problem in developing countries and particularly in malaria-endemic areas where both diseases co-exist. The present study examined the etiology of childhood diarrhea and its comorbidity with malaria in a rural area of Burkina Faso. METHODS: conventional culture techniques, direct stools examination, and viruses´ detection by rapid tests were performed on the fresh stools and microscopy was used to diagnose malaria. Some risk factors were also assessed. RESULTS: on a total of 191 samples collected, at least one pathogen was identified in 89 cases (46.6%). The proportions of pathogens found on the 89 positive stool samples were parasites 51.69% (46 cases), viruses 39.33% (35 cases), and bacteria 14.61% (13 cases), respectively. The relationship between malaria and infectious diarrhea was significant in viral and parasites causes (p=0.005 and 0.043 respectively). Fever, vomiting and abdominal pain were the major symptoms associated with diarrhea, with 71.51%, 31.72% and 23.66% respectively. The highest viral diarrhea prevalence was reported during the dry season (OR=5.29, 95% CI: 1.74 – 16.07, p=0.001) while parasite diarrhea was more encountered during the rainy season (OR=0.41, 95% CI: 0.33 – 0.87, p=0.011). CONCLUSION: Giardia spp and rotavirus were the leading cause of acute diarrhea in Nanoro, Burkina Faso with a predominance of rotavirus in children less than 2 years. Parasite and viral diarrhea were the most pathogens associated with malaria. However, the high rate of negative stool samples suggests the need to determine other enteric microorganisms. Close doi:10.11604/pamj.2021.38.259.15864 Close
	Annelies Post, Berenger Kaboré, Joel Bognini, Salou Diallo, Palpouguini Lompo, Basile Kam, Natacha Herssens, Fred Opzeeland, Christa E Gaast-de Jongh, Jeroen D Langereis, Marien I Jonge, Janette Rahamat-Langendoen, Teun Bousema, Heiman Wertheim, Robert W Sauerwein, Halidou Tinto, Jan Jacobs, Quirijn Mast, Andre J Ven Infection Manager System (IMS) as a new hemocytometry-based bacteremia detection tool: A diagnostic accuracy study in a malaria-endemic area of Burkina Faso (Journal Article) In: PLoS Negl. Trop. Dis., vol. 15, no. 3, pp. e0009187, 2021, ISSN: 1935-2735 1935-2727, (PMID: 33647009 PMCID: PMC7951874). (Abstract \| Links \| BibTeX \| Tags: Adolescent, Automation, Bacteremia/diagnosis, Burkina Faso, C-Reactive Protein/analysis, Child, Coinfection/diagnosis/microbiology/parasitology, Female, Fever of Unknown Origin/diagnosis, Humans, Infant, Laboratory/methods, Malaria/diagnosis, Male, Preschool, Procalcitonin/analysis, Prospective Studies, Sensitivity and Specificity, Software, Virus Diseases/diagnosis) Close @article{Post2021-zl, title = {Infection Manager System (IMS) as a new hemocytometry-based bacteremia detection tool: A diagnostic accuracy study in a malaria-endemic area of Burkina Faso}, author = {Annelies Post and Berenger Kabor\'{e} and Joel Bognini and Salou Diallo and Palpouguini Lompo and Basile Kam and Natacha Herssens and Fred Opzeeland and Christa E Gaast-de Jongh and Jeroen D Langereis and Marien I Jonge and Janette Rahamat-Langendoen and Teun Bousema and Heiman Wertheim and Robert W Sauerwein and Halidou Tinto and Jan Jacobs and Quirijn Mast and Andre J Ven}, doi = {10.1371/journal.pntd.0009187}, issn = {1935-2735 1935-2727}, year = {2021}, date = {2021-03-01}, urldate = {2021-03-01}, journal = {PLoS Negl. Trop. Dis.}, volume = {15}, number = {3}, pages = {e0009187}, publisher = {Public Library of Science (PLoS)}, abstract = {BACKGROUND: New hemocytometric parameters can be used to differentiate causes of acute febrile illness (AFI). We evaluated a software algorithm-Infection Manager System (IMS)-which uses hemocytometric data generated by Sysmex hematology analyzers, for its accuracy to detect bacteremia in AFI patients with and without malaria in Burkina Faso. Secondary aims included comparing the accuracy of IMS with C-reactive protein (CRP) and procalcitonin (PCT). METHODS: In a prospective observational study, patients of $geq$ three-month-old (range 3 months- 90 years) presenting with AFI were enrolled. IMS, blood culture and malaria diagnostics were done upon inclusion and additional diagnostics on clinical indication. CRP, PCT, viral multiplex PCR on nasopharyngeal swabs and bacterial- and malaria PCR were batch-tested retrospectively. Diagnostic classification was done retrospectively using all available data except IMS, CRP and PCT results. FINDINGS: A diagnosis was affirmed in 549/914 (60.1%) patients and included malaria (n = 191) bacteremia (n = 69), viral infections (n = 145), and malaria-bacteremia co-infections (n = 47). The overall sensitivity, specificity, and negative predictive value (NPV) of IMS for detection of bacteremia in patients of $geq$ 5 years were 97.0% (95% CI: 89.8-99.6), 68.2% (95% CI: 55.6-79.1) and 95.7% (95% CI: 85.5-99.5) respectively, compared to 93.9% (95% CI: 85.2-98.3), 39.4% (95% CI: 27.6-52.2), and 86.7% (95% CI: 69.3-96.2) for CRP at $geq$20mg/L. The sensitivity, specificity and NPV of PCT at 0.5 ng/ml were lower at respectively 72.7% (95% CI: 60.4-83.0), 50.0% (95% CI: 37.4-62.6) and 64.7% (95% CI: 50.1-77.6) The diagnostic accuracy of IMS was lower among malaria cases and patients \<5 years but remained equal to- or higher than the accuracy of CRP. INTERPRETATION: IMS is a new diagnostic tool to differentiate causes of AFI. Its high NPV for bacteremia has the potential to improve antibiotic dispensing practices in healthcare facilities with hematology analyzers. Future studies are needed to evaluate whether IMS, combined with malaria diagnostics, may be used to rationalize antimicrobial prescription in malaria endemic areas. TRIAL REGISTRATION: ClinicalTrials.gov (NCT02669823) https://clinicaltrials.gov/ct2/show/NCT02669823.}, note = {PMID: 33647009 PMCID: PMC7951874}, keywords = {Adolescent, Automation, Bacteremia/diagnosis, Burkina Faso, C-Reactive Protein/analysis, Child, Coinfection/diagnosis/microbiology/parasitology, Female, Fever of Unknown Origin/diagnosis, Humans, Infant, Laboratory/methods, Malaria/diagnosis, Male, Preschool, Procalcitonin/analysis, Prospective Studies, Sensitivity and Specificity, Software, Virus Diseases/diagnosis}, pubstate = {published}, tppubtype = {article} } Close BACKGROUND: New hemocytometric parameters can be used to differentiate causes of acute febrile illness (AFI). We evaluated a software algorithm-Infection Manager System (IMS)-which uses hemocytometric data generated by Sysmex hematology analyzers, for its accuracy to detect bacteremia in AFI patients with and without malaria in Burkina Faso. Secondary aims included comparing the accuracy of IMS with C-reactive protein (CRP) and procalcitonin (PCT). METHODS: In a prospective observational study, patients of $geq$ three-month-old (range 3 months- 90 years) presenting with AFI were enrolled. IMS, blood culture and malaria diagnostics were done upon inclusion and additional diagnostics on clinical indication. CRP, PCT, viral multiplex PCR on nasopharyngeal swabs and bacterial- and malaria PCR were batch-tested retrospectively. Diagnostic classification was done retrospectively using all available data except IMS, CRP and PCT results. FINDINGS: A diagnosis was affirmed in 549/914 (60.1%) patients and included malaria (n = 191) bacteremia (n = 69), viral infections (n = 145), and malaria-bacteremia co-infections (n = 47). The overall sensitivity, specificity, and negative predictive value (NPV) of IMS for detection of bacteremia in patients of $geq$ 5 years were 97.0% (95% CI: 89.8-99.6), 68.2% (95% CI: 55.6-79.1) and 95.7% (95% CI: 85.5-99.5) respectively, compared to 93.9% (95% CI: 85.2-98.3), 39.4% (95% CI: 27.6-52.2), and 86.7% (95% CI: 69.3-96.2) for CRP at $geq$20mg/L. The sensitivity, specificity and NPV of PCT at 0.5 ng/ml were lower at respectively 72.7% (95% CI: 60.4-83.0), 50.0% (95% CI: 37.4-62.6) and 64.7% (95% CI: 50.1-77.6) The diagnostic accuracy of IMS was lower among malaria cases and patients <5 years but remained equal to- or higher than the accuracy of CRP. INTERPRETATION: IMS is a new diagnostic tool to differentiate causes of AFI. Its high NPV for bacteremia has the potential to improve antibiotic dispensing practices in healthcare facilities with hematology analyzers. Future studies are needed to evaluate whether IMS, combined with malaria diagnostics, may be used to rationalize antimicrobial prescription in malaria endemic areas. TRIAL REGISTRATION: ClinicalTrials.gov (NCT02669823) https://clinicaltrials.gov/ct2/show/NCT02669823. Close doi:10.1371/journal.pntd.0009187 Close

270 entries « ‹ 4 of 14 › »

2021
Journal Articles
	Daniel Chandramohan, Issaka Zongo, Issaka Sagara, Matthew Cairns, Rakiswendé-Serge Yerbanga, Modibo Diarra, Frédéric Niki`ema, Amadou Tapily, Frédéric Sompougdou, Djibrilla Issiaka, Charles Zoungrana, Koualy Sanogo, Alassane Haro, Mahamadou Kaya, Abdoul-Aziz Sienou, Seydou Traore, Almahamoudou Mahamar, Ismaila Thera, Kalifa Diarra, Amagana Dolo, Irene Kuepfer, Paul Snell, Paul Milligan, Christian Ockenhouse, Opokua Ofori-Anyinam, Halidou Tinto, Abdoulaye Djimde, Jean-Bosco Ouédraogo, Alassane Dicko, Brian Greenwood Seasonal malaria vaccination with or without seasonal malaria chemoprevention (Journal Article) In: N. Engl. J. Med., vol. 385, no. 11, pp. 1005–1017, 2021, ISSN: 1533-4406 0028-4793, (Copyright © 2021 Massachusetts Medical Society. Place: United States PMID: 34432975). (Abstract \| Links \| BibTeX \| Tags: Amodiaquine/therapeutic use, Antimalarials/adverse effects/therapeutic use, Burkina Faso/epidemiology, Chemoprevention, Combination, Combined Modality Therapy, Double-Blind Method, Drug Combinations, Drug Therapy, Falciparum/epidemiology/mortality/prevention & control, Febrile/etiology, Female, Hospitalization/statistics & numerical data, Humans, Infant, Malaria, Malaria Vaccines/administration & dosage/adverse effects, Male, Mali/epidemiology, Pyrimethamine/therapeutic use, Seasons, Seizures, Sulfadoxine/therapeutic use) Close @article{Chandramohan2021-qm, title = {Seasonal malaria vaccination with or without seasonal malaria chemoprevention}, author = {Daniel Chandramohan and Issaka Zongo and Issaka Sagara and Matthew Cairns and Rakiswend\'{e}-Serge Yerbanga and Modibo Diarra and Fr\'{e}d\'{e}ric Niki`ema and Amadou Tapily and Fr\'{e}d\'{e}ric Sompougdou and Djibrilla Issiaka and Charles Zoungrana and Koualy Sanogo and Alassane Haro and Mahamadou Kaya and Abdoul-Aziz Sienou and Seydou Traore and Almahamoudou Mahamar and Ismaila Thera and Kalifa Diarra and Amagana Dolo and Irene Kuepfer and Paul Snell and Paul Milligan and Christian Ockenhouse and Opokua Ofori-Anyinam and Halidou Tinto and Abdoulaye Djimde and Jean-Bosco Ou\'{e}draogo and Alassane Dicko and Brian Greenwood}, doi = {10.1056/NEJMoa2026330}, issn = {1533-4406 0028-4793}, year = {2021}, date = {2021-09-09}, urldate = {2021-09-09}, journal = {N. Engl. J. Med.}, volume = {385}, number = {11}, pages = {1005--1017}, publisher = {Massachusetts Medical Society}, abstract = {BACKGROUND: Malaria control remains a challenge in many parts of the Sahel and sub-Sahel regions of Africa. METHODS: We conducted an individually randomized, controlled trial to assess whether seasonal vaccination with RTS,S/AS01E 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. RESULTS: We randomly assigned 6861 children 5 to 17 months of age to receive sulfadoxine-pyrimethamine and amodiaquine (2287 children [chemoprevention-alone group]), RTS,S/AS01E (2288 children [vaccine-alone group]), or chemoprevention and RTS,S/AS01E (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/AS01E 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. CONCLUSIONS: Administration of RTS,S/AS01E 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.).}, note = {Copyright © 2021 Massachusetts Medical Society. Place: United States PMID: 34432975}, keywords = {Amodiaquine/therapeutic use, Antimalarials/adverse effects/therapeutic use, Burkina Faso/epidemiology, Chemoprevention, Combination, Combined Modality Therapy, Double-Blind Method, Drug Combinations, Drug Therapy, Falciparum/epidemiology/mortality/prevention \& control, Febrile/etiology, Female, Hospitalization/statistics \& numerical data, Humans, Infant, Malaria, Malaria Vaccines/administration \& dosage/adverse effects, Male, Mali/epidemiology, Pyrimethamine/therapeutic use, Seasons, Seizures, Sulfadoxine/therapeutic use}, pubstate = {published}, tppubtype = {article} } Close BACKGROUND: Malaria control remains a challenge in many parts of the Sahel and sub-Sahel regions of Africa. METHODS: We conducted an individually randomized, controlled trial to assess whether seasonal vaccination with RTS,S/AS01E 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. RESULTS: We randomly assigned 6861 children 5 to 17 months of age to receive sulfadoxine-pyrimethamine and amodiaquine (2287 children [chemoprevention-alone group]), RTS,S/AS01E (2288 children [vaccine-alone group]), or chemoprevention and RTS,S/AS01E (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/AS01E 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. CONCLUSIONS: Administration of RTS,S/AS01E 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.). Close doi:10.1056/NEJMoa2026330 Close
	Isidore Tiandiogo Traoré, Samiratou Ouedraogo, Dramane Kania, Firmin Nongodo Kaboré, Blahima Konaté, Rachel Médah, Hermann Badolo, Nathalie Rekeneire, Ariane Mamguem Kamga, Armel Poda, Arnaud Eric Diendere, Boukary Ouédraogo, Esperance Ouédraogo, Oumar Billa, Halidou Tinto, Tienhan Sandrine Dabakuyo-Yonli COVID-19 epidemiological, sociological and anthropological investigation: study protocol for a multidisciplinary mixed methods research in Burkina Faso (Journal Article) In: BMC Infect. Dis., vol. 21, no. 1, pp. 896, 2021, ISSN: 1471-2334, (© 2021. The Author(s). PMID: 34479501 PMCID: PMC8414025). (Abstract \| Links \| BibTeX \| Tags: Burkina Faso/epidemiology, Clinical epidemiology, COVID-19, Humans, Predictive score, Prospective Studies, Retrospective Studies, SARS-Cov-2, Sero-epidemiology, Socio-anthropology) Close @article{Traore2021-vr, title = {COVID-19 epidemiological, sociological and anthropological investigation: study protocol for a multidisciplinary mixed methods research in Burkina Faso}, author = {Isidore Tiandiogo Traor\'{e} and Samiratou Ouedraogo and Dramane Kania and Firmin Nongodo Kabor\'{e} and Blahima Konat\'{e} and Rachel M\'{e}dah and Hermann Badolo and Nathalie Rekeneire and Ariane Mamguem Kamga and Armel Poda and Arnaud Eric Diendere and Boukary Ou\'{e}draogo and Esperance Ou\'{e}draogo and Oumar Billa and Halidou Tinto and Tienhan Sandrine Dabakuyo-Yonli}, doi = {10.1186/s12879-021-06543-4}, issn = {1471-2334}, year = {2021}, date = {2021-09-03}, urldate = {2021-09-03}, journal = {BMC Infect. Dis.}, volume = {21}, number = {1}, pages = {896}, abstract = {BACKGROUND: The world has high hopes of vaccination against COVID-19 to protect the population, boost economies and return to normal life. Vaccination programmes are being rolled out in high income countries, but the pandemic continues to progress in many low-and middle-income countries (LMICs) despite implementation of strict hygiene measures. We aim to present a comprehensive research protocol that will generate epidemiological, sociological and anthropological data about the COVID-19 epidemic in Burkina Faso, a landlocked country in West Africa with scarce resources. METHODS: We will perform a multidisciplinary research using mixed methods in the two main cities in Burkina Faso (Ouagadougou and Bobo-Dioulasso). Data will be collected in the general population and in COVID-19 patients, caregivers and health care professionals in reference care centers: (i) to determine cumulative incidence of SARS-CoV-2 infection in the Burkinabe population using blood samples collected from randomly selected households according to the WHO-recommended protocol; (ii) develop a score to predict severe complications of COVID-19 in persons infected with SARS-CoV-2 using retrospective and prospective data; (iii) perform semi-structured interviews and direct observation on site, to describe and analyze the healthcare pathways and experiences of patients with COVID-19 attending reference care centers, and to identify the perceptions, acceptability and application of preventive strategies among the population. DISCUSSION: This study will generate comprehensive data that will contribute to improving COVID-19 response strategies in Burkina Faso. The lessons learned from the management of this epidemic may serve as examples to the country authorities to better design preventive strategies in the case of future epidemics or pandemics. The protocol was approved by the Ministry for Health (N° 2020-00952/MS/CAB/INSP/CM) and the Health Research Ethics Committee in Burkina Faso (N° 2020-8-140).}, note = {© 2021. The Author(s). PMID: 34479501 PMCID: PMC8414025}, keywords = {Burkina Faso/epidemiology, Clinical epidemiology, COVID-19, Humans, Predictive score, Prospective Studies, Retrospective Studies, SARS-Cov-2, Sero-epidemiology, Socio-anthropology}, pubstate = {published}, tppubtype = {article} } Close BACKGROUND: The world has high hopes of vaccination against COVID-19 to protect the population, boost economies and return to normal life. Vaccination programmes are being rolled out in high income countries, but the pandemic continues to progress in many low-and middle-income countries (LMICs) despite implementation of strict hygiene measures. We aim to present a comprehensive research protocol that will generate epidemiological, sociological and anthropological data about the COVID-19 epidemic in Burkina Faso, a landlocked country in West Africa with scarce resources. METHODS: We will perform a multidisciplinary research using mixed methods in the two main cities in Burkina Faso (Ouagadougou and Bobo-Dioulasso). Data will be collected in the general population and in COVID-19 patients, caregivers and health care professionals in reference care centers: (i) to determine cumulative incidence of SARS-CoV-2 infection in the Burkinabe population using blood samples collected from randomly selected households according to the WHO-recommended protocol; (ii) develop a score to predict severe complications of COVID-19 in persons infected with SARS-CoV-2 using retrospective and prospective data; (iii) perform semi-structured interviews and direct observation on site, to describe and analyze the healthcare pathways and experiences of patients with COVID-19 attending reference care centers, and to identify the perceptions, acceptability and application of preventive strategies among the population. DISCUSSION: This study will generate comprehensive data that will contribute to improving COVID-19 response strategies in Burkina Faso. The lessons learned from the management of this epidemic may serve as examples to the country authorities to better design preventive strategies in the case of future epidemics or pandemics. The protocol was approved by the Ministry for Health (N° 2020-00952/MS/CAB/INSP/CM) and the Health Research Ethics Committee in Burkina Faso (N° 2020-8-140). Close doi:10.1186/s12879-021-06543-4 Close
	Stephen A Roberts, Loretta Brabin, Halidou Tinto, Sabine Gies, Salou Diallo, Bernard Brabin Seasonal patterns of malaria, genital infection, nutritional and iron status in non-pregnant and pregnant adolescents in Burkina Faso: a secondary analysis of trial data (Journal Article) In: BMC Public Health, vol. 21, no. 1, pp. 1764, 2021, ISSN: 1471-2458, (© 2021. The Author(s). PMID: 34579679 PMCID: PMC8477466). (Abstract \| Links \| BibTeX \| Tags: Abnormal vaginal flora, Adolescents, Bacterial vaginosis, Body Mass Index, Burkina Faso/epidemiology, Child, Female, Humans, Iron, iron biomarkers, Malaria, Malaria/drug therapy/epidemiology, MUAC, Pregnancy, Seasons, Vagina) Close @article{Roberts2021-gg, title = {Seasonal patterns of malaria, genital infection, nutritional and iron status in non-pregnant and pregnant adolescents in Burkina Faso: a secondary analysis of trial data}, author = {Stephen A Roberts and Loretta Brabin and Halidou Tinto and Sabine Gies and Salou Diallo and Bernard Brabin}, doi = {10.1186/s12889-021-11819-0}, issn = {1471-2458}, year = {2021}, date = {2021-09-01}, urldate = {2021-09-01}, journal = {BMC Public Health}, volume = {21}, number = {1}, pages = {1764}, publisher = {Springer Science and Business Media LLC}, abstract = {BACKGROUND: Adolescents are considered at high risk of developing iron deficiency. Studies in children indicate that the prevalence of iron deficiency increased with malaria transmission, suggesting malaria seasonally may drive iron deficiency. This paper examines monthly seasonal infection patterns of malaria, abnormal vaginal flora, chorioamnionitis, antibiotic and antimalarial prescriptions, in relation to changes in iron biomarkers and nutritional indices in adolescents living in a rural area of Burkina Faso, in order to assess the requirement for seasonal infection control and nutrition interventions. METHODS: Data collected between April 2011 and January 2014 were available for an observational seasonal analysis, comprising scheduled visits for 1949 non-pregnant adolescents (≤19 years), (315 of whom subsequently became pregnant), enrolled in a randomised trial of periconceptional iron supplementation. Data from trial arms were combined. Body Iron Stores (BIS) were calculated using an internal regression for ferritin to allow for inflammation. At recruitment 11% had low BIS (\< 0 mg/kg). Continuous outcomes were fitted to a mixed-effects linear model with month, age and pregnancy status as fixed effect covariates and woman as a random effect. Dichotomous infection outcomes were fitted with analogous logistic regression models. RESULTS: Seasonal variation in malaria parasitaemia prevalence ranged between 18 and 70% in non-pregnant adolescents (P \< 0.001), peaking at 81% in those who became pregnant. Seasonal variation occurred in antibiotic prescription rates (0.7-1.8 prescriptions/100 weekly visits, P \< 0.001) and chorioamnionitis prevalence (range 15-68%, P = 0.026). Mucosal vaginal lactoferrin concentration was lower at the end of the wet season (range 2-22 μg/ml, P \< 0.016), when chorioamnionitis was least frequent. BIS fluctuated annually by up to 53.2% per year around the mean BIS (5.1 mg/kg(2), range 4.1-6.8 mg/kg), with low BIS (\< 0 mg/kg) of 8.7% in the dry and 9.8% in the wet seasons (P = 0.36). Median serum transferrin receptor increased during the wet season (P \< 0.001). Higher hepcidin concentration in the wet season corresponded with rising malaria prevalence and use of prescriptions, but with no change in BIS. Mean Body Mass Index and Mid-Upper-Arm-Circumference values peaked mid-dry season (both P \< 0.001). CONCLUSIONS: Our analysis supports preventive treatment of malaria among adolescents 15-19 years to decrease their disease burden, especially asymptomatic malaria. As BIS were adequate in most adolescents despite seasonal malaria, a requirement for programmatic iron supplementation was not substantiated.}, note = {© 2021. The Author(s). PMID: 34579679 PMCID: PMC8477466}, keywords = {Abnormal vaginal flora, Adolescents, Bacterial vaginosis, Body Mass Index, Burkina Faso/epidemiology, Child, Female, Humans, Iron, iron biomarkers, Malaria, Malaria/drug therapy/epidemiology, MUAC, Pregnancy, Seasons, Vagina}, pubstate = {published}, tppubtype = {article} } Close BACKGROUND: Adolescents are considered at high risk of developing iron deficiency. Studies in children indicate that the prevalence of iron deficiency increased with malaria transmission, suggesting malaria seasonally may drive iron deficiency. This paper examines monthly seasonal infection patterns of malaria, abnormal vaginal flora, chorioamnionitis, antibiotic and antimalarial prescriptions, in relation to changes in iron biomarkers and nutritional indices in adolescents living in a rural area of Burkina Faso, in order to assess the requirement for seasonal infection control and nutrition interventions. METHODS: Data collected between April 2011 and January 2014 were available for an observational seasonal analysis, comprising scheduled visits for 1949 non-pregnant adolescents (≤19 years), (315 of whom subsequently became pregnant), enrolled in a randomised trial of periconceptional iron supplementation. Data from trial arms were combined. Body Iron Stores (BIS) were calculated using an internal regression for ferritin to allow for inflammation. At recruitment 11% had low BIS (< 0 mg/kg). Continuous outcomes were fitted to a mixed-effects linear model with month, age and pregnancy status as fixed effect covariates and woman as a random effect. Dichotomous infection outcomes were fitted with analogous logistic regression models. RESULTS: Seasonal variation in malaria parasitaemia prevalence ranged between 18 and 70% in non-pregnant adolescents (P < 0.001), peaking at 81% in those who became pregnant. Seasonal variation occurred in antibiotic prescription rates (0.7-1.8 prescriptions/100 weekly visits, P < 0.001) and chorioamnionitis prevalence (range 15-68%, P = 0.026). Mucosal vaginal lactoferrin concentration was lower at the end of the wet season (range 2-22 μg/ml, P < 0.016), when chorioamnionitis was least frequent. BIS fluctuated annually by up to 53.2% per year around the mean BIS (5.1 mg/kg(2), range 4.1-6.8 mg/kg), with low BIS (< 0 mg/kg) of 8.7% in the dry and 9.8% in the wet seasons (P = 0.36). Median serum transferrin receptor increased during the wet season (P < 0.001). Higher hepcidin concentration in the wet season corresponded with rising malaria prevalence and use of prescriptions, but with no change in BIS. Mean Body Mass Index and Mid-Upper-Arm-Circumference values peaked mid-dry season (both P < 0.001). CONCLUSIONS: Our analysis supports preventive treatment of malaria among adolescents 15-19 years to decrease their disease burden, especially asymptomatic malaria. As BIS were adequate in most adolescents despite seasonal malaria, a requirement for programmatic iron supplementation was not substantiated. Close doi:10.1186/s12889-021-11819-0 Close
	Adéla"ide Compaoré, Kadija Ouedraogo, Palwende R Boua, Daniella Watson, Sarah H Kehoe, Marie-Louise Newell, Halidou Tinto, Mary Barker, Hermann Sorgho, INPreP group ‘Men are not playing their roles’, maternal and child nutrition in Nanoro, Burkina Faso (Journal Article) In: Public Health Nutr., vol. 24, no. 12, pp. 3780–3790, 2021, ISSN: 1475-2727 1368-9800, (Place: England PMID: 33000717). (Abstract \| Links \| BibTeX \| Tags: Burkina Faso, Child, Child nutrition, Child Nutritional Physiological Phenomena, Community perceptions, Empowerment, Female, Humans, Male, Maternal nutrition, Mothers, Nutritional Status, Pregnancy, Qualitative research) Close @article{Compaore2021-hg, title = {'Men are not playing their roles', maternal and child nutrition in Nanoro, Burkina Faso}, author = {Ad\'{e}la"ide Compaor\'{e} and Kadija Ouedraogo and Palwende R Boua and Daniella Watson and Sarah H Kehoe and Marie-Louise Newell and Halidou Tinto and Mary Barker and Hermann Sorgho and INPreP group}, doi = {10.1017/S1368980020003365}, issn = {1475-2727 1368-9800}, year = {2021}, date = {2021-08-01}, urldate = {2021-08-01}, journal = {Public Health Nutr.}, volume = {24}, number = {12}, pages = {3780--3790}, publisher = {Cambridge University Press (CUP)}, abstract = {OBJECTIVE: To collect context-specific insights into maternal and child health and nutrition issues, and to explore potential solutions in Nanoro, Burkina Faso. DESIGN: Eleven focus groups with men and women from eleven communities, facilitated by local researchers. SETTING: The study took place in the Nanoro Health district, in the West-Central part of Burkina Faso. PARTICIPANTS: Eighty-six men (18-55 years) and women by age group: 18-25; 26-34 and 35-55 years, participated in the group discussions. RESULTS: Participants described barriers to optimal nutrition of mothers and children related to a range of community factors, with gender inequality as central. Major themes in the discussions are related to poverty and challenges generated by socially and culturally determined gender roles. Sub-themes are women lacking access to food whilst pregnant and having limited access to health care and opportunities to generate income. Although communities believe that food donations should be implemented to overcome this, they also pointed out the need for enhancing their own food production, requiring improved agricultural technologies. Given the important role that women could play in reducing malnutrition, these communities felt they needed to be empowered to do so and supported by men. They also felt that this had to be carried out in the context of an enhanced health care system. CONCLUSIONS: Findings reported here highlight the importance of nutrition-sensitive interventions and women's empowerment in improving maternal and child nutrition. There is a need to integrate a sustainable multi-sectorial approach which goes beyond food support.}, note = {Place: England PMID: 33000717}, keywords = {Burkina Faso, Child, Child nutrition, Child Nutritional Physiological Phenomena, Community perceptions, Empowerment, Female, Humans, Male, Maternal nutrition, Mothers, Nutritional Status, Pregnancy, Qualitative research}, pubstate = {published}, tppubtype = {article} } Close OBJECTIVE: To collect context-specific insights into maternal and child health and nutrition issues, and to explore potential solutions in Nanoro, Burkina Faso. DESIGN: Eleven focus groups with men and women from eleven communities, facilitated by local researchers. SETTING: The study took place in the Nanoro Health district, in the West-Central part of Burkina Faso. PARTICIPANTS: Eighty-six men (18-55 years) and women by age group: 18-25; 26-34 and 35-55 years, participated in the group discussions. RESULTS: Participants described barriers to optimal nutrition of mothers and children related to a range of community factors, with gender inequality as central. Major themes in the discussions are related to poverty and challenges generated by socially and culturally determined gender roles. Sub-themes are women lacking access to food whilst pregnant and having limited access to health care and opportunities to generate income. Although communities believe that food donations should be implemented to overcome this, they also pointed out the need for enhancing their own food production, requiring improved agricultural technologies. Given the important role that women could play in reducing malnutrition, these communities felt they needed to be empowered to do so and supported by men. They also felt that this had to be carried out in the context of an enhanced health care system. CONCLUSIONS: Findings reported here highlight the importance of nutrition-sensitive interventions and women’s empowerment in improving maternal and child nutrition. There is a need to integrate a sustainable multi-sectorial approach which goes beyond food support. Close doi:10.1017/S1368980020003365 Close
	Koudraogo Bienvenue Yaméogo, Rakiswendé Serge Yerbanga, Seydou Bienvenu Ouattara, Franck A Yao, Thierry Lef`evre, Issaka Zongo, Frederic Niki`ema, Yves Daniel Compaoré, Halidou Tinto, Daniel Chandramohan, Brian Greenwood, Adrien M G Belem, Anna Cohuet, Jean Bosco Ouédraogo Effect of seasonal malaria chemoprevention plus azithromycin on Plasmodium falciparum transmission: gametocyte infectivity and mosquito fitness (Journal Article) In: Malar. J., vol. 20, no. 1, pp. 326, 2021, ISSN: 1475-2875, (© 2021. The Author(s). PMID: 34315475 PMCID: PMC8314489). (Abstract \| Links \| BibTeX \| Tags: Amodiaquine/administration & dosage, Animals, Antimalarials/administration & dosage, Chemoprevention, Child, Culicidae/physiology, Drug Combinations, Falciparum/prevention & control/transmission, Gametocytes, Genetic Fitness, Humans, Malaria, Plasmodium falciparum/physiology, Preschool, Pyrimethamine/administration & dosage, seasonal malaria chemoprevention, Seasons, Sulfadoxine/administration & dosage, Transmission) Close @article{Yameogo2021-bb, title = {Effect of seasonal malaria chemoprevention plus azithromycin on Plasmodium falciparum transmission: gametocyte infectivity and mosquito fitness}, author = {Koudraogo Bienvenue Yam\'{e}ogo and Rakiswend\'{e} Serge Yerbanga and Seydou Bienvenu Ouattara and Franck A Yao and Thierry Lef`evre and Issaka Zongo and Frederic Niki`ema and Yves Daniel Compaor\'{e} and Halidou Tinto and Daniel Chandramohan and Brian Greenwood and Adrien M G Belem and Anna Cohuet and Jean Bosco Ou\'{e}draogo}, doi = {10.1186/s12936-021-03855-3}, issn = {1475-2875}, year = {2021}, date = {2021-07-27}, urldate = {2021-07-27}, journal = {Malar. J.}, volume = {20}, number = {1}, pages = {326}, publisher = {Springer Science and Business Media LLC}, abstract = {BACKGROUND: Seasonal malaria chemoprevention (SMC) consists of administration of sulfadoxine-pyrimethamine (SP) + amodiaquine (AQ) at monthly intervals to children during the malaria transmission period. Whether the addition of azithromycin (AZ) to SMC could potentiate the benefit of the intervention was tested through a double-blind, randomized, placebo-controlled trial. The effect of SMC and the addition of AZ, on malaria transmission and on the life history traits of Anopheles gambiae mosquitoes have been investigated. METHODS: The study included 438 children randomly selected from among participants in the SMC + AZ trial and 198 children from the same area who did not receive chemoprevention. For each participant in the SMC + AZ trial, blood was collected 14 to 21 days post treatment, examined for the presence of malaria sexual and asexual stages and provided as a blood meal to An. gambiae females using a direct membrane-feeding assay. RESULTS: The SMC treatment, with or without AZ, significantly reduced the prevalence of asexual Plasmodium falciparum (LRT X(2)(2) = 69, P \< 0.0001) and the gametocyte prevalence (LRT X(2)(2) = 54, P \< 0.0001). In addition, the proportion of infectious feeds (LRT X(2)(2) = 61, P \< 0.0001) and the prevalence of oocysts among exposed mosquitoes (LRT X(2)(2) = 22.8, P \< 0.001) was reduced when mosquitoes were fed on blood from treated children compared to untreated controls. The addition of AZ to SPAQ was associated with an increased proportion of infectious feeds (LRT X(2)(1) = 5.2, P = 0.02), suggesting a significant effect of AZ on gametocyte infectivity. There was a slight negative effect of SPAQ and SPAQ + AZ on mosquito survival compared to mosquitoes fed with blood from control children (LRTX(2)(2) = 330, P \< 0.0001). CONCLUSION: This study demonstrates that SMC may contribute to a reduction in human to mosquito transmission of P. falciparum, and the reduced mosquito longevity observed for females fed on treated blood may increase the benefit of this intervention in control of malaria. The addition of AZ to SPAQ in SMC appeared to enhance the infectivity of gametocytes providing further evidence that this combination is not an appropriate intervention.}, note = {© 2021. The Author(s). PMID: 34315475 PMCID: PMC8314489}, keywords = {Amodiaquine/administration \& dosage, Animals, Antimalarials/administration \& dosage, Chemoprevention, Child, Culicidae/physiology, Drug Combinations, Falciparum/prevention \& control/transmission, Gametocytes, Genetic Fitness, Humans, Malaria, Plasmodium falciparum/physiology, Preschool, Pyrimethamine/administration \& dosage, seasonal malaria chemoprevention, Seasons, Sulfadoxine/administration \& dosage, Transmission}, pubstate = {published}, tppubtype = {article} } Close BACKGROUND: Seasonal malaria chemoprevention (SMC) consists of administration of sulfadoxine-pyrimethamine (SP) + amodiaquine (AQ) at monthly intervals to children during the malaria transmission period. Whether the addition of azithromycin (AZ) to SMC could potentiate the benefit of the intervention was tested through a double-blind, randomized, placebo-controlled trial. The effect of SMC and the addition of AZ, on malaria transmission and on the life history traits of Anopheles gambiae mosquitoes have been investigated. METHODS: The study included 438 children randomly selected from among participants in the SMC + AZ trial and 198 children from the same area who did not receive chemoprevention. For each participant in the SMC + AZ trial, blood was collected 14 to 21 days post treatment, examined for the presence of malaria sexual and asexual stages and provided as a blood meal to An. gambiae females using a direct membrane-feeding assay. RESULTS: The SMC treatment, with or without AZ, significantly reduced the prevalence of asexual Plasmodium falciparum (LRT X(2)(2) = 69, P < 0.0001) and the gametocyte prevalence (LRT X(2)(2) = 54, P < 0.0001). In addition, the proportion of infectious feeds (LRT X(2)(2) = 61, P < 0.0001) and the prevalence of oocysts among exposed mosquitoes (LRT X(2)(2) = 22.8, P < 0.001) was reduced when mosquitoes were fed on blood from treated children compared to untreated controls. The addition of AZ to SPAQ was associated with an increased proportion of infectious feeds (LRT X(2)(1) = 5.2, P = 0.02), suggesting a significant effect of AZ on gametocyte infectivity. There was a slight negative effect of SPAQ and SPAQ + AZ on mosquito survival compared to mosquitoes fed with blood from control children (LRTX(2)(2) = 330, P < 0.0001). CONCLUSION: This study demonstrates that SMC may contribute to a reduction in human to mosquito transmission of P. falciparum, and the reduced mosquito longevity observed for females fed on treated blood may increase the benefit of this intervention in control of malaria. The addition of AZ to SPAQ in SMC appeared to enhance the infectivity of gametocytes providing further evidence that this combination is not an appropriate intervention. Close doi:10.1186/s12936-021-03855-3 Close
	Navideh Noori, Karim Derra, Innocent Valea, Assaf P Oron, Aminata Welgo, Toussaint Rouamba, Palwende Romuald Boua, Athanase M Somé, Eli Rouamba, Edward Wenger, Hermann Sorgho, Halidou Tinto, Andre Lin Ouédraogo Patterns of child mortality in rural area of Burkina Faso: evidence from the Nanoro health and demographic surveillance system (HDSS) (Journal Article) In: BMC Public Health, vol. 21, no. 1, pp. 1425, 2021, ISSN: 1471-2458, (© 2021. The Author(s). PMID: 34281547 PMCID: PMC8287796). (Abstract \| Links \| BibTeX \| Tags: Burkina Faso, Burkina Faso/epidemiology, child mortality, ChildHealth Facilities, Children under 5, Demographic surveillance, HDSS, Humans, Infant, Malaria, Nanoro, Spatial analysis, Travel) Close @article{Noori2021-te, title = {Patterns of child mortality in rural area of Burkina Faso: evidence from the Nanoro health and demographic surveillance system (HDSS)}, author = {Navideh Noori and Karim Derra and Innocent Valea and Assaf P Oron and Aminata Welgo and Toussaint Rouamba and Palwende Romuald Boua and Athanase M Som\'{e} and Eli Rouamba and Edward Wenger and Hermann Sorgho and Halidou Tinto and Andre Lin Ou\'{e}draogo}, doi = {10.1186/s12889-021-11483-4}, issn = {1471-2458}, year = {2021}, date = {2021-07-19}, urldate = {2021-07-19}, journal = {BMC Public Health}, volume = {21}, number = {1}, pages = {1425}, publisher = {Springer Science and Business Media LLC}, abstract = {BACKGROUND: Half of global child deaths occur in sub-Saharan Africa. Understanding child mortality patterns and risk factors will help inform interventions to reduce this heavy toll. The Nanoro Health and Demographic Surveillance System (HDSS), Burkina Faso was described previously, but patterns and potential drivers of heterogeneity in child mortality in the district had not been studied. Similar studies in other districts indicated proximity to health facilities as a risk factor, usually without distinction between facility types. METHODS: Using Nanoro HDSS data from 2009 to 2013, we estimated the association between under-5 mortality and proximity to inpatient and outpatient health facilities, seasonality of death, age group, and standard demographic risk factors. RESULTS: Living in homes 40-60 min and \> 60 min travel time from an inpatient facility was associated with 1.52 (95% CI: 1.13-2.06) and 1.74 (95% CI: 1.27-2.40) greater hazard of under-5 mortality, respectively, than living in homes \< 20 min from an inpatient facility. No such association was found for outpatient facilities. The wet season (July-November) was associated with 1.28 (95% CI: 1.07, 1.53) higher under-5 mortality than the dry season (December-June), likely reflecting the malaria season. CONCLUSIONS: Our results emphasize the importance of geographical proximity to health care, distinguish between inpatient and outpatient facilities, and also show a seasonal effect, probably driven by malaria.}, note = {© 2021. The Author(s). PMID: 34281547 PMCID: PMC8287796}, keywords = {Burkina Faso, Burkina Faso/epidemiology, child mortality, ChildHealth Facilities, Children under 5, Demographic surveillance, HDSS, Humans, Infant, Malaria, Nanoro, Spatial analysis, Travel}, pubstate = {published}, tppubtype = {article} } Close BACKGROUND: Half of global child deaths occur in sub-Saharan Africa. Understanding child mortality patterns and risk factors will help inform interventions to reduce this heavy toll. The Nanoro Health and Demographic Surveillance System (HDSS), Burkina Faso was described previously, but patterns and potential drivers of heterogeneity in child mortality in the district had not been studied. Similar studies in other districts indicated proximity to health facilities as a risk factor, usually without distinction between facility types. METHODS: Using Nanoro HDSS data from 2009 to 2013, we estimated the association between under-5 mortality and proximity to inpatient and outpatient health facilities, seasonality of death, age group, and standard demographic risk factors. RESULTS: Living in homes 40-60 min and > 60 min travel time from an inpatient facility was associated with 1.52 (95% CI: 1.13-2.06) and 1.74 (95% CI: 1.27-2.40) greater hazard of under-5 mortality, respectively, than living in homes < 20 min from an inpatient facility. No such association was found for outpatient facilities. The wet season (July-November) was associated with 1.28 (95% CI: 1.07, 1.53) higher under-5 mortality than the dry season (December-June), likely reflecting the malaria season. CONCLUSIONS: Our results emphasize the importance of geographical proximity to health care, distinguish between inpatient and outpatient facilities, and also show a seasonal effect, probably driven by malaria. Close doi:10.1186/s12889-021-11483-4 Close
	Marie Jaspard, Mamadou Saliou Sow, Sylvain Juchet, Eric Dienderé, Beatrice Serra, Richard Kojan, Billy Sivahera, Caroline Martin, Moumouni Kinda, Hans-Joerg Lang, Fodé Bangaly Sako, Fodé Amara Traoré, Eudoxie Koumbem, Halidou Tinto, Adama Sanou, Apoline Sondo, Flavien Kaboré, Joseph Donamou, Jean-Paul-Yassa Guilavogui, Fanny Velardo, Brice Bicaba, Olivier Marcy, Augustin Augier, Sani Sayadi, Armel Poda, Sakoba Keita, Xavier Anglaret, Denis Malvy, COVISTA group Clinical presentation, outcomes and factors associated with mortality: A prospective study from three COVID-19 referral care centres in West Africa (Journal Article) In: Int. J. Infect. Dis., vol. 108, pp. 45–52, 2021, ISSN: 1878-3511 1201-9712, (Copyright © 2021 The Authors. Published by Elsevier Ltd.. All rights reserved. PMID: 34000419 PMCID: PMC8120805). (Abstract \| Links \| BibTeX \| Tags: Adult, Aged, Burkina Faso/epidemiology, Comorbidities, COVID-19, Female, Hospitalization, Humans, Male, Mortality, Prospective Studies, Referral and Consultation, SARS-Cov-2, sub-Saharan Africa) Close @article{Jaspard2021-bl, title = {Clinical presentation, outcomes and factors associated with mortality: A prospective study from three COVID-19 referral care centres in West Africa}, author = {Marie Jaspard and Mamadou Saliou Sow and Sylvain Juchet and Eric Diender\'{e} and Beatrice Serra and Richard Kojan and Billy Sivahera and Caroline Martin and Moumouni Kinda and Hans-Joerg Lang and Fod\'{e} Bangaly Sako and Fod\'{e} Amara Traor\'{e} and Eudoxie Koumbem and Halidou Tinto and Adama Sanou and Apoline Sondo and Flavien Kabor\'{e} and Joseph Donamou and Jean-Paul-Yassa Guilavogui and Fanny Velardo and Brice Bicaba and Olivier Marcy and Augustin Augier and Sani Sayadi and Armel Poda and Sakoba Keita and Xavier Anglaret and Denis Malvy and COVISTA group}, doi = {10.1016/j.ijid.2021.05.024}, issn = {1878-3511 1201-9712}, year = {2021}, date = {2021-07-01}, urldate = {2021-07-01}, journal = {Int. J. Infect. Dis.}, volume = {108}, pages = {45--52}, publisher = {Elsevier BV}, abstract = {OBJECTIVES: The overall death toll from COVID-19 in Africa is reported to be low but there is little individual-level evidence on the severity of the disease. This study examined the clinical spectrum and outcome of patients monitored in COVID-19 care centres (CCCs) in two West-African countries. METHODS: Burkina Faso and Guinea set up referral CCCs to hospitalise all symptomatic SARS-CoV-2 carriers, regardless of the severity of their symptoms. Data collected from hospitalised patients by November 2020 are presented. RESULT: A total of 1,805 patients (64% men, median age 41 years) were admitted with COVID-19. Symptoms lasted for a median of 7 days (IQR 4-11). During hospitalisation, 443 (25%) had a SpO2 \< 94% at least once, 237 (13%) received oxygen and 266 (15%) took corticosteroids. Mortality was 5% overall, and 1%, 5% and 14% in patients aged \<40, 40-59 and $geq$60 years, respectively. In multivariable analysis, the risk of death was higher in men (aOR 2.0, 95% CI 1.1; 3.6), people aged $geq$60 years (aOR 2.9, 95% CI 1.7; 4.8) and those with chronic hypertension (aOR 2.1, 95% CI 1.2; 3.4). CONCLUSION: COVID-19 is as severe in Africa as elsewhere, and there must be more vigilance for common risk factors such as older age and hypertension.}, note = {Copyright © 2021 The Authors. Published by Elsevier Ltd.. All rights reserved. PMID: 34000419 PMCID: PMC8120805}, keywords = {Adult, Aged, Burkina Faso/epidemiology, Comorbidities, COVID-19, Female, Hospitalization, Humans, Male, Mortality, Prospective Studies, Referral and Consultation, SARS-Cov-2, sub-Saharan Africa}, pubstate = {published}, tppubtype = {article} } Close OBJECTIVES: The overall death toll from COVID-19 in Africa is reported to be low but there is little individual-level evidence on the severity of the disease. This study examined the clinical spectrum and outcome of patients monitored in COVID-19 care centres (CCCs) in two West-African countries. METHODS: Burkina Faso and Guinea set up referral CCCs to hospitalise all symptomatic SARS-CoV-2 carriers, regardless of the severity of their symptoms. Data collected from hospitalised patients by November 2020 are presented. RESULT: A total of 1,805 patients (64% men, median age 41 years) were admitted with COVID-19. Symptoms lasted for a median of 7 days (IQR 4-11). During hospitalisation, 443 (25%) had a SpO2 < 94% at least once, 237 (13%) received oxygen and 266 (15%) took corticosteroids. Mortality was 5% overall, and 1%, 5% and 14% in patients aged <40, 40-59 and $geq$60 years, respectively. In multivariable analysis, the risk of death was higher in men (aOR 2.0, 95% CI 1.1; 3.6), people aged $geq$60 years (aOR 2.9, 95% CI 1.7; 4.8) and those with chronic hypertension (aOR 2.1, 95% CI 1.2; 3.4). CONCLUSION: COVID-19 is as severe in Africa as elsewhere, and there must be more vigilance for common risk factors such as older age and hypertension. Close doi:10.1016/j.ijid.2021.05.024 Close
	Mariken Wit, Matthew Cairns, Yves Daniel Compaoré, Issaka Sagara, Irene Kuepfer, Issaka Zongo, Amadou Barry, Modibo Diarra, Amadou Tapily, Samba Coumare, Ismaila Thera, Frederic Nikiema, R Serge Yerbanga, Rosemonde M Guissou, Halidou Tinto, Alassane Dicko, Daniel Chandramohan, Brian Greenwood, Jean Bosco Ouedraogo Nutritional status in young children prior to the malaria transmission season in Burkina Faso and Mali, and its impact on the incidence of clinical malaria (Journal Article) In: Malar. J., vol. 20, no. 1, pp. 274, 2021, ISSN: 1475-2875, (PMID: 34158054 PMCID: PMC8220741). (Abstract \| Links \| BibTeX \| Tags: Acute malnutrition, Antimalarials/administration & dosage, Azithromycin/administration & dosage, Burkina Faso, Burkina Faso/epidemiology, Child, Chronic malnutrition, Female, Humans, Incidence, Infant, Malaria, Malaria/epidemiology/transmission, Male, Nutritional Status, Preschool, seasonal malaria chemoprevention, Seasons) Close @article{De_Wit2021-yi, title = {Nutritional status in young children prior to the malaria transmission season in Burkina Faso and Mali, and its impact on the incidence of clinical malaria}, author = {Mariken Wit and Matthew Cairns and Yves Daniel Compaor\'{e} and Issaka Sagara and Irene Kuepfer and Issaka Zongo and Amadou Barry and Modibo Diarra and Amadou Tapily and Samba Coumare and Ismaila Thera and Frederic Nikiema and R Serge Yerbanga and Rosemonde M Guissou and Halidou Tinto and Alassane Dicko and Daniel Chandramohan and Brian Greenwood and Jean Bosco Ouedraogo}, doi = {10.1186/s12936-021-03802-2}, issn = {1475-2875}, year = {2021}, date = {2021-06-22}, urldate = {2021-06-22}, journal = {Malar. J.}, volume = {20}, number = {1}, pages = {274}, publisher = {Springer Science and Business Media LLC}, abstract = {BACKGROUND: Malaria and malnutrition remain major problems in Sahel countries, especially in young children. The direct effect of malnutrition on malaria remains poorly understood, and may have important implications for malaria control. In this study, nutritional status and the association between malnutrition and subsequent incidence of symptomatic malaria were examined in children in Burkina Faso and Mali who received either azithromycin or placebo, alongside seasonal malaria chemoprevention. METHODS: Mid-upper arm circumference (MUAC) was measured in all 20,185 children who attended a screening visit prior to the malaria transmission season in 2015. Prior to the 2016 malaria season, weight, height and MUAC were measured among 4149 randomly selected children. Height-for-age, weight-for-age, weight-for-height, and MUAC-for-age were calculated as indicators of nutritional status. Malaria incidence was measured during the following rainy seasons. Multivariable random effects Poisson models were created for each nutritional indicator to study the effect of malnutrition on clinical malaria incidence for each country. RESULTS: In both 2015 and 2016, nutritional status prior to the malaria season was poor. The most prevalent form of malnutrition in Burkina Faso was being underweight (30.5%; 95% CI 28.6-32.6), whereas in Mali stunting was most prevalent (27.5%; 95% CI 25.6-29.5). In 2016, clinical malaria incidence was 675 per 1000 person-years (95% CI 613-744) in Burkina Faso, and 1245 per 1000 person-years (95% CI 1152-1347) in Mali. There was some evidence that severe stunting was associated with lower incidence of malaria in Mali (RR 0.81; 95% CI 0.64-1.02; p = 0.08), but this association was not seen in Burkina Faso. Being moderately underweight tended to be associated with higher incidence of clinical malaria in Burkina Faso (RR 1.27; 95% CI 0.98-1.64; p = 0.07), while this was the case in Mali for moderate wasting (RR 1.27; 95% CI 0.98-1.64; p = 0.07). However, these associations were not observed in severely affected children, nor consistent between countries. MUAC-for-age was not associated with malaria risk. CONCLUSIONS: Both malnutrition and malaria were common in the study areas, high despite high coverage of seasonal malaria chemoprevention and long-lasting insecticidal nets. However, no strong or consistent evidence was found for an association between any of the nutritional indicators and the subsequent incidence of clinical malaria.}, note = {PMID: 34158054 PMCID: PMC8220741}, keywords = {Acute malnutrition, Antimalarials/administration \& dosage, Azithromycin/administration \& dosage, Burkina Faso, Burkina Faso/epidemiology, Child, Chronic malnutrition, Female, Humans, Incidence, Infant, Malaria, Malaria/epidemiology/transmission, Male, Nutritional Status, Preschool, seasonal malaria chemoprevention, Seasons}, pubstate = {published}, tppubtype = {article} } Close BACKGROUND: Malaria and malnutrition remain major problems in Sahel countries, especially in young children. The direct effect of malnutrition on malaria remains poorly understood, and may have important implications for malaria control. In this study, nutritional status and the association between malnutrition and subsequent incidence of symptomatic malaria were examined in children in Burkina Faso and Mali who received either azithromycin or placebo, alongside seasonal malaria chemoprevention. METHODS: Mid-upper arm circumference (MUAC) was measured in all 20,185 children who attended a screening visit prior to the malaria transmission season in 2015. Prior to the 2016 malaria season, weight, height and MUAC were measured among 4149 randomly selected children. Height-for-age, weight-for-age, weight-for-height, and MUAC-for-age were calculated as indicators of nutritional status. Malaria incidence was measured during the following rainy seasons. Multivariable random effects Poisson models were created for each nutritional indicator to study the effect of malnutrition on clinical malaria incidence for each country. RESULTS: In both 2015 and 2016, nutritional status prior to the malaria season was poor. The most prevalent form of malnutrition in Burkina Faso was being underweight (30.5%; 95% CI 28.6-32.6), whereas in Mali stunting was most prevalent (27.5%; 95% CI 25.6-29.5). In 2016, clinical malaria incidence was 675 per 1000 person-years (95% CI 613-744) in Burkina Faso, and 1245 per 1000 person-years (95% CI 1152-1347) in Mali. There was some evidence that severe stunting was associated with lower incidence of malaria in Mali (RR 0.81; 95% CI 0.64-1.02; p = 0.08), but this association was not seen in Burkina Faso. Being moderately underweight tended to be associated with higher incidence of clinical malaria in Burkina Faso (RR 1.27; 95% CI 0.98-1.64; p = 0.07), while this was the case in Mali for moderate wasting (RR 1.27; 95% CI 0.98-1.64; p = 0.07). However, these associations were not observed in severely affected children, nor consistent between countries. MUAC-for-age was not associated with malaria risk. CONCLUSIONS: Both malnutrition and malaria were common in the study areas, high despite high coverage of seasonal malaria chemoprevention and long-lasting insecticidal nets. However, no strong or consistent evidence was found for an association between any of the nutritional indicators and the subsequent incidence of clinical malaria. Close doi:10.1186/s12936-021-03802-2 Close
	Paul Sondo, Biebo Bihoun, Bérenger Kabore, Marc Christian Tahita, Karim Derra, Toussaint Rouamba, Seydou Nakanabo Diallo, Adama Kazienga, Hamidou Ilboudo, Innocent Valea, Zekiba Tarnagda, Hermann Sorgho, Thierry Lefevre, Halidou Tinto Polymorphisms in Plasmodium falciparum parasites and mutations in the resistance genes Pfcrt and Pfmdr1 in Nanoro area, Burkina Faso. (Journal Article) In: Pan Afr. Med. J., vol. 39, pp. 118, 2021, ISSN: 1937-8688, (Copyright: Paul Sondo et al. PMID: 34512854 PMCID: PMC8396377). (Abstract \| Links \| BibTeX \| Tags: Antimalarials/pharmacology, Burkina Faso, Drug Resistance, Falciparum/drug therapy/parasitology, GeneticRestriction Fragment Length, Genotype, Humans, Malaria, Membrane Transport Proteins/genetics, msp1, msp2, Multidrug Resistance-Associated Proteins/genetics, Mutation, Pfcrt, Pfmdr1, Plasmodium falciparum, Plasmodium falciparum/drug effects/genetics/isolation & purification, Polymerase Chain Reaction, Polymorphism, Protozoan Proteins/genetics) Close @article{Sondo2021-qe, title = {Polymorphisms in Plasmodium falciparum parasites and mutations in the resistance genes Pfcrt and Pfmdr1 in Nanoro area, Burkina Faso.}, author = {Paul Sondo and Biebo Bihoun and B\'{e}renger Kabore and Marc Christian Tahita and Karim Derra and Toussaint Rouamba and Seydou Nakanabo Diallo and Adama Kazienga and Hamidou Ilboudo and Innocent Valea and Zekiba Tarnagda and Hermann Sorgho and Thierry Lefevre and Halidou Tinto}, doi = {10.11604/pamj.2021.39.118.26959}, issn = {1937-8688}, year = {2021}, date = {2021-06-10}, urldate = {2021-06-10}, journal = {Pan Afr. Med. J.}, volume = {39}, pages = {118}, publisher = {Pan African Medical Journal}, abstract = {Introduction: from a genetic point of view P. falciparumis extremely polymorphic. There is a variety of parasite strains infesting individuals living in malaria endemic areas. The purpose of this study is to investigate the relationship between polymorphisms in Plasmodium falciparum parasites and Pfcrt and Pfmdr1 gene mutations in Nanoro area, Burkina Faso. Methods: blood samples from plasmodium carriers residing in the Nanoro Health District were genotyped using nested PCR. Parasite gene mutations associated with resistance to antimalarial drugs were detected by PCR-RFLP. Results: samples of 672 patients were successfully genotyped. No msp1and msp2allelic families exhibited an increase in developing mutations in resistance genes. However, mutant strains of these genes were present at greater levels in monoclonal infections than in multi-clonal infections. Conclusion: this study provides an overview of the relationship between polymorphisms in Plasmodium falciparum parasites and mutations in resistance genes. These data will undoubtedly contribute to improving knowledge of the parasite´s biology and its mechanisms of resistance to antimalarial drugs.}, note = {Copyright: Paul Sondo et al. PMID: 34512854 PMCID: PMC8396377}, keywords = {Antimalarials/pharmacology, Burkina Faso, Drug Resistance, Falciparum/drug therapy/parasitology, GeneticRestriction Fragment Length, Genotype, Humans, Malaria, Membrane Transport Proteins/genetics, msp1, msp2, Multidrug Resistance-Associated Proteins/genetics, Mutation, Pfcrt, Pfmdr1, Plasmodium falciparum, Plasmodium falciparum/drug effects/genetics/isolation \& purification, Polymerase Chain Reaction, Polymorphism, Protozoan Proteins/genetics}, pubstate = {published}, tppubtype = {article} } Close Introduction: from a genetic point of view P. falciparumis extremely polymorphic. There is a variety of parasite strains infesting individuals living in malaria endemic areas. The purpose of this study is to investigate the relationship between polymorphisms in Plasmodium falciparum parasites and Pfcrt and Pfmdr1 gene mutations in Nanoro area, Burkina Faso. Methods: blood samples from plasmodium carriers residing in the Nanoro Health District were genotyped using nested PCR. Parasite gene mutations associated with resistance to antimalarial drugs were detected by PCR-RFLP. Results: samples of 672 patients were successfully genotyped. No msp1and msp2allelic families exhibited an increase in developing mutations in resistance genes. However, mutant strains of these genes were present at greater levels in monoclonal infections than in multi-clonal infections. Conclusion: this study provides an overview of the relationship between polymorphisms in Plasmodium falciparum parasites and mutations in resistance genes. These data will undoubtedly contribute to improving knowledge of the parasite´s biology and its mechanisms of resistance to antimalarial drugs. Close doi:10.11604/pamj.2021.39.118.26959 Close
	Annelies Post, Berenger Kaboré, Mike Berendsen, Salou Diallo, Ousmane Traore, Rob J W Arts, Mihai G Netea, Leo A B Joosten, Halidou Tinto, Jan Jacobs, Quirijn Mast, André Ven Altered ex-vivo cytokine responses in children with asymptomatic Plasmodium falciparum infection in Burkina Faso: An additional argument to treat asymptomatic malaria? (Journal Article) In: Front. Immunol., vol. 12, pp. 614817, 2021, ISSN: 1664-3224, (Copyright © 2021 Post, Kaboré, Berendsen, Diallo, Traore, Arts, Netea, Joosten, Tinto, Jacobs, de Mast and van der Ven. PMID: 34177883 PMCID: PMC8220162). (Abstract \| Links \| BibTeX \| Tags: Asymptomatic Diseases, asymptomatic malaria, bacteraemia, Bacteremia, bloodstream infection, Burkina Faso/epidemiology, Cells, Child, Cultured, Cytokines/metabolism, Endemic Diseases, Female, Humans, Infant, iNTS, Lipopolysaccharides/immunology, Malaria/epidemiology/immunology, Male, Parasite Load, Plasmodium falciparum/physiology, Preschool, Salmonella) Close @article{Post2021-oo, title = {Altered ex-vivo cytokine responses in children with asymptomatic Plasmodium falciparum infection in Burkina Faso: An additional argument to treat asymptomatic malaria?}, author = {Annelies Post and Berenger Kabor\'{e} and Mike Berendsen and Salou Diallo and Ousmane Traore and Rob J W Arts and Mihai G Netea and Leo A B Joosten and Halidou Tinto and Jan Jacobs and Quirijn Mast and Andr\'{e} Ven}, doi = {10.3389/fimmu.2021.614817}, issn = {1664-3224}, year = {2021}, date = {2021-06-09}, urldate = {2021-06-09}, journal = {Front. Immunol.}, volume = {12}, pages = {614817}, publisher = {Frontiers Media SA}, abstract = {Introduction: Patients with clinical malaria have an increased risk for bacterial bloodstream infections. We hypothesized that asymptomatic malaria parasitemia increases susceptibility for bacterial infections through an effect on the innate immune system. We measured circulating cytokine levels and ex-vivo cytokine production capacity in asymptomatic malaria and compared with controls. Methods: Data were collected from asymptomatic participants \<5 years old with and without positive malaria microscopy, as well as from hospitalized patients \<5 years old with clinical malaria, bacteremia, or malaria/bacteremia co-infections in a malaria endemic region of Burkina Faso. Circulating cytokines (TNF-$alpha$, IFN-$gamma$, IL-6, IL-10) were measured using multiplex assays. Whole blood from asymptomatic participants with and without positive malaria microscopy were ex-vivo stimulated with S. aureus, E. coli LPS and Salmonella Typhimurium; cytokine concentrations (TNF-$alpha$, IFN-$gamma$, IL-1$beta$, IL-6, IL-10) were measured on supernatants using ELISA. Results: Included were children with clinical malaria (n=118), bacteremia (n=22), malaria and bacteremia co-infection (n=9), asymptomatic malaria (n=125), and asymptomatic controls (n=237). Children with either clinical or asymptomatic malaria had higher plasma cytokine concentrations than controls. Cytokine concentrations correlated positively with malaria parasite density with the strongest correlation for IL-10 in both asymptomatic (r=0.63) and clinical malaria (r=0.53). Patients with bacteremia had lower circulating IL-10, TNF-$alpha$ and IFN-$gamma$ and higher IL-6 concentrations, compared to clinical malaria. Ex-vivo whole blood cytokine production to LPS and S. aureus was significantly lower in asymptomatic malaria compared to controls. Whole blood IFN-$gamma$ and IL-10 production in response to Salmonella was also lower in asymptomatic malaria. Interpretation: In children with asymptomatic malaria, cytokine responses upon ex-vivo bacterial stimulation are downregulated. Further studies are needed to explore if the suggested impaired innate immune response to bacterial pathogens also translates into impaired control of pathogens such as Salmonella spp.}, note = {Copyright © 2021 Post, Kabor\'{e}, Berendsen, Diallo, Traore, Arts, Netea, Joosten, Tinto, Jacobs, de Mast and van der Ven. PMID: 34177883 PMCID: PMC8220162}, keywords = {Asymptomatic Diseases, asymptomatic malaria, bacteraemia, Bacteremia, bloodstream infection, Burkina Faso/epidemiology, Cells, Child, Cultured, Cytokines/metabolism, Endemic Diseases, Female, Humans, Infant, iNTS, Lipopolysaccharides/immunology, Malaria/epidemiology/immunology, Male, Parasite Load, Plasmodium falciparum/physiology, Preschool, Salmonella}, pubstate = {published}, tppubtype = {article} } Close Introduction: Patients with clinical malaria have an increased risk for bacterial bloodstream infections. We hypothesized that asymptomatic malaria parasitemia increases susceptibility for bacterial infections through an effect on the innate immune system. We measured circulating cytokine levels and ex-vivo cytokine production capacity in asymptomatic malaria and compared with controls. Methods: Data were collected from asymptomatic participants <5 years old with and without positive malaria microscopy, as well as from hospitalized patients <5 years old with clinical malaria, bacteremia, or malaria/bacteremia co-infections in a malaria endemic region of Burkina Faso. Circulating cytokines (TNF-$alpha$, IFN-$gamma$, IL-6, IL-10) were measured using multiplex assays. Whole blood from asymptomatic participants with and without positive malaria microscopy were ex-vivo stimulated with S. aureus, E. coli LPS and Salmonella Typhimurium; cytokine concentrations (TNF-$alpha$, IFN-$gamma$, IL-1$beta$, IL-6, IL-10) were measured on supernatants using ELISA. Results: Included were children with clinical malaria (n=118), bacteremia (n=22), malaria and bacteremia co-infection (n=9), asymptomatic malaria (n=125), and asymptomatic controls (n=237). Children with either clinical or asymptomatic malaria had higher plasma cytokine concentrations than controls. Cytokine concentrations correlated positively with malaria parasite density with the strongest correlation for IL-10 in both asymptomatic (r=0.63) and clinical malaria (r=0.53). Patients with bacteremia had lower circulating IL-10, TNF-$alpha$ and IFN-$gamma$ and higher IL-6 concentrations, compared to clinical malaria. Ex-vivo whole blood cytokine production to LPS and S. aureus was significantly lower in asymptomatic malaria compared to controls. Whole blood IFN-$gamma$ and IL-10 production in response to Salmonella was also lower in asymptomatic malaria. Interpretation: In children with asymptomatic malaria, cytokine responses upon ex-vivo bacterial stimulation are downregulated. Further studies are needed to explore if the suggested impaired innate immune response to bacterial pathogens also translates into impaired control of pathogens such as Salmonella spp. Close doi:10.3389/fimmu.2021.614817 Close
	Paul Sondo, Marc Christian Tahita, Toussaint Rouamba, Karim Derra, Bérenger Kaboré, Cheick Sa"id Compaoré, Florence Ouédraogo, Eli Rouamba, Hamidou Ilboudo, Estelle A"issa Bambara, Macaire Nana, Edmond Yabré Sawadogo, Hermann Sorgho, Athanase Mwinessobaonfou Somé, Innocent Valéa, Prabin Dahal, Maminata Traoré/Coulibaly, Halidou Tinto Assessment of a combined strategy of seasonal malaria chemoprevention and supplementation with vitamin A, zinc and Plumpy’Doz™ to prevent malaria and malnutrition in children under 5 years old in Burkina Faso: a randomized open-label trial (SMC-NUT) (Journal Article) In: Trials, vol. 22, no. 1, pp. 360, 2021, ISSN: 1745-6215, (PMID: 34030705 PMCID: PMC8142067). (Abstract \| Links \| BibTeX \| Tags: Antimalarials/adverse effects, Burkina Faso/epidemiology, Chemoprevention, Child, Child Nutrition Disorders, Dietary Supplements, Humans, Infant, Malaria, Malaria/diagnosis/epidemiology/prevention & control, Malnutrition, Malnutrition/diagnosis/drug therapy/prevention & control, Pharmaceutical Preparations, Plumpy’Doz™, Preschool, Randomized controlled trial, Seasonal chemoprevention, Seasons, Vitamin A, Vitamin A/adverse effects, Zinc) Close @article{Sondo2021-kc, title = {Assessment of a combined strategy of seasonal malaria chemoprevention and supplementation with vitamin A, zinc and Plumpy'Doz™ to prevent malaria and malnutrition in children under 5 years old in Burkina Faso: a randomized open-label trial (SMC-NUT)}, author = {Paul Sondo and Marc Christian Tahita and Toussaint Rouamba and Karim Derra and B\'{e}renger Kabor\'{e} and Cheick Sa"id Compaor\'{e} and Florence Ou\'{e}draogo and Eli Rouamba and Hamidou Ilboudo and Estelle A"issa Bambara and Macaire Nana and Edmond Yabr\'{e} Sawadogo and Hermann Sorgho and Athanase Mwinessobaonfou Som\'{e} and Innocent Val\'{e}a and Prabin Dahal and Maminata Traor\'{e}/Coulibaly and Halidou Tinto}, doi = {10.1186/s13063-021-05320-7}, issn = {1745-6215}, year = {2021}, date = {2021-05-24}, urldate = {2021-05-24}, journal = {Trials}, volume = {22}, number = {1}, pages = {360}, publisher = {Springer Science and Business Media LLC}, abstract = {BACKGROUND: Malaria and malnutrition represent major public health concerns worldwide especially in Sub-Sahara Africa. Despite implementation of seasonal malaria chemoprophylaxis (SMC), an intervention aimed at reducing malaria incidence among children aged 3-59 months, the burden of malaria and associated mortality among children below age 5 years remains high in Burkina Faso. Malnutrition, in particular micronutrient deficiency, appears to be one of the potential factors that can negatively affect the effectiveness of SMC. Treating micronutrient deficiencies is known to reduce the incidence of malaria in highly prevalent malaria zone such as rural settings. Therefore, we hypothesized that a combined strategy of SMC together with a daily oral nutrients supplement will enhance the immune response and decrease the incidence of malaria and malnutrition among children under SMC coverage. METHODS: Children (6-59 months) under SMC coverage receiving vitamin A supplementation will be randomly assigned to one of the three study arms (a) SMC + vitamin A alone, (b) SMC + vitamin A + zinc, or (c) SMC + vitamin A + Plumpy'Doz™ using 1:1:1 allocation ratio. After each SMC monthly distribution, children will be visited at home to confirm drug administration and followed-up for 1 year. Anthropometric indicators will be recorded at each visit and blood samples will be collected for microscopy slides, haemoglobin measurement, and spotted onto filter paper for further PCR analyses. The primary outcome measure is the incidence of malaria in each arm. Secondary outcome measures will include mid-upper arm circumference and weight gain from baseline measurements, coverage and compliance to SMC, occurrence of adverse events (AEs), and prevalence of molecular markers of antimalarial resistance comprising Pfcrt, Pfmdr1, Pfdhfr, and Pfdhps. DISCUSSION: This study will demonstrate an integrated strategy of malaria and malnutrition programmes in order to mutualize resources for best impact. By relying on existing strategies, the policy implementation of this joint intervention will be scalable at country and regional levels. TRIAL REGISTRATION: ClinicalTrials.gov NCT04238845 . Registered on 23 January 2020 https://clinicaltrials.gov/ct2/show/NCT04238845.}, note = {PMID: 34030705 PMCID: PMC8142067}, keywords = {Antimalarials/adverse effects, Burkina Faso/epidemiology, Chemoprevention, Child, Child Nutrition Disorders, Dietary Supplements, Humans, Infant, Malaria, Malaria/diagnosis/epidemiology/prevention \& control, Malnutrition, Malnutrition/diagnosis/drug therapy/prevention \& control, Pharmaceutical Preparations, Plumpy’Doz™, Preschool, Randomized controlled trial, Seasonal chemoprevention, Seasons, Vitamin A, Vitamin A/adverse effects, Zinc}, pubstate = {published}, tppubtype = {article} } Close BACKGROUND: Malaria and malnutrition represent major public health concerns worldwide especially in Sub-Sahara Africa. Despite implementation of seasonal malaria chemoprophylaxis (SMC), an intervention aimed at reducing malaria incidence among children aged 3-59 months, the burden of malaria and associated mortality among children below age 5 years remains high in Burkina Faso. Malnutrition, in particular micronutrient deficiency, appears to be one of the potential factors that can negatively affect the effectiveness of SMC. Treating micronutrient deficiencies is known to reduce the incidence of malaria in highly prevalent malaria zone such as rural settings. Therefore, we hypothesized that a combined strategy of SMC together with a daily oral nutrients supplement will enhance the immune response and decrease the incidence of malaria and malnutrition among children under SMC coverage. METHODS: Children (6-59 months) under SMC coverage receiving vitamin A supplementation will be randomly assigned to one of the three study arms (a) SMC + vitamin A alone, (b) SMC + vitamin A + zinc, or (c) SMC + vitamin A + Plumpy’Doz™ using 1:1:1 allocation ratio. After each SMC monthly distribution, children will be visited at home to confirm drug administration and followed-up for 1 year. Anthropometric indicators will be recorded at each visit and blood samples will be collected for microscopy slides, haemoglobin measurement, and spotted onto filter paper for further PCR analyses. The primary outcome measure is the incidence of malaria in each arm. Secondary outcome measures will include mid-upper arm circumference and weight gain from baseline measurements, coverage and compliance to SMC, occurrence of adverse events (AEs), and prevalence of molecular markers of antimalarial resistance comprising Pfcrt, Pfmdr1, Pfdhfr, and Pfdhps. DISCUSSION: This study will demonstrate an integrated strategy of malaria and malnutrition programmes in order to mutualize resources for best impact. By relying on existing strategies, the policy implementation of this joint intervention will be scalable at country and regional levels. TRIAL REGISTRATION: ClinicalTrials.gov NCT04238845 . Registered on 23 January 2020 https://clinicaltrials.gov/ct2/show/NCT04238845. Close doi:10.1186/s13063-021-05320-7 Close
	Joel D Bognini, Sekou Samadoulougou, Mady Ouedraogo, Tiga David Kangoye, Carine Van Malderen, Halidou Tinto, Fati Kirakoya-Samadoulougou Socioeconomic inequalities in curative healthcare-seeking for children under five before and after the free healthcare initiative in Sierra Leone: analysis of population-based survey data (Journal Article) In: Int. J. Equity Health, vol. 20, no. 1, pp. 124, 2021, ISSN: 1475-9276, (PMID: 34020665 PMCID: PMC8140517). (Abstract \| Links \| BibTeX \| Tags: Adolescent, Adult, Child, Children under five, Delivery of Health Care/economics, Female, Health Care Surveys, Healthcare Disparities/economics/statistics & numerical data, Healthcare utilization, Humans, Infant, Male, Parents/psychology, Patient Acceptance of Health Care/statistics & numerical data, Preschool, Sierra Leone, Socioeconomic Factors, Young Adult) Close @article{Bognini2021-mk, title = {Socioeconomic inequalities in curative healthcare-seeking for children under five before and after the free healthcare initiative in Sierra Leone: analysis of population-based survey data}, author = {Joel D Bognini and Sekou Samadoulougou and Mady Ouedraogo and Tiga David Kangoye and Carine Van Malderen and Halidou Tinto and Fati Kirakoya-Samadoulougou}, doi = {10.1186/s12939-021-01474-7}, issn = {1475-9276}, year = {2021}, date = {2021-05-21}, urldate = {2021-05-21}, journal = {Int. J. Equity Health}, volume = {20}, number = {1}, pages = {124}, publisher = {Springer Science and Business Media LLC}, abstract = {BACKGROUND: Socioeconomic inequalities between and within countries lead to disparities in the use of health services. These disparities could lead to child mortality in children under 5 years by depriving them of healthcare. Therefore, initiatives to remove healthcare fees such as the Free Healthcare Initiative (FHCI) adopted in Sierra Leone can contribute to reducing these inequities in healthcare-seeking for children. This study aimed to assess the socioeconomic inequalities in healthcare-seeking for children under 5 years of age before and after the implementation of the FHCI. METHODS: Data were included on 1207, 2815, 1633, and 1476 children under 5 years of age with fever from the 2008, 2013, 2016, and 2019 nationwide surveys, respectively. Concentration curves were drawn for the period before (2008) and after (2013-2019) the implementation of the FHCI to assess socioeconomic inequalities in healthcare-seeking. Finally, Erreyger's corrected concentration indices were calculated to understand the magnitude of these inequalities. RESULTS: Before the implementation of the FHCI, there were inequalities in healthcare-seeking for children under five (Erreyger's corrected concentration index (CI) = 0.168, standard error (SE) = 0.049; p \< 0.001) in favor of the wealthy households. These inequalities decreased after the implementation of the FHCI (CI = 0.061, SE = 0.033; p = 0.06 in 2013, CI = 0.039, SE = 0.04; p = 0.32 in 2016, and CI = - 0.0005, SE = 0.362; p = 0.98 in 2019). Furthermore, before the implementation of the FHCI, a significant pro-rich inequality in the districts of Kenema (CI = 0.117, SE = 0.168, p = 0.021), Kono (CI = 0.175, SE = 0.078, p = 0.028) and Western Area Urban (CI = 0.070, SE = 0.032, p = 0.031) has been observed. After the implementation of the FHCI in 2019, these disparities were reduced, 11 of the 14 districts had a CI around the value of equality, and only in 2 districts the pro-rich inequality were significant (Western Area Urban (CI = 0.035, SE = 0.016, p = 0.039) and Western Area Rural (CI = 0.066, SE = 0.030, p = 0.027)). CONCLUSION: The results of this study demonstrated that socio-economic inequalities in healthcare-seeking for children have been considerably reduced after the FHCI in Sierra Leone. To further reduce these inequalities, policy actions can focus on the increase of availability of health services in the districts where the healthcare-seeking remained pro-rich.}, note = {PMID: 34020665 PMCID: PMC8140517}, keywords = {Adolescent, Adult, Child, Children under five, Delivery of Health Care/economics, Female, Health Care Surveys, Healthcare Disparities/economics/statistics \& numerical data, Healthcare utilization, Humans, Infant, Male, Parents/psychology, Patient Acceptance of Health Care/statistics \& numerical data, Preschool, Sierra Leone, Socioeconomic Factors, Young Adult}, pubstate = {published}, tppubtype = {article} } Close BACKGROUND: Socioeconomic inequalities between and within countries lead to disparities in the use of health services. These disparities could lead to child mortality in children under 5 years by depriving them of healthcare. Therefore, initiatives to remove healthcare fees such as the Free Healthcare Initiative (FHCI) adopted in Sierra Leone can contribute to reducing these inequities in healthcare-seeking for children. This study aimed to assess the socioeconomic inequalities in healthcare-seeking for children under 5 years of age before and after the implementation of the FHCI. METHODS: Data were included on 1207, 2815, 1633, and 1476 children under 5 years of age with fever from the 2008, 2013, 2016, and 2019 nationwide surveys, respectively. Concentration curves were drawn for the period before (2008) and after (2013-2019) the implementation of the FHCI to assess socioeconomic inequalities in healthcare-seeking. Finally, Erreyger’s corrected concentration indices were calculated to understand the magnitude of these inequalities. RESULTS: Before the implementation of the FHCI, there were inequalities in healthcare-seeking for children under five (Erreyger’s corrected concentration index (CI) = 0.168, standard error (SE) = 0.049; p < 0.001) in favor of the wealthy households. These inequalities decreased after the implementation of the FHCI (CI = 0.061, SE = 0.033; p = 0.06 in 2013, CI = 0.039, SE = 0.04; p = 0.32 in 2016, and CI = - 0.0005, SE = 0.362; p = 0.98 in 2019). Furthermore, before the implementation of the FHCI, a significant pro-rich inequality in the districts of Kenema (CI = 0.117, SE = 0.168, p = 0.021), Kono (CI = 0.175, SE = 0.078, p = 0.028) and Western Area Urban (CI = 0.070, SE = 0.032, p = 0.031) has been observed. After the implementation of the FHCI in 2019, these disparities were reduced, 11 of the 14 districts had a CI around the value of equality, and only in 2 districts the pro-rich inequality were significant (Western Area Urban (CI = 0.035, SE = 0.016, p = 0.039) and Western Area Rural (CI = 0.066, SE = 0.030, p = 0.027)). CONCLUSION: The results of this study demonstrated that socio-economic inequalities in healthcare-seeking for children have been considerably reduced after the FHCI in Sierra Leone. To further reduce these inequalities, policy actions can focus on the increase of availability of health services in the districts where the healthcare-seeking remained pro-rich. Close doi:10.1186/s12939-021-01474-7 Close
	Yeka Adoke, Rella Zoleko-Manego, Serge Ouoba, Alfred B Tiono, Grace Kaguthi, Juv^encio Eduardo Bonzela, Tran Thanh Duong, Alain Nahum, Marielle Bouyou-Akotet, Bernhards Ogutu, Alphonse Ouedraogo, Fiona Macintyre, Andreas Jessel, Bart Laurijssens, Mohammed H Cherkaoui-Rbati, Cathy Cantalloube, Anne Claire Marrast, Rapha"el Bejuit, David White, Timothy N C Wells, Florian Wartha, Didier Leroy, Afizi Kibuuka, Ghyslain Mombo-Ngoma, Daouda Ouattara, Ir`ene Mugenya, Bui Quang Phuc, Francis Bohissou, Denise P Mawili-Mboumba, Fredrick Olewe, Issiaka Soulama, Halidou Tinto, FALCI Study Group A randomized, double-blind, phase 2b study to investigate the efficacy, safety, tolerability and pharmacokinetics of a single-dose regimen of ferroquine with artefenomel in adults and children with uncomplicated Plasmodium falciparum malaria (Journal Article) In: Malar. J., vol. 20, no. 1, pp. 222, 2021, ISSN: 1475-2875, (PMID: 34011358 PMCID: PMC8135182). (Abstract \| Links \| BibTeX \| Tags: Adamantane/administration & dosage/analogs & derivatives, Adolescent, Adult, Aged, Aminoquinolines/administration & dosage, Benin, Burkina Faso, C580Y, Child, Combination treatment, Double-Blind Method, Drug Combinations, Exposure–response, Falciparum/prevention & control, Female, Ferroquine, Ferrous Compounds/administration & dosage, Gabon, Humans, Infant, Kelch-13 mutation, Kenya, Malaria, Male, Metallocenes/administration & dosage, Middle Aged, Mozambique, Parasite clearance, Peroxides/administration & dosage, Pharmacokinetics/pharmacodynamics, Plasmodium falciparum/drug effects, Preschool, resistance, Uganda, Vietnam, Vomiting, Young Adult) Close @article{Adoke2021-el, title = {A randomized, double-blind, phase 2b study to investigate the efficacy, safety, tolerability and pharmacokinetics of a single-dose regimen of ferroquine with artefenomel in adults and children with uncomplicated Plasmodium falciparum malaria}, author = {Yeka Adoke and Rella Zoleko-Manego and Serge Ouoba and Alfred B Tiono and Grace Kaguthi and Juv^encio Eduardo Bonzela and Tran Thanh Duong and Alain Nahum and Marielle Bouyou-Akotet and Bernhards Ogutu and Alphonse Ouedraogo and Fiona Macintyre and Andreas Jessel and Bart Laurijssens and Mohammed H Cherkaoui-Rbati and Cathy Cantalloube and Anne Claire Marrast and Rapha"el Bejuit and David White and Timothy N C Wells and Florian Wartha and Didier Leroy and Afizi Kibuuka and Ghyslain Mombo-Ngoma and Daouda Ouattara and Ir`ene Mugenya and Bui Quang Phuc and Francis Bohissou and Denise P Mawili-Mboumba and Fredrick Olewe and Issiaka Soulama and Halidou Tinto and FALCI Study Group}, doi = {10.1186/s12936-021-03749-4}, issn = {1475-2875}, year = {2021}, date = {2021-05-19}, urldate = {2021-05-19}, journal = {Malar. J.}, volume = {20}, number = {1}, pages = {222}, publisher = {Springer Science and Business Media LLC}, abstract = {BACKGROUND: For uncomplicated Plasmodium falciparum malaria, highly efficacious single-dose treatments are expected to increase compliance and improve treatment outcomes, and thereby may slow the development of resistance. The efficacy and safety of a single-dose combination of artefenomel (800 mg) plus ferroquine (400/600/900/1200 mg doses) for the treatment of uncomplicated P. falciparum malaria were evaluated in Africa (focusing on children $\leq$ 5 years) and Asia. METHODS: The study was a randomized, double-blind, single-dose, multi-arm clinical trial in patients aged \> 6 months to 5 years and 20 Asian patients. None of the treatment arms met the target efficacy criterion for PCR-adjusted ACPR at Day 28 (lower limit of 95% confidence interval [CI] \> 90%). PCR-adjusted ACPR at Day 28 [95% CI] in the PP Set ranged from 78.4% [64.7; 88.7%] to 91.7% [81.6; 97.2%] for the 400 mg to 1200 mg ferroquine dose. Efficacy rates were low in Vietnamese patients, ranging from 20 to 40%. A clear relationship was found between drug exposure (artefenomel and ferroquine concentrations at Day 7) and efficacy (primary endpoint), with higher concentrations of both drugs resulting in higher efficacy. Six distinct kelch-13 mutations were detected in parasite isolates from 10/272 African patients (with 2 mutations known to be associated with artemisinin resistance) and 18/20 Asian patients (all C580Y mutation). Vomiting within 6 h of initial artefenomel administration was common (24.6%) and associated with lower drug exposures. CONCLUSION: The efficacy of artefenomel/ferroquine combination was suboptimal in African children aged $\leq$ 5 years, the population of interest, and vomiting most likely had a negative impact on efficacy. Trial registration ClinicalTrials.gov, NCT02497612. Registered 14 Jul 2015, https://clinicaltrials.gov/ct2/show/NCT02497612?term=NCT02497612\&draw=2\&rank=1.}, note = {PMID: 34011358 PMCID: PMC8135182}, keywords = {Adamantane/administration \& dosage/analogs \& derivatives, Adolescent, Adult, Aged, Aminoquinolines/administration \& dosage, Benin, Burkina Faso, C580Y, Child, Combination treatment, Double-Blind Method, Drug Combinations, Exposure\textendashresponse, Falciparum/prevention \& control, Female, Ferroquine, Ferrous Compounds/administration \& dosage, Gabon, Humans, Infant, Kelch-13 mutation, Kenya, Malaria, Male, Metallocenes/administration \& dosage, Middle Aged, Mozambique, Parasite clearance, Peroxides/administration \& dosage, Pharmacokinetics/pharmacodynamics, Plasmodium falciparum/drug effects, Preschool, resistance, Uganda, Vietnam, Vomiting, Young Adult}, pubstate = {published}, tppubtype = {article} } Close BACKGROUND: For uncomplicated Plasmodium falciparum malaria, highly efficacious single-dose treatments are expected to increase compliance and improve treatment outcomes, and thereby may slow the development of resistance. The efficacy and safety of a single-dose combination of artefenomel (800 mg) plus ferroquine (400/600/900/1200 mg doses) for the treatment of uncomplicated P. falciparum malaria were evaluated in Africa (focusing on children $łeq$ 5 years) and Asia. METHODS: The study was a randomized, double-blind, single-dose, multi-arm clinical trial in patients aged > 6 months to 5 years and 20 Asian patients. None of the treatment arms met the target efficacy criterion for PCR-adjusted ACPR at Day 28 (lower limit of 95% confidence interval [CI] > 90%). PCR-adjusted ACPR at Day 28 [95% CI] in the PP Set ranged from 78.4% [64.7; 88.7%] to 91.7% [81.6; 97.2%] for the 400 mg to 1200 mg ferroquine dose. Efficacy rates were low in Vietnamese patients, ranging from 20 to 40%. A clear relationship was found between drug exposure (artefenomel and ferroquine concentrations at Day 7) and efficacy (primary endpoint), with higher concentrations of both drugs resulting in higher efficacy. Six distinct kelch-13 mutations were detected in parasite isolates from 10/272 African patients (with 2 mutations known to be associated with artemisinin resistance) and 18/20 Asian patients (all C580Y mutation). Vomiting within 6 h of initial artefenomel administration was common (24.6%) and associated with lower drug exposures. CONCLUSION: The efficacy of artefenomel/ferroquine combination was suboptimal in African children aged $łeq$ 5 years, the population of interest, and vomiting most likely had a negative impact on efficacy. Trial registration ClinicalTrials.gov, NCT02497612. Registered 14 Jul 2015, https://clinicaltrials.gov/ct2/show/NCT02497612?term=NCT02497612&draw=2&rank=1. Close doi:10.1186/s12936-021-03749-4 Close
	Mehreen S Datoo, Magloire H Natama, Athanase Somé, Ousmane Traoré, Toussaint Rouamba, Duncan Bellamy, Prisca Yameogo, Daniel Valia, Moubarak Tegneri, Florence Ouedraogo, Rachidatou Soma, Seydou Sawadogo, Faizatou Sorgho, Karim Derra, Eli Rouamba, Benedict Orindi, Fernando Ramos Lopez, Amy Flaxman, Federica Cappuccini, Reshma Kailath, Sean Elias, Ekta Mukhopadhyay, Andres Noe, Matthew Cairns, Alison Lawrie, Rachel Roberts, Innocent Valéa, Hermann Sorgho, Nicola Williams, Gregory Glenn, Louis Fries, Jenny Reimer, Katie J Ewer, Umesh Shaligram, Adrian V S Hill, Halidou Tinto Efficacy of a low-dose candidate malaria vaccine, R21 in adjuvant Matrix-M, with seasonal administration to children in Burkina Faso: a randomised controlled trial (Journal Article) In: Lancet, vol. 397, no. 10287, pp. 1809–1818, 2021, ISSN: 1474-547X 0140-6736, (Copyright © 2021 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license. Published by Elsevier Ltd.. All rights reserved. PMID: 33964223 PMCID: PMC8121760). (Abstract \| Links \| BibTeX \| Tags: Adjuvants, Burkina Faso, Double-Blind Method, Falciparum/prevention & control, Female, Hepatitis B Surface Antigens, Humans, Immunogenicity, Immunologic/administration & dosage, Infant, Malaria, Malaria Vaccines/therapeutic use, Malaria/prevention & control, Male, Nanoparticles/administration & dosage, Proportional Hazards Models, Protozoan Proteins/immunology, Saponins/administration & dosage, Treatment Outcome, Vaccine, Vaccines, Virus-Like Particle/therapeutic use) Close @article{Datoo2021-dk, title = {Efficacy of a low-dose candidate malaria vaccine, R21 in adjuvant Matrix-M, with seasonal administration to children in Burkina Faso: a randomised controlled trial}, author = {Mehreen S Datoo and Magloire H Natama and Athanase Som\'{e} and Ousmane Traor\'{e} and Toussaint Rouamba and Duncan Bellamy and Prisca Yameogo and Daniel Valia and Moubarak Tegneri and Florence Ouedraogo and Rachidatou Soma and Seydou Sawadogo and Faizatou Sorgho and Karim Derra and Eli Rouamba and Benedict Orindi and Fernando Ramos Lopez and Amy Flaxman and Federica Cappuccini and Reshma Kailath and Sean Elias and Ekta Mukhopadhyay and Andres Noe and Matthew Cairns and Alison Lawrie and Rachel Roberts and Innocent Val\'{e}a and Hermann Sorgho and Nicola Williams and Gregory Glenn and Louis Fries and Jenny Reimer and Katie J Ewer and Umesh Shaligram and Adrian V S Hill and Halidou Tinto}, doi = {10.1016/S0140-6736(21)00943-0}, issn = {1474-547X 0140-6736}, year = {2021}, date = {2021-05-15}, urldate = {2021-05-15}, journal = {Lancet}, volume = {397}, number = {10287}, pages = {1809--1818}, publisher = {Elsevier BV}, abstract = {BACKGROUND: Stalled progress in controlling Plasmodium falciparum malaria highlights the need for an effective and deployable vaccine. RTS,S/AS01, the most effective malaria vaccine candidate to date, demonstrated 56% efficacy over 12 months in African children. We therefore assessed a new candidate vaccine for safety and efficacy. METHODS: In this double-blind, randomised, controlled, phase 2b trial, the low-dose circumsporozoite protein-based vaccine R21, with two different doses of adjuvant Matrix-M (MM), was given to children aged 5-17 months in Nanoro, Burkina Faso-a highly seasonal malaria transmission setting. Three vaccinations were administered at 4-week intervals before the malaria season, with a fourth dose 1 year later. All vaccines were administered intramuscularly into the thigh. Group 1 received 5 $mu$g R21 plus 25 $mu$g MM, group 2 received 5 $mu$g R21 plus 50 $mu$g MM, and group 3, the control group, received rabies vaccinations. Children were randomly assigned (1:1:1) to groups 1-3. An independent statistician generated a random allocation list, using block randomisation with variable block sizes, which was used to assign participants. Participants, their families, and the local study team were all masked to group allocation. Only the pharmacists preparing the vaccine were unmasked to group allocation. Vaccine safety, immunogenicity, and efficacy were evaluated over 1 year. The primary objective assessed protective efficacy of R21 plus MM (R21/MM) from 14 days after the third vaccination to 6 months. Primary analyses of vaccine efficacy were based on a modified intention-to-treat population, which included all participants who received three vaccinations, allowing for inclusion of participants who received the wrong vaccine at any timepoint. This trial is registered with ClinicalTrials.gov, NCT03896724. FINDINGS: From May 7 to June 13, 2019, 498 children aged 5-17 months were screened, and 48 were excluded. 450 children were enrolled and received at least one vaccination. 150 children were allocated to group 1, 150 children were allocated to group 2, and 150 children were allocated to group 3. The final vaccination of the primary series was administered on Aug 7, 2019. R21/MM had a favourable safety profile and was well tolerated. The majority of adverse events were mild, with the most common event being fever. None of the seven serious adverse events were attributed to the vaccine. At the 6-month primary efficacy analysis, 43 (29%) of 146 participants in group 1, 38 (26%) of 146 participants in group 2, and 105 (71%) of 147 participants in group 3 developed clinical malaria. Vaccine efficacy was 74% (95% CI 63-82) in group 1 and 77% (67-84) in group 2 at 6 months. At 1 year, vaccine efficacy remained high, at 77% (67-84) in group 1. Participants vaccinated with R21/MM showed high titres of malaria-specific anti-Asn-Ala-Asn-Pro (NANP) antibodies 28 days after the third vaccination, which were almost doubled with the higher adjuvant dose. Titres waned but were boosted to levels similar to peak titres after the primary series of vaccinations after a fourth dose administered 1 year later. INTERPRETATION: R21/MM appears safe and very immunogenic in African children, and shows promising high-level efficacy. FUNDING: The European \& Developing Countries Clinical Trials Partnership, Wellcome Trust, and National Institute for Health Research Oxford Biomedical Research Centre.}, note = {Copyright © 2021 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license. Published by Elsevier Ltd.. All rights reserved. PMID: 33964223 PMCID: PMC8121760}, keywords = {Adjuvants, Burkina Faso, Double-Blind Method, Falciparum/prevention \& control, Female, Hepatitis B Surface Antigens, Humans, Immunogenicity, Immunologic/administration \& dosage, Infant, Malaria, Malaria Vaccines/therapeutic use, Malaria/prevention \& control, Male, Nanoparticles/administration \& dosage, Proportional Hazards Models, Protozoan Proteins/immunology, Saponins/administration \& dosage, Treatment Outcome, Vaccine, Vaccines, Virus-Like Particle/therapeutic use}, pubstate = {published}, tppubtype = {article} } Close BACKGROUND: Stalled progress in controlling Plasmodium falciparum malaria highlights the need for an effective and deployable vaccine. RTS,S/AS01, the most effective malaria vaccine candidate to date, demonstrated 56% efficacy over 12 months in African children. We therefore assessed a new candidate vaccine for safety and efficacy. METHODS: In this double-blind, randomised, controlled, phase 2b trial, the low-dose circumsporozoite protein-based vaccine R21, with two different doses of adjuvant Matrix-M (MM), was given to children aged 5-17 months in Nanoro, Burkina Faso-a highly seasonal malaria transmission setting. Three vaccinations were administered at 4-week intervals before the malaria season, with a fourth dose 1 year later. All vaccines were administered intramuscularly into the thigh. Group 1 received 5 $mu$g R21 plus 25 $mu$g MM, group 2 received 5 $mu$g R21 plus 50 $mu$g MM, and group 3, the control group, received rabies vaccinations. Children were randomly assigned (1:1:1) to groups 1-3. An independent statistician generated a random allocation list, using block randomisation with variable block sizes, which was used to assign participants. Participants, their families, and the local study team were all masked to group allocation. Only the pharmacists preparing the vaccine were unmasked to group allocation. Vaccine safety, immunogenicity, and efficacy were evaluated over 1 year. The primary objective assessed protective efficacy of R21 plus MM (R21/MM) from 14 days after the third vaccination to 6 months. Primary analyses of vaccine efficacy were based on a modified intention-to-treat population, which included all participants who received three vaccinations, allowing for inclusion of participants who received the wrong vaccine at any timepoint. This trial is registered with ClinicalTrials.gov, NCT03896724. FINDINGS: From May 7 to June 13, 2019, 498 children aged 5-17 months were screened, and 48 were excluded. 450 children were enrolled and received at least one vaccination. 150 children were allocated to group 1, 150 children were allocated to group 2, and 150 children were allocated to group 3. The final vaccination of the primary series was administered on Aug 7, 2019. R21/MM had a favourable safety profile and was well tolerated. The majority of adverse events were mild, with the most common event being fever. None of the seven serious adverse events were attributed to the vaccine. At the 6-month primary efficacy analysis, 43 (29%) of 146 participants in group 1, 38 (26%) of 146 participants in group 2, and 105 (71%) of 147 participants in group 3 developed clinical malaria. Vaccine efficacy was 74% (95% CI 63-82) in group 1 and 77% (67-84) in group 2 at 6 months. At 1 year, vaccine efficacy remained high, at 77% (67-84) in group 1. Participants vaccinated with R21/MM showed high titres of malaria-specific anti-Asn-Ala-Asn-Pro (NANP) antibodies 28 days after the third vaccination, which were almost doubled with the higher adjuvant dose. Titres waned but were boosted to levels similar to peak titres after the primary series of vaccinations after a fourth dose administered 1 year later. INTERPRETATION: R21/MM appears safe and very immunogenic in African children, and shows promising high-level efficacy. FUNDING: The European & Developing Countries Clinical Trials Partnership, Wellcome Trust, and National Institute for Health Research Oxford Biomedical Research Centre. Close doi:10.1016/S0140-6736(21)00943-0 Close
	Toussaint Rouamba, Sékou Samadoulougou, Mady Ouédraogo, Hervé Hien, Halidou Tinto, Fati Kirakoya-Samadoulougou Asymptomatic malaria and anaemia among pregnant women during high and low malaria transmission seasons in Burkina Faso: household-based cross-sectional surveys in Burkina Faso, 2013 and 2017 (Journal Article) In: Malar. J., vol. 20, no. 1, pp. 211, 2021, ISSN: 1475-2875. (Abstract \| Links \| BibTeX \| Tags: Adult, Anemia/epidemiology/parasitology, Asymptomatic carriage, Asymptomatic Infections/epidemiology, Burkina Faso/epidemiology, Community, Cross-Sectional Studies, Female, Haemoglobin, Humans, Malaria/epidemiology/parasitology, Parasitic/epidemiology/parasitology, Plasmodium, Pregnancy, Pregnancy Complications, Pregnant, Pregnant Women, Prevalence, Young Adult) Close @article{Rouamba2021-gn, title = {Asymptomatic malaria and anaemia among pregnant women during high and low malaria transmission seasons in Burkina Faso: household-based cross-sectional surveys in Burkina Faso, 2013 and 2017}, author = {Toussaint Rouamba and S\'{e}kou Samadoulougou and Mady Ou\'{e}draogo and Herv\'{e} Hien and Halidou Tinto and Fati Kirakoya-Samadoulougou}, doi = {10.1186/s12936-021-03703-4}, issn = {1475-2875}, year = {2021}, date = {2021-05-01}, urldate = {2021-05-01}, journal = {Malar. J.}, volume = {20}, number = {1}, pages = {211}, publisher = {Springer Science and Business Media LLC}, abstract = {BACKGROUND: Malaria in endemic countries is often asymptomatic during pregnancy, but it has substantial consequences for both the mother and her unborn baby. During pregnancy, anaemia is an important consequence of malaria infection. In Burkina Faso, the intensity of malaria varies according to the season, albeit the prevalence of malaria and anaemia as well as their risk factors, during high and low malaria transmission seasons is underexplored at the household level. METHODS: Data of 1751 pregnant women from October 2013 to March 2014 and 1931 pregnant women from April 2017 to June 2017 were drawn from two cross-sectional household surveys conducted in 24 health districts of Burkina Faso. Pregnant women were tested for malaria in their household after consenting. Asymptomatic carriage was defined as a positive result from malaria rapid diagnostic tests in the absence of clinical symptoms of malaria. Anaemia was defined as haemoglobin level less than 11 g/dL in the first and third trimester and less than 10.5 g/dL in the second trimester of pregnancy. RESULTS: Prevalence of asymptomatic malaria in pregnancy was estimated at 23.9% (95% CI 20.2-28.0) during the high transmission season (October-November) in 2013. During the low transmission season, it was 12.7% (95% CI 10.9-14.7) between December and March in 2013-2014 and halved (6.4%; 95% CI 5.3-7.6) between April and June 2017. Anaemia prevalence was estimated at 59.4% (95% CI 54.8-63.8) during the high transmission season in 2013. During the low transmission season, it was 50.6% (95% CI 47.7-53.4) between December and March 2013-2014 and 65.0% (95% CI 62.8-67.2) between April and June, 2017. CONCLUSION: This study revealed that the prevalence of malaria asymptomatic carriage and anaemia among pregnant women at the community level remain high throughout the year. Thus, more efforts are needed to increase prevention measures such as IPTp-SP coverage in order to reduce anaemia and contribute to preventing low birth weight and poor pregnancy outcomes.}, keywords = {Adult, Anemia/epidemiology/parasitology, Asymptomatic carriage, Asymptomatic Infections/epidemiology, Burkina Faso/epidemiology, Community, Cross-Sectional Studies, Female, Haemoglobin, Humans, Malaria/epidemiology/parasitology, Parasitic/epidemiology/parasitology, Plasmodium, Pregnancy, Pregnancy Complications, Pregnant, Pregnant Women, Prevalence, Young Adult}, pubstate = {published}, tppubtype = {article} } Close BACKGROUND: Malaria in endemic countries is often asymptomatic during pregnancy, but it has substantial consequences for both the mother and her unborn baby. During pregnancy, anaemia is an important consequence of malaria infection. In Burkina Faso, the intensity of malaria varies according to the season, albeit the prevalence of malaria and anaemia as well as their risk factors, during high and low malaria transmission seasons is underexplored at the household level. METHODS: Data of 1751 pregnant women from October 2013 to March 2014 and 1931 pregnant women from April 2017 to June 2017 were drawn from two cross-sectional household surveys conducted in 24 health districts of Burkina Faso. Pregnant women were tested for malaria in their household after consenting. Asymptomatic carriage was defined as a positive result from malaria rapid diagnostic tests in the absence of clinical symptoms of malaria. Anaemia was defined as haemoglobin level less than 11 g/dL in the first and third trimester and less than 10.5 g/dL in the second trimester of pregnancy. RESULTS: Prevalence of asymptomatic malaria in pregnancy was estimated at 23.9% (95% CI 20.2-28.0) during the high transmission season (October-November) in 2013. During the low transmission season, it was 12.7% (95% CI 10.9-14.7) between December and March in 2013-2014 and halved (6.4%; 95% CI 5.3-7.6) between April and June 2017. Anaemia prevalence was estimated at 59.4% (95% CI 54.8-63.8) during the high transmission season in 2013. During the low transmission season, it was 50.6% (95% CI 47.7-53.4) between December and March 2013-2014 and 65.0% (95% CI 62.8-67.2) between April and June, 2017. CONCLUSION: This study revealed that the prevalence of malaria asymptomatic carriage and anaemia among pregnant women at the community level remain high throughout the year. Thus, more efforts are needed to increase prevention measures such as IPTp-SP coverage in order to reduce anaemia and contribute to preventing low birth weight and poor pregnancy outcomes. Close doi:10.1186/s12936-021-03703-4 Close
	Massa Dit Achille Bonko, Palpouguini Lompo, Marc Christian Tahita, Francois Kiemde, Ibrahima Karama, Athanase M Somé, Petra F Mens, Sandra Menting, Halidou Tinto, Henk D F H Schallig Antibiotic susceptibility of Staphylococcus aureus and Streptococcus pneumoniae isolates from the nasopharynx of febrile children under 5 years in Nanoro, Burkina Faso (Journal Article) In: Antibiotics (Basel), vol. 10, no. 4, 2021, ISSN: 2079-6382, (PMID: 33920987 PMCID: PMC8071235). (Abstract \| Links \| BibTeX \| Tags: antibiotics, children; nasopharynx, resistance, Staphylococcus aureus, Streptococcus pneumoniae) Close @article{Bonko2021-kv, title = {Antibiotic susceptibility of Staphylococcus aureus and Streptococcus pneumoniae isolates from the nasopharynx of febrile children under 5 years in Nanoro, Burkina Faso}, author = {Massa Dit Achille Bonko and Palpouguini Lompo and Marc Christian Tahita and Francois Kiemde and Ibrahima Karama and Athanase M Som\'{e} and Petra F Mens and Sandra Menting and Halidou Tinto and Henk D F H Schallig}, doi = {10.3390/antibiotics10040444}, issn = {2079-6382}, year = {2021}, date = {2021-04-15}, urldate = {2021-04-15}, journal = {Antibiotics (Basel)}, volume = {10}, number = {4}, abstract = {(1) Background: nasopharynx colonization by resistant Staphylococcus aureus and Streptococcus pneumoniae can lead to serious diseases. Emerging resistance to antibiotics commonly used to treat infections due to these pathogens poses a serious threat to the health system. The present study aimed to determine the antibiotic susceptibility of S. aureus and S. pneumoniae isolates from the febrile children's nasopharynx under 5 years in Nanoro (Burkina Faso). (2) Methods: bacterial isolates were identified from nasopharyngeal swabs prospectively collected from 629 febrile children. Antibiotic susceptibility of S. aureus and S. pneumoniae isolates was assessed by Kirby-Bauer method and results were interpreted according to the Clinical and Laboratory Standard Institute guidelines. (3) Results: bacterial colonization was confirmed in 154 (24.5%) of children of whom 96.1% carried S. aureus, 3.2% had S. pneumoniae, and 0.6% carried both bacteria. S. aureus isolates showed alarming resistance to penicillin (96.0%) and S. pneumoniae was highly resistant to tetracycline (100%) and trimethoprim-sulfamethoxazole (83.3%), and moderately resistant to penicillin (50.0%). Furthermore, 4.0% of S. aureus identified were methicillin resistant. (4) Conclusion: this study showed concerning resistance rates to antibiotics to treat suspected bacterial respiratory tract infections. The work highlights the necessity to implement continuous antibiotic resistance surveillance.}, note = {PMID: 33920987 PMCID: PMC8071235}, keywords = {antibiotics, children; nasopharynx, resistance, Staphylococcus aureus, Streptococcus pneumoniae}, pubstate = {published}, tppubtype = {article} } Close (1) Background: nasopharynx colonization by resistant Staphylococcus aureus and Streptococcus pneumoniae can lead to serious diseases. Emerging resistance to antibiotics commonly used to treat infections due to these pathogens poses a serious threat to the health system. The present study aimed to determine the antibiotic susceptibility of S. aureus and S. pneumoniae isolates from the febrile children’s nasopharynx under 5 years in Nanoro (Burkina Faso). (2) Methods: bacterial isolates were identified from nasopharyngeal swabs prospectively collected from 629 febrile children. Antibiotic susceptibility of S. aureus and S. pneumoniae isolates was assessed by Kirby-Bauer method and results were interpreted according to the Clinical and Laboratory Standard Institute guidelines. (3) Results: bacterial colonization was confirmed in 154 (24.5%) of children of whom 96.1% carried S. aureus, 3.2% had S. pneumoniae, and 0.6% carried both bacteria. S. aureus isolates showed alarming resistance to penicillin (96.0%) and S. pneumoniae was highly resistant to tetracycline (100%) and trimethoprim-sulfamethoxazole (83.3%), and moderately resistant to penicillin (50.0%). Furthermore, 4.0% of S. aureus identified were methicillin resistant. (4) Conclusion: this study showed concerning resistance rates to antibiotics to treat suspected bacterial respiratory tract infections. The work highlights the necessity to implement continuous antibiotic resistance surveillance. Close doi:10.3390/antibiotics10040444 Close
	Sabine Gies, Stephen A Roberts, Salou Diallo, Olga M Lompo, Halidou Tinto, Bernard J Brabin Risk of malaria in young children after periconceptional iron supplementation (Journal Article) In: Matern. Child Nutr., vol. 17, no. 2, pp. e13106, 2021, ISSN: 1740-8709 1740-8695, (© 2020 The Authors. Maternal & Child Nutrition published by John Wiley & Sons Ltd. PMID: 33236840 PMCID: PMC7988873). (Abstract \| Links \| BibTeX \| Tags: Burkina Faso, child iron, Dietary Supplements/analysis, Female, Folic Acid, Humans, Infant, Malaria, Newborn, periconceptional, placenta, Pregnancy, Premature Birth, Preschool) Close @article{Gies2021-aw, title = {Risk of malaria in young children after periconceptional iron supplementation}, author = {Sabine Gies and Stephen A Roberts and Salou Diallo and Olga M Lompo and Halidou Tinto and Bernard J Brabin}, doi = {10.1111/mcn.13106}, issn = {1740-8709 1740-8695}, year = {2021}, date = {2021-04-01}, urldate = {2021-04-01}, journal = {Matern. Child Nutr.}, volume = {17}, number = {2}, pages = {e13106}, publisher = {Wiley}, abstract = {This study in Burkina Faso investigated whether offspring of young mothers who had received weekly periconceptional iron supplementation in a randomised controlled trial were at increased risk of malaria. A child safety survey was undertaken in the peak month of malaria transmission towards the end of the trial to assess child iron biomarkers, nutritional status, anaemia and malaria outcomes. Antenatal iron biomarkers, preterm birth, fetal growth restriction and placental pathology for malaria and chorioamnionitis were assessed. Data were available for 180 babies surviving to the time of the survey when their median age was 9 months. Prevalence of maternal iron deficiency in the last trimester based on low body iron stores was 16%. Prevalence of active placental malaria infection was 24.8%, past infection 59% and chorioamnionitis 55.6%. Babies of iron supplemented women had lower median gestational age. Four out of five children ≥ 6 months were iron deficient, and 98% were anaemic. At 4 months malaria prevalence was 45%. Child iron biomarkers, anaemia and malaria outcomes did not differ by trial arm. Factors associated with childhood parasitaemia were third trimester C-reactive protein level (OR 2.1; 95% CI 1.1-3.9), active placental malaria (OR 5.8; 1.0-32.5, P = 0.042) and child body iron stores (OR 1.13; 1.04-1.23, P = 0.002). Chorioamnionitis was associated with reduced risk of child parasitaemia (OR 0.4; 0.1-1.0, P = 0.038). Periconceptional iron supplementation of young women did not alter body iron stores of their children. Higher child body iron stores and placental malaria increased risk of childhood parasitaemia.}, note = {© 2020 The Authors. Maternal \& Child Nutrition published by John Wiley \& Sons Ltd. PMID: 33236840 PMCID: PMC7988873}, keywords = {Burkina Faso, child iron, Dietary Supplements/analysis, Female, Folic Acid, Humans, Infant, Malaria, Newborn, periconceptional, placenta, Pregnancy, Premature Birth, Preschool}, pubstate = {published}, tppubtype = {article} } Close This study in Burkina Faso investigated whether offspring of young mothers who had received weekly periconceptional iron supplementation in a randomised controlled trial were at increased risk of malaria. A child safety survey was undertaken in the peak month of malaria transmission towards the end of the trial to assess child iron biomarkers, nutritional status, anaemia and malaria outcomes. Antenatal iron biomarkers, preterm birth, fetal growth restriction and placental pathology for malaria and chorioamnionitis were assessed. Data were available for 180 babies surviving to the time of the survey when their median age was 9 months. Prevalence of maternal iron deficiency in the last trimester based on low body iron stores was 16%. Prevalence of active placental malaria infection was 24.8%, past infection 59% and chorioamnionitis 55.6%. Babies of iron supplemented women had lower median gestational age. Four out of five children ≥ 6 months were iron deficient, and 98% were anaemic. At 4 months malaria prevalence was 45%. Child iron biomarkers, anaemia and malaria outcomes did not differ by trial arm. Factors associated with childhood parasitaemia were third trimester C-reactive protein level (OR 2.1; 95% CI 1.1-3.9), active placental malaria (OR 5.8; 1.0-32.5, P = 0.042) and child body iron stores (OR 1.13; 1.04-1.23, P = 0.002). Chorioamnionitis was associated with reduced risk of child parasitaemia (OR 0.4; 0.1-1.0, P = 0.038). Periconceptional iron supplementation of young women did not alter body iron stores of their children. Higher child body iron stores and placental malaria increased risk of childhood parasitaemia. Close doi:10.1111/mcn.13106 Close
	Engelbert A Nonterah, Michiel L Bots, Abraham Oduro, Godfred Agongo, Cassandra C Soo, Lisa K Micklesfield, Felistas Mashinya, Palwendé R Boua, Shukri F Mohamed, Alisha N Wade, Catherine Kyobutungi, Halidou Tinto, Shane A Norris, Stephen M Tollman, Mich`ele Ramsay, Diederick E Grobbee, Kerstin Klipstein-Grobusch, Nigel J Crowther, AWI-Gen, H3Africa Consortium Adiposity phenotypes and subclinical atherosclerosis in adults from sub-Saharan Africa: An H3Africa AWI-gen study (Journal Article) In: Glob. Heart, vol. 16, no. 1, pp. 19, 2021, ISSN: 2211-8179 2211-8160, (Copyright: © 2021 The Author(s). PMID: 33833943 PMCID: PMC7977036). (Abstract \| Links \| BibTeX \| Tags: adiposity, Adult, Body Mass Index, cardiovascular disease, Carotid intima-media thickness, Cross-Sectional Studies, Female, Ghana, Humans, Male, Middle Aged, obesity, Obesity/complications/epidemiology, Phenotype, Risk Factors, sub-Saharan Africa, subclinical atherosclerosis) Close @article{Nonterah2021-pc, title = {Adiposity phenotypes and subclinical atherosclerosis in adults from sub-Saharan Africa: An H3Africa AWI-gen study}, author = {Engelbert A Nonterah and Michiel L Bots and Abraham Oduro and Godfred Agongo and Cassandra C Soo and Lisa K Micklesfield and Felistas Mashinya and Palwend\'{e} R Boua and Shukri F Mohamed and Alisha N Wade and Catherine Kyobutungi and Halidou Tinto and Shane A Norris and Stephen M Tollman and Mich`ele Ramsay and Diederick E Grobbee and Kerstin Klipstein-Grobusch and Nigel J Crowther and AWI-Gen and H3Africa Consortium}, doi = {10.5334/gh.863}, issn = {2211-8179 2211-8160}, year = {2021}, date = {2021-03-19}, urldate = {2021-03-19}, journal = {Glob. Heart}, volume = {16}, number = {1}, pages = {19}, publisher = {Ubiquity Press, Ltd.}, abstract = {Background: Obesity and adipose tissue distribution contribute to an increased risk of cardiovascular disease (CVD) by promoting atherosclerosis. This association has been poorly studied in sub-Saharan Africa (SSA) despite the rising prevalence of cardiovascular disease. Objectives: We determined the association between various adiposity phenotypes and carotid intima-media thickness (CIMT), a proxy of subclinical atherosclerosis, in a large SSA population. Methods: A population-based cross-sectional study was performed from 2013-2016 in Burkina Faso, Ghana, Kenya and South Africa. Body mass index (BMI), waist (WC), hip circumferences (HC), visceral (VAT) and subcutaneous adipose tissue (SCAT) using B-mode ultrasound were measured. Ultrasonography of left and right far wall CIMT of the common carotid artery was used as an indicator of subclinical atherosclerosis. Individual participant data meta-analyses were used to determine the associations between adiposity phenotypes and CIMT in the pooled sample while adjusted multivariable linear regression analyses were used for site specific analyses. Results: Data were obtained from 9,010 adults (50.3% women and a mean age of 50$pm$ 6years). Men had higher levels of visceral fat than women while women had higher BMI, waist and hip circumference and subcutaneous fat than men at all sites except Burkina Faso. In the pooled analyses, BMI ($beta$-value [95% CIs]: 19.5 [16.8, 22.3] $mu$m) showed the strongest relationship with CIMT followed by VAT (5.86 [4.65, 7.07] $mu$m), SCAT (5.00 [2.85, 7.15] $mu$m), WC (1.27 [1.09, 1.44] $mu$m) and HC (1.23 [1.04, 1.42] $mu$m). Stronger associations were observed in men than in women. Conclusion: Obesity within SSA will likely result in higher levels of atherosclerosis and promote the occurrence of cardio- and cerebrovascular events, especially in males, unless addressed through primary prevention of obesity in both rural and urban communities across Africa. The inverse association of VAT with CIMT in Burkina Faso and Ghana requires further investigation. Highlights: All adiposity phenotypes were positively associated with common carotid intima-media thickness (CIMT) in the entire cohort (pooled analyses).BMI had the strongest association with CIMT compared to other phenotypes.The magnitude of association between adiposity phenotypes and CIMT was higher in men than in women.Subcutaneous adipose tissue was inversely associated with CIMT only in women.An unexpected finding was the inverse association of visceral adipose tissue with CIMT in Burkina Faso and Ghana.}, note = {Copyright: © 2021 The Author(s). PMID: 33833943 PMCID: PMC7977036}, keywords = {adiposity, Adult, Body Mass Index, cardiovascular disease, Carotid intima-media thickness, Cross-Sectional Studies, Female, Ghana, Humans, Male, Middle Aged, obesity, Obesity/complications/epidemiology, Phenotype, Risk Factors, sub-Saharan Africa, subclinical atherosclerosis}, pubstate = {published}, tppubtype = {article} } Close Background: Obesity and adipose tissue distribution contribute to an increased risk of cardiovascular disease (CVD) by promoting atherosclerosis. This association has been poorly studied in sub-Saharan Africa (SSA) despite the rising prevalence of cardiovascular disease. Objectives: We determined the association between various adiposity phenotypes and carotid intima-media thickness (CIMT), a proxy of subclinical atherosclerosis, in a large SSA population. Methods: A population-based cross-sectional study was performed from 2013-2016 in Burkina Faso, Ghana, Kenya and South Africa. Body mass index (BMI), waist (WC), hip circumferences (HC), visceral (VAT) and subcutaneous adipose tissue (SCAT) using B-mode ultrasound were measured. Ultrasonography of left and right far wall CIMT of the common carotid artery was used as an indicator of subclinical atherosclerosis. Individual participant data meta-analyses were used to determine the associations between adiposity phenotypes and CIMT in the pooled sample while adjusted multivariable linear regression analyses were used for site specific analyses. Results: Data were obtained from 9,010 adults (50.3% women and a mean age of 50$pm$ 6years). Men had higher levels of visceral fat than women while women had higher BMI, waist and hip circumference and subcutaneous fat than men at all sites except Burkina Faso. In the pooled analyses, BMI ($beta$-value [95% CIs]: 19.5 [16.8, 22.3] $mu$m) showed the strongest relationship with CIMT followed by VAT (5.86 [4.65, 7.07] $mu$m), SCAT (5.00 [2.85, 7.15] $mu$m), WC (1.27 [1.09, 1.44] $mu$m) and HC (1.23 [1.04, 1.42] $mu$m). Stronger associations were observed in men than in women. Conclusion: Obesity within SSA will likely result in higher levels of atherosclerosis and promote the occurrence of cardio- and cerebrovascular events, especially in males, unless addressed through primary prevention of obesity in both rural and urban communities across Africa. The inverse association of VAT with CIMT in Burkina Faso and Ghana requires further investigation. Highlights: All adiposity phenotypes were positively associated with common carotid intima-media thickness (CIMT) in the entire cohort (pooled analyses).BMI had the strongest association with CIMT compared to other phenotypes.The magnitude of association between adiposity phenotypes and CIMT was higher in men than in women.Subcutaneous adipose tissue was inversely associated with CIMT only in women.An unexpected finding was the inverse association of visceral adipose tissue with CIMT in Burkina Faso and Ghana. Close doi:10.5334/gh.863 Close
	Palpouguini Lompo, Marc Christian Tahita, Hermann Sorgho, William Kaboré, Adama Kazienga, Ashmed Cheick Bachirou Nana, Hamtandi Magloire Natama, Isidore Juste Ouindgueta Bonkoungou, Nicolas Barro, Halidou Tinto Pathogens associated with acute diarrhea, and comorbidity with malaria among children under five years old in rural Burkina Faso (Journal Article) In: Pan Afr. Med. J., vol. 38, pp. 259, 2021, ISSN: 1937-8688, (Copyright: Palpouguini Lompo et al. PMID: 34104307 PMCID: PMC8164431). (Abstract \| Links \| BibTeX \| Tags: Abdominal Pain/epidemiology, Acute Disease, bacteria, Burkina Faso, Burkina Faso/epidemiology, Child, Comorbidity, Diarrhea, Diarrhea/epidemiology/microbiology, Female, Fever/epidemiology, Giardiasis/epidemiology, Humans, Infant, infectious, Malaria, Malaria/epidemiology, Male, parasite, pathogens, Preschool, Prevalence, Risk Factors, rotavirus, Rotavirus Infections/epidemiology, Rural Population, Seasons, Vomiting/epidemiology) Close @article{Lompo2021-sk, title = {Pathogens associated with acute diarrhea, and comorbidity with malaria among children under five years old in rural Burkina Faso}, author = {Palpouguini Lompo and Marc Christian Tahita and Hermann Sorgho and William Kabor\'{e} and Adama Kazienga and Ashmed Cheick Bachirou Nana and Hamtandi Magloire Natama and Isidore Juste Ouindgueta Bonkoungou and Nicolas Barro and Halidou Tinto}, doi = {10.11604/pamj.2021.38.259.15864}, issn = {1937-8688}, year = {2021}, date = {2021-03-01}, urldate = {2021-03-01}, journal = {Pan Afr. Med. J.}, volume = {38}, pages = {259}, publisher = {Pan African Medical Journal}, abstract = {INTRODUCTION: acute diarrhea in children under five years is a public health problem in developing countries and particularly in malaria-endemic areas where both diseases co-exist. The present study examined the etiology of childhood diarrhea and its comorbidity with malaria in a rural area of Burkina Faso. METHODS: conventional culture techniques, direct stools examination, and viruses´ detection by rapid tests were performed on the fresh stools and microscopy was used to diagnose malaria. Some risk factors were also assessed. RESULTS: on a total of 191 samples collected, at least one pathogen was identified in 89 cases (46.6%). The proportions of pathogens found on the 89 positive stool samples were parasites 51.69% (46 cases), viruses 39.33% (35 cases), and bacteria 14.61% (13 cases), respectively. The relationship between malaria and infectious diarrhea was significant in viral and parasites causes (p=0.005 and 0.043 respectively). Fever, vomiting and abdominal pain were the major symptoms associated with diarrhea, with 71.51%, 31.72% and 23.66% respectively. The highest viral diarrhea prevalence was reported during the dry season (OR=5.29, 95% CI: 1.74 - 16.07, p=0.001) while parasite diarrhea was more encountered during the rainy season (OR=0.41, 95% CI: 0.33 - 0.87, p=0.011). CONCLUSION: Giardia spp and rotavirus were the leading cause of acute diarrhea in Nanoro, Burkina Faso with a predominance of rotavirus in children less than 2 years. Parasite and viral diarrhea were the most pathogens associated with malaria. However, the high rate of negative stool samples suggests the need to determine other enteric microorganisms.}, note = {Copyright: Palpouguini Lompo et al. PMID: 34104307 PMCID: PMC8164431}, keywords = {Abdominal Pain/epidemiology, Acute Disease, bacteria, Burkina Faso, Burkina Faso/epidemiology, Child, Comorbidity, Diarrhea, Diarrhea/epidemiology/microbiology, Female, Fever/epidemiology, Giardiasis/epidemiology, Humans, Infant, infectious, Malaria, Malaria/epidemiology, Male, parasite, pathogens, Preschool, Prevalence, Risk Factors, rotavirus, Rotavirus Infections/epidemiology, Rural Population, Seasons, Vomiting/epidemiology}, pubstate = {published}, tppubtype = {article} } Close INTRODUCTION: acute diarrhea in children under five years is a public health problem in developing countries and particularly in malaria-endemic areas where both diseases co-exist. The present study examined the etiology of childhood diarrhea and its comorbidity with malaria in a rural area of Burkina Faso. METHODS: conventional culture techniques, direct stools examination, and viruses´ detection by rapid tests were performed on the fresh stools and microscopy was used to diagnose malaria. Some risk factors were also assessed. RESULTS: on a total of 191 samples collected, at least one pathogen was identified in 89 cases (46.6%). The proportions of pathogens found on the 89 positive stool samples were parasites 51.69% (46 cases), viruses 39.33% (35 cases), and bacteria 14.61% (13 cases), respectively. The relationship between malaria and infectious diarrhea was significant in viral and parasites causes (p=0.005 and 0.043 respectively). Fever, vomiting and abdominal pain were the major symptoms associated with diarrhea, with 71.51%, 31.72% and 23.66% respectively. The highest viral diarrhea prevalence was reported during the dry season (OR=5.29, 95% CI: 1.74 – 16.07, p=0.001) while parasite diarrhea was more encountered during the rainy season (OR=0.41, 95% CI: 0.33 – 0.87, p=0.011). CONCLUSION: Giardia spp and rotavirus were the leading cause of acute diarrhea in Nanoro, Burkina Faso with a predominance of rotavirus in children less than 2 years. Parasite and viral diarrhea were the most pathogens associated with malaria. However, the high rate of negative stool samples suggests the need to determine other enteric microorganisms. Close doi:10.11604/pamj.2021.38.259.15864 Close
	Annelies Post, Berenger Kaboré, Joel Bognini, Salou Diallo, Palpouguini Lompo, Basile Kam, Natacha Herssens, Fred Opzeeland, Christa E Gaast-de Jongh, Jeroen D Langereis, Marien I Jonge, Janette Rahamat-Langendoen, Teun Bousema, Heiman Wertheim, Robert W Sauerwein, Halidou Tinto, Jan Jacobs, Quirijn Mast, Andre J Ven Infection Manager System (IMS) as a new hemocytometry-based bacteremia detection tool: A diagnostic accuracy study in a malaria-endemic area of Burkina Faso (Journal Article) In: PLoS Negl. Trop. Dis., vol. 15, no. 3, pp. e0009187, 2021, ISSN: 1935-2735 1935-2727, (PMID: 33647009 PMCID: PMC7951874). (Abstract \| Links \| BibTeX \| Tags: Adolescent, Automation, Bacteremia/diagnosis, Burkina Faso, C-Reactive Protein/analysis, Child, Coinfection/diagnosis/microbiology/parasitology, Female, Fever of Unknown Origin/diagnosis, Humans, Infant, Laboratory/methods, Malaria/diagnosis, Male, Preschool, Procalcitonin/analysis, Prospective Studies, Sensitivity and Specificity, Software, Virus Diseases/diagnosis) Close @article{Post2021-zl, title = {Infection Manager System (IMS) as a new hemocytometry-based bacteremia detection tool: A diagnostic accuracy study in a malaria-endemic area of Burkina Faso}, author = {Annelies Post and Berenger Kabor\'{e} and Joel Bognini and Salou Diallo and Palpouguini Lompo and Basile Kam and Natacha Herssens and Fred Opzeeland and Christa E Gaast-de Jongh and Jeroen D Langereis and Marien I Jonge and Janette Rahamat-Langendoen and Teun Bousema and Heiman Wertheim and Robert W Sauerwein and Halidou Tinto and Jan Jacobs and Quirijn Mast and Andre J Ven}, doi = {10.1371/journal.pntd.0009187}, issn = {1935-2735 1935-2727}, year = {2021}, date = {2021-03-01}, urldate = {2021-03-01}, journal = {PLoS Negl. Trop. Dis.}, volume = {15}, number = {3}, pages = {e0009187}, publisher = {Public Library of Science (PLoS)}, abstract = {BACKGROUND: New hemocytometric parameters can be used to differentiate causes of acute febrile illness (AFI). We evaluated a software algorithm-Infection Manager System (IMS)-which uses hemocytometric data generated by Sysmex hematology analyzers, for its accuracy to detect bacteremia in AFI patients with and without malaria in Burkina Faso. Secondary aims included comparing the accuracy of IMS with C-reactive protein (CRP) and procalcitonin (PCT). METHODS: In a prospective observational study, patients of $geq$ three-month-old (range 3 months- 90 years) presenting with AFI were enrolled. IMS, blood culture and malaria diagnostics were done upon inclusion and additional diagnostics on clinical indication. CRP, PCT, viral multiplex PCR on nasopharyngeal swabs and bacterial- and malaria PCR were batch-tested retrospectively. Diagnostic classification was done retrospectively using all available data except IMS, CRP and PCT results. FINDINGS: A diagnosis was affirmed in 549/914 (60.1%) patients and included malaria (n = 191) bacteremia (n = 69), viral infections (n = 145), and malaria-bacteremia co-infections (n = 47). The overall sensitivity, specificity, and negative predictive value (NPV) of IMS for detection of bacteremia in patients of $geq$ 5 years were 97.0% (95% CI: 89.8-99.6), 68.2% (95% CI: 55.6-79.1) and 95.7% (95% CI: 85.5-99.5) respectively, compared to 93.9% (95% CI: 85.2-98.3), 39.4% (95% CI: 27.6-52.2), and 86.7% (95% CI: 69.3-96.2) for CRP at $geq$20mg/L. The sensitivity, specificity and NPV of PCT at 0.5 ng/ml were lower at respectively 72.7% (95% CI: 60.4-83.0), 50.0% (95% CI: 37.4-62.6) and 64.7% (95% CI: 50.1-77.6) The diagnostic accuracy of IMS was lower among malaria cases and patients \<5 years but remained equal to- or higher than the accuracy of CRP. INTERPRETATION: IMS is a new diagnostic tool to differentiate causes of AFI. Its high NPV for bacteremia has the potential to improve antibiotic dispensing practices in healthcare facilities with hematology analyzers. Future studies are needed to evaluate whether IMS, combined with malaria diagnostics, may be used to rationalize antimicrobial prescription in malaria endemic areas. TRIAL REGISTRATION: ClinicalTrials.gov (NCT02669823) https://clinicaltrials.gov/ct2/show/NCT02669823.}, note = {PMID: 33647009 PMCID: PMC7951874}, keywords = {Adolescent, Automation, Bacteremia/diagnosis, Burkina Faso, C-Reactive Protein/analysis, Child, Coinfection/diagnosis/microbiology/parasitology, Female, Fever of Unknown Origin/diagnosis, Humans, Infant, Laboratory/methods, Malaria/diagnosis, Male, Preschool, Procalcitonin/analysis, Prospective Studies, Sensitivity and Specificity, Software, Virus Diseases/diagnosis}, pubstate = {published}, tppubtype = {article} } Close BACKGROUND: New hemocytometric parameters can be used to differentiate causes of acute febrile illness (AFI). We evaluated a software algorithm-Infection Manager System (IMS)-which uses hemocytometric data generated by Sysmex hematology analyzers, for its accuracy to detect bacteremia in AFI patients with and without malaria in Burkina Faso. Secondary aims included comparing the accuracy of IMS with C-reactive protein (CRP) and procalcitonin (PCT). METHODS: In a prospective observational study, patients of $geq$ three-month-old (range 3 months- 90 years) presenting with AFI were enrolled. IMS, blood culture and malaria diagnostics were done upon inclusion and additional diagnostics on clinical indication. CRP, PCT, viral multiplex PCR on nasopharyngeal swabs and bacterial- and malaria PCR were batch-tested retrospectively. Diagnostic classification was done retrospectively using all available data except IMS, CRP and PCT results. FINDINGS: A diagnosis was affirmed in 549/914 (60.1%) patients and included malaria (n = 191) bacteremia (n = 69), viral infections (n = 145), and malaria-bacteremia co-infections (n = 47). The overall sensitivity, specificity, and negative predictive value (NPV) of IMS for detection of bacteremia in patients of $geq$ 5 years were 97.0% (95% CI: 89.8-99.6), 68.2% (95% CI: 55.6-79.1) and 95.7% (95% CI: 85.5-99.5) respectively, compared to 93.9% (95% CI: 85.2-98.3), 39.4% (95% CI: 27.6-52.2), and 86.7% (95% CI: 69.3-96.2) for CRP at $geq$20mg/L. The sensitivity, specificity and NPV of PCT at 0.5 ng/ml were lower at respectively 72.7% (95% CI: 60.4-83.0), 50.0% (95% CI: 37.4-62.6) and 64.7% (95% CI: 50.1-77.6) The diagnostic accuracy of IMS was lower among malaria cases and patients <5 years but remained equal to- or higher than the accuracy of CRP. INTERPRETATION: IMS is a new diagnostic tool to differentiate causes of AFI. Its high NPV for bacteremia has the potential to improve antibiotic dispensing practices in healthcare facilities with hematology analyzers. Future studies are needed to evaluate whether IMS, combined with malaria diagnostics, may be used to rationalize antimicrobial prescription in malaria endemic areas. TRIAL REGISTRATION: ClinicalTrials.gov (NCT02669823) https://clinicaltrials.gov/ct2/show/NCT02669823. Close doi:10.1371/journal.pntd.0009187 Close

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" Our main objective is to develop and maintain over time a good expertise and infrastructure ensuring high quality training and clinical research."
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" Our main objective is to develop and maintain over time a good expertise and infrastructure ensuring high quality training and clinical research." Prof Halidou TINTO, PharmD, Msc, PhD Head of the CRUN

2021

Journal Articles

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" Our main objective is to develop and maintain over time a good expertise and infrastructure ensuring high quality training and clinical research."
Prof Halidou TINTO, PharmD, Msc, PhD Head of the CRUN