Publications

@article{Valia2024,

title = {Antibiotic use by clinical presentation across all healthcare providers in rural Burkina Faso: a healthcare visit exit survey},

author = {Daniel Valia and Brecht Ingelbeen and Gu\'{e}tawend\'{e} Job Wilfried Nassa and B\'{e}renger Kabor\'{e} and Fran\c{c}ois Kiemd\'{e} and Toussaint Rouamba and Ad\'{e}la\"{i}de Compaor\'{e} and Juste St\'{e}phane Kouanda and Annie Robert and Hector Rodriguez-Villalobos and Marianne A B Van Der Sande and Halidou Tinto},

url = {https://pubmed.ncbi.nlm.nih.gov/39051704/},

doi = {10.1093/JAC/DKAE252},

issn = {1460-2091},

year  = {2024},

date = {2024-01-01},

journal = {The Journal of antimicrobial chemotherapy},

volume = {79},

issue = {10},

publisher = {J Antimicrob Chemother},

abstract = {DOI: 10.1093/jac/dkae252; Journal of Antimicrobial Chemotherapy, 00, 0, 2024-07-25.; Abstract: Background: To guide antibiotic stewardship interventions, understanding for what indications antibiotics are used is essential. Methods: In rural Burkina Faso, we measured antibiotic dispensing across all healthcare providers. From October 2021 to February 2022, we surveyed patients in Nanoro district, Burkina Faso, following visits to health centres (3), pharmacies (2), informal medicine vendors (5) and inpatients in health centres. We estimated prevalence of antibiotic use and the proportion of Watch group antibiotics by provider type and by clinical presentation, assessing compliance with WHO’s AWaRe Antibiotic Book. We estimated per capita antibiotic use by multiplying prevalence of antibiotic use, mean DDD per adult treatment course, and the rate of healthcare visits per 1000 inhabitants per day, estimated from a prior household survey. Results: Outpatient antibiotic use was more fre},

keywords = {Adolescent, Adult, Anti-Bacterial Agents* / therapeutic use, Antimicrobial Stewardship* / statistics \& numerical data, Brecht Ingelbeen, Burkina Faso, Daniel Valia, doi:10.1093/jac/dkae252, Drug Utilization / statistics \& numerical data, Female, Halidou Tinto, Health Personnel* / statistics \& numerical data, Humans, Male, MEDLINE, Middle Aged, National Center for Biotechnology Information, National Institutes of Health, National Library of Medicine, NCBI, NIH, NLM, PMC11441991, pmid:39051704, PubMed Abstract, Rural Population* / statistics \& numerical data, Surveys and Questionnaires, Young Adult},

pubstate = {published},

tppubtype = {article}

}

@article{Kiemde2024,

title = {Impact of a package of point-of-care diagnostic tests, a clinical diagnostic algorithm and adherence training on antibiotic prescriptions for the management of non-severe acute febrile illness in primary health facilities during the COVID-19 pandemic in Burkina Faso},

author = {Francois Kiemde and Juvenal Nkeramahame and Ana Belen Ibarz and Sabine Dittrich and Piero Olliaro and Daniel Valia and Toussaint Rouamba and Berenger Kabore and Alima Nadine Kone and Seydou Sawadogo and Antonia Windkouni Bere and Diane Yirgnur Some and Athanase Mwinessobaonfou Some and Adelaide Compaore and Philip Horgan and Stephan Weber and Thomas Keller and Halidou Tinto},

url = {https://pubmed.ncbi.nlm.nih.gov/39192209/},

doi = {10.1186/S12879-024-09787-Y},

issn = {1471-2334},

year  = {2024},

date = {2024-01-01},

journal = {BMC infectious diseases},

volume = {24},

issue = {1},

publisher = {BMC Infect Dis},

abstract = {Objective: To assess the impact of an intervention package on the prescription of antibiotic and subsequently the rate of clinical recovery for non-severe acute febrile illnesses at primary health centers. Methods: Patients over 6 months of age presenting to primary health care centres with fever or history of fever within the past 7 days were randomized to receive either the intervention package constituted of point-of-care tests including COVID-19 antigen tests, a diagnostic algorithm and training and communication packages, or the standard practice. The primary outcomes were antibiotic prescriptions at Day 0 (D0) and the clinical recovery at Day 7 (D7). Secondary outcomes were non-adherence of participants and parents/caregivers to prescriptions, health workers’ non-adherence to the algorithm, and the safety of the intervention. Results: A total of 1098 patients were enrolled. 551 (50.2%) were randomized to receive the intervention versus 547 (49.8%) received standard care. 1054 (96.0%) completed follow-up and all of them recovered at D7 in both arms. The proportion of patients with antibiotic prescriptions at D0 were 33.2% (183/551) in the intervention arm versus 58.1% (318/547) under standard care, risk difference (RD) -24.9 (95% CI -30.6 to -19.2, p \< 0.001), corresponding to one more antibiotic saved every four (95% CI: 3 to 5) consultations. This reduction was also statistically significant in children from 6 to 59 months (RD -34.5; 95% CI -41.7 to -27.3; p \< 0.001), patients over 18 years (RD -35.9; 95%CI -58.5 to -13.4; p = 0.002), patients with negative malaria test (RD -46.9; 95% CI -53.9 to -39.8; p \< 0.001), those with a respiratory diagnosis (RD -48.9; 95% CI -56.9 to -41.0, p \< 0.001) and those not vaccinated against COVID-19 (-24.8% 95%CI -30.7 to -18.9, p-value: \<0.001). A significant reduction in non-adherence to prescription by patients was reported (RD -7.1; 95% CI -10.9 to -3.3; p \< 0.001). Conclusion: The intervention was associated with significant reductions of antibiotic prescriptions and non-adherence, chiefly among patients with non-malaria fever, those with respiratory symptoms and children below 5 years of age. The addition of COVID-19 testing did not have a major impact on antibiotic use at primary health centers. Trial registration: Clinitrial.gov; NCT04081051 registered on 06/09/2019.},

keywords = {Adolescent, Adult, Algorithms*, Anti-Bacterial Agents* / therapeutic use, Burkina Faso, Child, COVID-19* / diagnosis, doi:10.1186/s12879-024-09787-y, Female, Fever* / drug therapy, Francois Kiemde, Halidou Tinto, Humans, Infant, Juvenal Nkeramahame, Male, MEDLINE, National Center for Biotechnology Information, National Institutes of Health, National Library of Medicine, NCBI, NIH, NLM, PMC11351252, pmid:39192209, Point-of-Care Systems, Point-of-Care Testing, Preschool, Primary Health Care*, PubMed Abstract, Randomized controlled trial, SARS-Cov-2},

pubstate = {published},

tppubtype = {article}

}

@article{Lompo2024,

title = {Knowledge, awareness, and risk practices related to bacterial contamination of antiseptics, disinfectants, and hand hygiene products among healthcare workers in sub-saharan Africa: a cross-sectional survey in three tertiary care hospitals (Benin, Burkina Faso, and DR Congo)},

author = {Palpouguini Lompo and Anne Sophie Heroes and Kadija Ou\'{e}draogo and Patient Okitale and Abel Wakpo and Jocelyne Kalema and Octavie Lunguya and Halidou Tinto and Dissou Affolabi and Lassana Sangar\'{e} and Jan Jacobs},

url = {https://pubmed.ncbi.nlm.nih.gov/38627805/},

doi = {10.1186/S13756-024-01396-3},

issn = {2047-2994},

year  = {2024},

date = {2024-01-01},

journal = {Antimicrobial resistance and infection control},

volume = {13},

issue = {1},

publisher = {Antimicrob Resist Infect Control},

abstract = {Background: Antiseptics, disinfectants, and hand hygiene products can be contaminated with bacteria and cause healthcare-associated infections, which are underreported from low- and middle-income countries. To better understand the user-related risk factors, we conducted a knowledge, awareness, and practice survey among hospital staff in sub-Saharan Africa. Methods: Self-administered questionnaire distributed among healthcare workers in three tertiary care hospitals (Burkina Faso, Benin, Democratic Republic of the Congo). Results: 617 healthcare workers (85.3% (para)medical and 14.7% auxiliary staff) participated. Less than half (45.5%) had been trained in Infection Prevention \& Control (IPC), and only 15.7% were trained \< 1 year ago. Near two-thirds (64.2%) preferred liquid soap for hand hygiene, versus 33.1% for alcohol-based hand rub (ABHR). Most (58.3%) expressed confidence in the locally available products. Knowledge of product categories, storage conditions and shelf-life was inadequate: eosin was considered as an antiseptic (47.5% of (para)medical staff), the shelf life and storage conditions (non-transparent container) of freshly prepared chlorine 0.5% were known by only 42.6% and 34.8% of participants, respectively. Approximately one-third of participants approved using tap water for preparation of chlorine 0.5% and liquid soap. Most participants (\> 80%) disapproved recycling soft-drink bottles as liquid soap containers. Nearly two-thirds (65.0%) declared that bacteria may be resistant to and survive in ABHR, versus 51.0% and 37.4% for povidone iodine and chlorine 0.5%, respectively. Depicted risk practices (n = 4) were ignored by 30 to 40% of participants: they included touching the rim or content of stock containers with compresses or small containers, storing of cotton balls soaked in an antiseptic, and hand-touching the spout of pump dispenser. Filling containers by topping-up was considered good practice by 18.3% of participants. Half (52.1%) of participants acknowledged indefinite reuse of containers. Besides small differences, the findings were similar across the study sites and professional groups. Among IPC-trained staff, proportions recognizing all 4 risk practices were higher compared to non-trained staff (35.9% versus 23.8%, p \< 0.0001). Conclusions: The present findings can guide tailored training and IPC implementation at the healthcare facility and national levels, and sensitize stakeholders’ and funders’ interest.},

keywords = {Anne-Sophie Heroes, Anti-Infective Agents, bacteria, Benin, Burkina Faso, Chlorine, Cross-Sectional Studies, Democratic Republic of the Congo, Disinfectants*, doi:10.1186/s13756-024-01396-3, Ethanol, Hand Hygiene*, Hospital, Humans, Jan Jacobs, Local*, MEDLINE, National Center for Biotechnology Information, National Institutes of Health, National Library of Medicine, NCBI, NIH, NLM, Palpouguini Lompo, Personnel, PMC11020199, pmid:38627805, PubMed Abstract, Soaps, Tertiary Care Centers},

pubstate = {published},

tppubtype = {article}

}

@article{Datoo2024,

title = {Safety and efficacy of malaria vaccine candidate R21/Matrix-M in African children: a multicentre, double-blind, randomised, phase 3 trial},

author = {Mehreen S. Datoo and Alassane Dicko and Halidou Tinto and Jean Bosco Ou\'{e}draogo and Mainga Hamaluba and Ally Olotu and Emma Beaumont and Fernando Ramos Lopez and Hamtandi Magloire Natama and Sophie Weston and Mwajuma Chemba and Yves Daniel Compaore and Djibrilla Issiaka and Diallo Salou and Athanase M. Some and Sharon Omenda and Alison Lawrie and Philip Bejon and Harish Rao and Daniel Chandramohan and Rachel Roberts and Sandesh Bharati and Lisa Stockdale and Sunil Gairola and Brian M. Greenwood and Katie J. Ewer and John Bradley and Prasad S. Kulkarni and Umesh Shaligram and Adrian V. S. Hill and Almahamoudou Mahamar and Koualy Sanogo and Youssoufa Sidibe and Kalifa Diarra and Mamoudou Samassekou and Oumar Attaher and Amadou Tapily and Makonon Diallo and Oumar Mohamed Dicko and Mahamadou Kaya and Seydina Oumar Maguiraga and Yaya Sankare and Hama Yalcouye and Soumaila Diarra and Sidi Mohamed Niambele and Ismaila Thera and Issaka Sagara and Mala Sylla and Amagana Dolo and Nsajigwa Misidai and Sylvester Simando and Hania Msami and Omary Juma and Nicolaus Gutapaka and Rose Paul and Sarah Mswata and Ibrahim Sasamalo and Kasmir Johaness and Mwantumu Sultan and Annastazia Alexander and Isaac Kimaro and Kauye Lwanga and Mwajuma Mtungwe and Kassim Khamis and Lighton Rugarabam and Wilmina Kalinga and Mohammed Mohammed and Janeth Kamange and Jubilate Msangi and Batuli Mwaijande and Ivanny Mtaka and Matilda Mhapa and Tarsis Mlaganile and Thabit Mbaga and Rakiswende Serge Yerbanga and Wendkouni Samtouma and Abdoul Aziz Sienou and Zachari Kabre and Wendinpui Jedida Muriel Ouedraogo and G. Armel Bienvenu Yarbanga and Issaka Zongo and Hamade Savadogo and Joseph Sanon and Judicael Compaore and Idrissa Kere and Ferdinand Lionel Yoni and Tewende Martine Sanre and Seydou Bienvenu Ouattara and Samuel Provstgaard-Morys and Danielle Woods and Robert W. Snow and Nyaguara Amek and Caroline J. Ngetsa and Lynette Isabella Ochola-Oyier and Jennifer Musyoki and Marianne Munene and Noni Mumba and Uche Jane Adetifa and Charles Mwangi Muiruri and Jimmy Shangala Mwawaka and Mwatasa Hussein Mwaganyuma and Martha Njeri Ndichu and Joseph Ochieng Weya and Kelvin Njogu and Jane Grant and Jayne Webster and Anand Lakhkar and N. F\'{e}lix Andr\'{e} Ido and Ousmane Traore and Marc Christian Tahita and Massa Achille Bonko and Toussaint Rouamba and D. Florence Ouedraogo and Rachidatou Soma and Aida Millogo and Edouard Ouedraogo and Faizatou Sorgho and Fab\'{e} Konate and Innocent Valea},

url = {https://pubmed.ncbi.nlm.nih.gov/38310910/},

doi = {10.1016/S0140-6736(23)02511-4},

issn = {1474-547X},

year  = {2024},

date = {2024-01-01},

journal = {Lancet (London, England)},

volume = {403},

issue = {10426},

pages = {533-544},

publisher = {Lancet},

abstract = {Background: Recently, we found that a new malaria vaccine, R21/Matrix-M, had over 75% efficacy against clinical malaria with seasonal administration in a phase 2b trial in Burkina Faso. Here, we report on safety and efficacy of the vaccine in a phase 3 trial enrolling over 4800 children across four countries followed for up to 18 months at seasonal sites and 12 months at standard sites. Methods: We did a double-blind, randomised, phase 3 trial of the R21/Matrix-M malaria vaccine across five sites in four African countries with differing malaria transmission intensities and seasonality. Children (aged 5\textendash36 months) were enrolled and randomly assigned (2:1) to receive 5 μg R21 plus 50 μg Matrix-M or a control vaccine (licensed rabies vaccine [Abhayrab]). Participants, their families, investigators, laboratory teams, and the local study team were masked to treatment. Vaccines were administered as three doses, 4 weeks apart, with a booster administered 12 months after the third dose. Half of the children were recruited at two sites with seasonal malaria transmission and the remainder at standard sites with perennial malaria transmission using age-based immunisation. The primary objective was protective efficacy of R21/Matrix-M from 14 days after third vaccination to 12 months after completion of the primary series at seasonal and standard sites separately as co-primary endpoints. Vaccine efficacy against multiple malaria episodes and severe malaria, as well as safety and immunogenicity, were also assessed. This trial is registered on ClinicalTrials.gov, NCT04704830, and is ongoing. Findings: From April 26, 2021, to Jan 12, 2022, 5477 children consented to be screened, of whom 1705 were randomly assigned to control vaccine and 3434 to R21/Matrix-M; 4878 participants received the first dose of vaccine. 3103 participants in the R21/Matrix-M group and 1541 participants in the control group were included in the modified per-protocol analysis (2412 [51·9%] male and 2232 [48·1%] female). R21/Matrix-M vaccine was well tolerated, with injection site pain (301 [18·6%] of 1615 participants) and fever (754 [46·7%] of 1615 participants) as the most frequent adverse events. Number of adverse events of special interest and serious adverse events did not significantly differ between the vaccine groups. There were no treatment-related deaths. 12-month vaccine efficacy was 75% (95% CI 71\textendash79; p\<0·0001) at the seasonal sites and 68% (61\textendash74; p\<0·0001) at the standard sites for time to first clinical malaria episode. Similarly, vaccine efficacy against multiple clinical malaria episodes was 75% (71\textendash78; p\<0·0001) at the seasonal sites and 67% (59\textendash73; p\<0·0001) at standard sites. A modest reduction in vaccine efficacy was observed over the first 12 months of follow-up, of similar size at seasonal and standard sites. A rate reduction of 868 (95% CI 762\textendash974) cases per 1000 children-years at seasonal sites and 296 (231\textendash362) at standard sites occurred over 12 months. Vaccine-induced antibodies against the conserved central Asn-Ala-Asn-Pro (NANP) repeat sequence of circumsporozoite protein correlated with vaccine efficacy. Higher NANP-specific antibody titres were observed in the 5\textendash17 month age group compared with 18\textendash36 month age group, and the younger age group had the highest 12-month vaccine efficacy on time to first clinical malaria episode at seasonal (79% [95% CI 73\textendash84]; p\<0·001) and standard (75% [65\textendash83]; p\<0·001) sites. Interpretation: R21/Matrix-M was well tolerated and offered high efficacy against clinical malaria in African children. This low-cost, high-efficacy vaccine is already licensed by several African countries, and recently received a WHO policy recommendation and prequalification, offering large-scale supply to help reduce the great burden of malaria in sub-Saharan Africa. Funding: The Serum Institute of India, the Wellcome Trust, the UK National Institute for Health Research Oxford Biomedical Research Centre, and Open Philanthropy.},

keywords = {{Alassane Dicko, Antibodies, Burkina Faso, Child, Clinical Trial, Double-Blind Method, Female, Humans, Immunization, Infant, Malaria Vaccines* / adverse effects, Malaria* / drug therapy, Male, MEDLINE, Mehreen S Datoo, Multicenter Study, Nanoparticles*, National Center for Biotechnology Information, National Institutes of Health, National Library of Medicine, NCBI, NIH, NLM, Non-U.S. Gov't, Phase III, Preschool, PubMed Abstract, Randomized controlled trial, Research Support, Saponins*},

pubstate = {published},

tppubtype = {article}

}

@article{Koita2024,

title = {Increasing the uptake of Intermittent Preventive Treatment of malaria in pregnancy using Sulfadoxine-Pyrimethamine (IPTp-SP) through seasonal malaria chemoprevention channel delivery: protocol of a multicenter cluster randomized implementation trial in Mali and Burkina Faso},

author = {Kadiatou Koita and Joel D. Bognini and Efundem Agboraw and Mahamadou Demb\'{e}l\'{e} and Seydou Yabr\'{e} and Bi\'{e}bo Bihoun and Oumou Coulibaly and Hamidou Niangaly and Jean Batiste N’Takp\'{e} and Maia Lesosky and Dario Scaramuzzi and Eve Worrall and Jenny Hill and Val\'{e}rie Briand and Halidou Tinto and Kassoum Kayentao},

url = {https://pubmed.ncbi.nlm.nih.gov/38166711/},

doi = {10.1186/S12889-023-17529-Z},

issn = {1471-2458},

year  = {2024},

date = {2024-01-01},

journal = {BMC public health},

volume = {24},

issue = {1},

publisher = {BMC Public Health},

abstract = {Background: The uptake of Intermittent Preventive Treatment of malaria in pregnancy using Sulfadoxine-Pyrimethamine (IPTp-SP) remains unacceptably low, with more than two-thirds of pregnant women in sub-Saharan Africa still not accessing the three or more doses recommended by the World Health Organisation (WHO). In contrast, the coverage of Seasonal Malaria Chemoprevention (SMC), a more recent strategy recommended by the WHO for malaria prevention in children under five years living in Sahelian countries with seasonal transmission, including Mali and Burkina-Faso, is high (up to 90%). We hypothesized that IPTp-SP delivery to pregnant women through SMC alongside antenatal care (ANC) will increase IPTp-SP coverage, boost ANC attendance, and increase public health impact. This protocol describes the approach to assess acceptability, feasibility, effectiveness, and cost-effectiveness of the integrated strategy. Methods and analysis: This is a multicentre, cluster-randomized, implementation trial of IPTp-SP delivery through ANC + SMC vs ANC alone in 40 health facilities and their catchment populations (20 clusters per arm). The intervention will consist of monthly administration of IPTp-SP through four monthly rounds of SMC during the malaria transmission season (July to October), for two consecutive years. Effectiveness of the strategy to increase coverage of three or more doses of IPTp-SP (IPTp3 +) will be assessed using household surveys and ANC exit interviews. Statistical analysis of IPT3 + and four or more ANC uptake will use a generalized linear mixed model. Feasibility and acceptability will be assessed through in-depth interviews and focus group discussions with health workers, pregnant women, and women with a child \< 12 months. Discussion: This multicentre cluster randomized implementation trial powered to detect a 45% and 22% increase in IPTp-SP3 + uptake in Mali and Burkina-Faso, respectively, will generate evidence on the feasibility, acceptability, effectiveness, and cost-effectiveness of IPTp-SP delivered through the ANC + SMC channel. The intervention is designed to facilitate scalability and translation into policy by leveraging existing resources, while strengthening local capacities in research, health, and community institutions. Findings will inform the local national malaria control policies. Trial registration: Retrospectively registered on August 11th, 2022; registration # PACTR202208844472053. Protocol v4.0 dated September 04, 2023. Trail sponsor: University of Sciences Techniques and Technologies of Bamako (USTTB), Mali.},

keywords = {Antimalarials* / therapeutic use, Burkina Faso, Chemoprevention, Child, Clinical Trial Protocol, doi:10.1186/s12889-023-17529-z, Drug Combinations, Female, Humans, Joel D Bognini, Kadiatou Koita, Kassoum Kayentao, Malaria* / drug therapy, Malaria* / prevention \& control, Mali, MEDLINE, Multicenter Studies as Topic, National Center for Biotechnology Information, National Institutes of Health, National Library of Medicine, NCBI, NIH, NLM, Non-U.S. Gov't, Parasitic* / prevention \& control, PMC10763117, pmid:38166711, Pregnancy, Pregnancy Complications, Preschool, PubMed Abstract, Pyrimethamine / therapeutic use, Randomized Controlled Trials as Topic, Research Support, Seasons, Sulfadoxine / therapeutic use},

pubstate = {published},

tppubtype = {article}

}

@article{Garba2023,

title = {Wastewater from healthcare centers in Burkina Faso is a source of ESBL, AmpC-β-lactamase and carbapenemase-producing Escherichia coli and Klebsiella pneumoniae},

author = {Zakaria Garba and Isidore O. J. Bonkoungou and Nad\`{e}ge O. Millogo and H. Magloire Natama and Pingdwend\'{e} A. P. Vokouma and Massa A. Bonko and Ibrahima Karama and Lagm\^{e}yesgo A. W. Tiendrebeogo and Kaisa Haukka and Halidou Tinto and Lassana Sangar\'{e} and Nicolas Barro},

url = {https://pubmed.ncbi.nlm.nih.gov/37978428/},

doi = {10.1186/S12866-023-03108-0},

issn = {1471-2180},

year  = {2023},

date = {2023-01-01},

journal = {BMC microbiology},

volume = {23},

issue = {1},

publisher = {BMC Microbiol},

abstract = {Background: Extended-spectrum β-lactamase (ESBL), plasmid-mediated AmpC-β-lactamase and carbapenemase-producing Escherichia coli and Klebsiella pneumoniae have spread into the environment worldwide posing a potential public health threat. However, the prevalence data for low- and middle-income countries are still scarce. The aim of this study was to evaluate the presence of ESBL, AmpC-β-lactamase and carbapenemase-producing and multidrug-resistant E. coli and K. pneumoniae in wastewaters from healthcare centers in Burkina Faso. Results: Eighty-four (84) wastewater samples were collected from five healthcare centers and plated on selective ESBL ChromAgar. E. coli and Klebsiella pneumoniae isolates were identified using API20E. ESBL-producing bacteria were detected in 97.6% of the samples and their average concentration per hospital ranged from 1.10 × 105 to 5.23 × 106 CFU/mL. Out of 170 putative ESBL-producing isolates (64% of them were E. coli) and 51 putative AmpC-β-lactamase-producing isolates, 95% and 45% were confirmed, respectively. Carbapenemase production was detected in 10 isolates, of which 6 were NDM producers, 3 were OXA-48 producers and 1 was NDM and OXA-48 producer. All isolates were multidrug resistant and, moreover, all of them were resistant to all tested β-lactams. Resistance to ESBL inhibitors was also common, up to 66% in E. coli and 62% in K. pneumoniae. Amikacin, fosfomycin and nitrofurantoin were the antibiotics to which the least resistance was detected. Conclusions: This study showed that wastewater from healthcare centers constitutes a reservoir of multidrug-resistant bacteria in Burkina Faso, including carbapenemase producers. Untreated healthcare wastewater entering the environment exposes people and animals to infections caused by these multi-resistant bacteria, which are difficult to treat, especially in the resource-poor settings.},

keywords = {Animals, Anti-Bacterial Agents / pharmacology, bacteria, Bacterial Proteins, beta-Lactamases, Burkina Faso, Carbapenem-Resistant Enterobacteriaceae*, doi:10.1186/s12866-023-03108-0, Escherichia coli, Escherichia coli Infections* / microbiology, Humans, Isidore O J Bonkoungou, Klebsiella pneumoniae, MEDLINE, Microbial Sensitivity Tests, National Center for Biotechnology Information, National Institutes of Health, National Library of Medicine, NCBI, Nicolas Barro, NIH, NLM, Non-U.S. Gov't, PMC10655474, pmid:37978428, PubMed Abstract, Research Support, Wastewater, Zakaria Garba},

pubstate = {published},

tppubtype = {article}

}

@article{Olliaro2023,

title = {Synthesis and Meta-analysis of 3 Randomized Trials Conducted in Burkina Faso, Ghana, and Uganda Comparing the Effects of Point-of-Care Tests and Diagnostic Algorithms Versus Routine Care on Antibiotic Prescriptions and Clinical Outcomes in Ambulatory Patients \<18 Years of Age With Acute Febrile Illness},

author = {Piero Olliaro and Juvenal Nkeramahame and Philip Horgan and Halidou Tinto and Fran\c{c}ois Kiemde and Rita Baiden and Alexander Adjei and James Kapisi and Heidi Hopkins and Olawale Salami and Catrin E. Moore and Sabine Dittrich and Stephan Weber and Stefano Ongarello},

url = {https://pubmed.ncbi.nlm.nih.gov/37490743/},

doi = {10.1093/CID/CIAD324},

issn = {1537-6591},

year  = {2023},

date = {2023-01-01},

journal = {Clinical infectious diseases : an official publication of the Infectious Diseases Society of America},

volume = {77},

issue = {Suppl 2},

pages = {S199-S205},

publisher = {Clin Infect Dis},

keywords = {{Algorithms, Anti-Bacterial Agents* / therapeutic use, Author(firstnames='Ad\'{e}la\"{i}de', Author(firstnames='Alexander', Author(firstnames='Asadu', Author(firstnames='Daniel', Author(firstnames='David', Author(firstnames='Deborah', Author(firstnames='Elizeus', Author(firstnames='Fran\c{c}ois', Author(firstnames='Freddy Eric', Author(firstnames='Halidou', Author(firstnames='Heidi', Author(firstnames='James', Author(firstnames='Rita', Author(firstnames='Vida', Burkina Faso, CollabAuthor(name='ADIP study group', Diagnostic Tests, Ghana, Humans, Juvenal Nkeramahame, MEDLINE, Meta-Analysis, National Center for Biotechnology Information, National Institutes of Health, National Library of Medicine, NCBI, NIH, NLM, Non-U.S. Gov't, Piero Olliaro, PMC10368413, Point-of-Care Testing*, Prescriptions, PubMed Abstract, Randomized Controlled Trials as Topic, Research Support},

pubstate = {published},

tppubtype = {article}

}

@article{Kiemde2023,

title = {A Randomized Trial to Assess the Impact of a Package of Diagnostic Tools and Diagnostic Algorithm on Antibiotic Prescriptions for the Management of Febrile Illnesses Among Children and Adolescents in Primary Health Facilities in Burkina Faso},

author = {Francois Kiemde and Daniel Valia and Berenger Kabore and Toussaint Rouamba and Alima Nadine Kone and Seydou Sawadogo and Adelaide Compaore and Olawale Salami and Philip Horgan and Catrin E. Moore and Sabine Dittrich and Juvenal Nkeramahame and Piero Olliaro and Halidou Tinto},

url = {https://pubmed.ncbi.nlm.nih.gov/37490742/},

doi = {10.1093/CID/CIAD331},

issn = {1537-6591},

year  = {2023},

date = {2023-01-01},

journal = {Clinical infectious diseases : an official publication of the Infectious Diseases Society of America},

volume = {77},

issue = {Suppl 2},

pages = {S134-S144},

publisher = {Clin Infect Dis},

abstract = {Background: Low- and middle-income countries face significant challenges in differentiating bacterial from viral causes of febrile illnesses, leading to inappropriate use of antibiotics. This trial aimed to evaluate the impact of an intervention package comprising diagnostic tests, a diagnostic algorithm, and a training-and-communication package on antibiotic prescriptions and clinical outcomes. Methods: Patients aged 6 months to 18 years with fever or history of fever within the past 7 days with no focus, or a suspected respiratory tract infection, arriving at 2 health facilities were randomized to either the intervention package or standard practice. The primary outcomes were the proportions of patients who recovered at day 7 (D7) and patients prescribed antibiotics at day 0. Results: Of 1718 patients randomized, 1681 (97.8%; intervention: 844; control: 837) completed follow-up: 99.5% recovered at D7 in the intervention arm versus 100% in standard practice (P =. 135). Antibiotics were prescribed to 40.6% of patients in the intervention group versus 57.5% in the control arm (risk ratio: 29.3%; 95% CI: 21.8-36.0%; risk difference [RD]: -16.8%; 95% CI: -21.7% to -12.0%; P \<. 001), which translates to 1 additional antibiotic prescription saved every 6 (95% CI: 5-8) consultations. This reduction was significant regardless of test results for malaria, but was greater in patients without malaria (RD: -46.0%; -54.7% to -37.4%; P \<. 001), those with a respiratory diagnosis (RD: -38.2%; -43.8% to -32.6%; P \<. 001), and in children 6-59 months old (RD: -20.4%; -26.0% to -14.9%; P \<. 001). Except for the period July-September, the reduction was consistent across the other quarters (P \<. 001). Conclusions: The implementation of the package can reduce inappropriate antibiotic prescription without compromising clinical outcomes. Clinical Trials Registration: clinicaltrials.gov; NCT04081051.},

keywords = {Adolescent, Algorithms, Anti-Bacterial Agents* / therapeutic use, Burkina Faso, Child, Daniel Valia, doi:10.1093/cid/ciad331, Francois Kiemde, Halidou Tinto, Health Facilities, Humans, Infant, Malaria* / drug therapy, MEDLINE, National Center for Biotechnology Information, National Institutes of Health, National Library of Medicine, NCBI, NIH, NLM, Non-U.S. Gov't, PMC10368409, pmid:37490742, Preschool, Prescriptions, PubMed Abstract, Randomized controlled trial, Research Support},

pubstate = {published},

tppubtype = {article}

}

@article{nokey,

title = {Incidence rate and predictors of COVID-19 in the two largest cities of Burkina Faso - prospective cohort study in 2021 (ANRS-COV13)},

author = {Nongodo Firmin Kabor\'{e} and Samiratou Ou\'{e}draogo and Ariane Kamga Mamguem and Isidore Tiandiogo Traor\'{e} and Dramane Kania and Hermann Badolo and Guillaume Sanou and Amariane Kon\'{e} and Mimbour\'{e} Yara and Th\'{e}r\`{e}se Kagon\'{e} and Esperance Ou\'{e}draogo and Blahima Konat\'{e} and Rachel M\'{e}dah and Nathalie Rekeneire and Armel Poda and Arnaud Eric Diend\'{e}r\'{e} and Boukary Ou\'{e}draogo and Oumar Billa and Gilles Paradis and Tienhan Sandrine Dabakuyo-Yonli and Halidou Tinto},

url = {https://pubmed.ncbi.nlm.nih.gov/37308819/},

doi = {10.1186/S12879-023-08361-2},

issn = {1471-2334},

year  = {2023},

date = {2023-01-01},

journal = {BMC infectious diseases},

volume = {23},

issue = {1},

publisher = {BMC Infect Dis},

abstract = {Background: Early data on COVID-19 (based primarily on PCR testing) indicated a low burden in Sub-Saharan Africa. To better understand this, this study aimed to estimate the incidence rate and identify predictors of SARS-CoV-2 seroconversion in the two largest cities of Burkina Faso. This study is part of the EmulCOVID-19 project (ANRS-COV13). Methods: Our study utilized the WHO Unity protocol for cohort sero-epidemiological studies of COVID-19 in general population. We conducted random sampling stratified by age group and sex. Individuals aged 10 years and older in the cities of Ouagadougou and Bobo-Dioulasso, Burkina Faso were included and surveyed at 4 time points, each 21 days apart, from March 3 to May 15, 2021. WANTAI SARS-CoV-2 Ab ELISA serological tests were used to detect total antibodies (IgM, IgG) in serum. Predictors were investigated using Cox proportional hazards regression. Results: We analyzed the data from 1399 participants (1051 in Ouagadougou, 348 in Bobo-Dioulasso) who were SARS-CoV-2 seronegative at baseline and had at least one follow-up visit. The incidence rate of SARS-CoV-2 seroconversion was 14.3 cases [95%CI 13.3\textendash15.4] per 100 person-weeks. The incidence rate was almost three times higher in Ouagadougou than in Bobo-Dioulasso (Incidence rate ratio: IRR = 2.7 [2.2\textendash3.2], p \< 0.001). The highest incidence rate was reported among women aged 19\textendash59 years in Ouagadougou (22.8 cases [19.6\textendash26.4] per 100 person-weeks) and the lowest among participants aged 60 years and over in Bobo-Dioulasso, 6.3 cases [4.6\textendash8.6] per 100 person-weeks. Multivariable analysis showed that participants aged 19 years and older were almost twice as likely to seroconvert during the study period compared with those aged 10 to 18 years (Hazard ratio: HR = 1.7 [1.3\textendash2.3], p \< 0.001). Those aged 10\textendash18 years exhibited more asymptomatic forms than those aged 19 years and older, among those who achieved seroconversion (72.9% vs. 40.4%, p \< 0.001). Conclusion: The spread of COVID-19 is more rapid in adults and in large cities. Strategies to control this pandemic in Burkina Faso, must take this into account. Adults living in large cities should be the priority targets for vaccination efforts against COVID-19.},

keywords = {Adult, Aged, Burkina Faso, Cities, COVID-19*, doi:10.1186/s12879-023-08361-2, Female, Halidou Tinto, Humans, Incidence, MEDLINE, Middle Aged, National Center for Biotechnology Information, National Institutes of Health, National Library of Medicine, NCBI, NIH, NLM, Nongodo Firmin Kabor\'{e}, PMC10258776, pmid:37308819, Prospective Studies, PubMed Abstract, Samiratou Ou\'{e}draogo, SARS-Cov-2},

pubstate = {published},

tppubtype = {article}

}

@article{Valia2023,

title = {Healthcare seeking outside healthcare facilities and antibiotic dispensing patterns in rural Burkina Faso: A mixed methods study},

author = {Daniel Valia and Juste St\'{e}phane Kouanda and Brecht Ingelbeen and Karim Derra and B\'{e}renger Kabor\'{e} and Fran\c{c}ois Kiemd\'{e} and Toussaint Rouamba and Eli Rouamba and Franck Sovi Hien and Linda Campbell and Marie Meudec and Annie Robert and Halidou Tinto and Marianne A. B. Sande and Hector Rodriguez Villalobos},

url = {https://pubmed.ncbi.nlm.nih.gov/36871194/},

doi = {10.1111/TMI.13868},

issn = {1365-3156},

year  = {2023},

date = {2023-01-01},

journal = {Tropical medicine \& international health : TM \& IH},

volume = {28},

issue = {5},

pages = {391-400},

publisher = {Trop Med Int Health},

abstract = {Objective: Optimising antibiotic use is important to limit increasing antibiotic resistance. In rural Burkina Faso, over-the-counter dispensing of antibiotics in community pharmacies and non-licensed medicine retail outlets facilitates self-medication. We investigated its extent, reasons and dispensing patterns. Methods: In an exploratory mixed-method design conducted between October 2020 and December 2021, this study first explored illness perceptions, the range of healthcare providers in communities, antibiotics knowledge and reasons for seeking healthcare outside healthcare facilities. Second, frequencies of illness and healthcare utilisation in the last 3 months were quantitatively measured. Results: Participants distinguished between natural and magico-religious illnesses, according to origins. For illnesses considered to be ‘natural’, healthcare was mainly sought at healthcare facilities, private pharmacies and informal drug outlets. For illnesses considered as magico-religious, traditional healers were mainly visited. Antibiotics were perceived in the community as medicines similar to painkillers. Healthcare-seeking outside healthcare facilities was reported by 660/1973 (33.5%) participants reporting symptoms, including 315 (47.7%) to informal vendors. Healthcare seeking outside facilities was less common for 0\textendash4-year-olds (58/534, 10.9% vs. 379/850, 44.1% for ≥5-year-olds) and decreased with improving socio-economic status (108/237, 45.6% in the lowest quintile; 96/418, 23.0% in the highest). Reported reasons included financial limitation, and also proximity to informal drug vendors, long waiting times at healthcare facilities, and health professionals' non-empathetic attitudes towards their patients. Conclusion: This study highlights the need to facilitate and promote access to healthcare facilities through universal health insurance and patient-centred care including reducing patients' waiting time. Furthermore, community-level antibiotic stewardship programmes should include community pharmacies and informal vendors.},

keywords = {Anti-Bacterial Agents* / therapeutic use, Attitude of Health Personnel, Burkina Faso, Child, Daniel Valia, doi:10.1111/tmi.13868, Hector Rodriguez Villalobos, Humans, Juste St\'{e}phane Kouanda, MEDLINE, National Center for Biotechnology Information, National Institutes of Health, National Library of Medicine, NCBI, NIH, NLM, Non-U.S. Gov't, Patient Acceptance of Health Care*, pmid:36871194, Preschool, PubMed Abstract, Research Support, Self Medication},

pubstate = {published},

tppubtype = {article}

}

@article{nokey,

title = {Changing Dietary Habits: The Impact of Urbanization and Rising Socio-Economic Status in Families from Burkina Faso in Sub-Saharan Africa.},

author = {Silene Casari and Monica Di Paola and Elena Banci and Salou Diallo and Luca Scarallo and Sara Renzo and Agnese Gori and Sonia Renzi and Monica Paci and Quirijn Mast and Tal Pecht and Karim Derra and Berenger Kabor\'{e} and Halidou Tinto and Duccio Cavalieri and Paolo Lionetti},

doi = {10.3390/nu14091782},

issn = {2072-6643},

year  = {2022},

date = {2022-04-01},

urldate = {2022-04-01},

journal = {Nutrients},

volume = {14},

issue = {9},

abstract = {(1) Background: Sub-Saharan Africa is experiencing the fastest urbanization worldwide. People in rural areas still have a traditional and rural lifestyle, whereas the Westernization of diet and lifestyle is already evident in urban areas. This study describes dietary habits of families in Burkina Faso living at different levels of urbanization. (2) Methods: Data on lifestyle, socio-economic conditions, health status and anthropometry were collected from 30 families living in rural villages, a small town and the capital city. A food frequency questionnaire and a 24 h recall diary were used to estimate dietary habits and macronutrients intake. (3) Results: The urban cohort showed a more diversified diet, with a higher intake of animal protein and, especially in children, a higher consumption of simple sugars. Fiber intake was significantly higher in the rural and semi-urbanized cohorts. As expected, overweight and obesity gradually increased with the level of urbanization. In semi-urbanized and urban families, we observed coexistence of under- and over-nutrition, whereas in rural families, a portion of children were wasted and stunted, and adults were underweight. (4) Conclusions: These three cohorts represent a model of the effect on diet of rural-to-urban migration. Rural diet and traditional habits are replaced by a Western-oriented diet when families move to urbanized areas. This dietary transition and increased socio-economic status in newly developing urban areas have a major impact on disease epidemiology, resembling the past evolution in Western countries.},

keywords = {*Economic Status, *Urbanization, Burkina Faso, Burkina Faso/epidemiology, Feeding Behavior, fiber intake, Humans, rural diet, Rural Population, sub-Saharan Africa, Urban Population, urbanization, Western diet},

pubstate = {published},

tppubtype = {article}

}

@article{nokey,

title = {Low birth weight and its associated risk factors in a rural health district of Burkina Faso: a cross sectional study.},

author = {Moussa Lingani and Serge Henri Zango and Innocent Val\'{e}a and Georges Som\'{e} and Ma\"{i}mouna Sanou and S\'{e}kou O. Samadoulougou and Serge Ouoba and Eli Rouamba and Annie Robert and Mich\`{e}le Dramaix and Philippe Donnen and Halidou Tinto},

doi = {10.1186/s12884-022-04554-w},

issn = {1471-2393},

year  = {2022},

date = {2022-03-01},

urldate = {2022-03-01},

journal = {BMC pregnancy and childbirth},

volume = {22},

issue = {1},

pages = {228},

abstract = {BACKGROUND: Low birth weight (LBW) is a major factor of neonate mortality that particularly affects developing countries. However, the scarcity of data to support decision making to reduce LBW occurrence is a major obstacle in sub-Saharan Africa. The aim of this research was to determine the prevalence and associated factors of LBW at the Yako health district in a rural area of Burkina Faso. METHODS: A cross sectional survey was conducted at four peripheral health centers among mothers and their newly delivered babies. The mothers' socio-demographic and obstetrical characteristics were collected by face-to-face interview or by review of antenatal care books. Maternal malaria was tested by standard microscopy and neonates' birth weights were documented. Multivariate logistic regression was used to determine factors associated with LBW. A p-value \< 0.05 was considered statistically significant. RESULTS: Of 600 neonates examined, the prevalence of low birth weight was 11.0%. Adjustment for socio-demographic characteristic, medical conditions, obstetrical history, malaria prevention measures by multivariate logistic regression found that being a primigravid mother (aOR = 1.8, [95% CI: 1.1-3.0]), the presence of malaria infection (aOR = 1.9, [95% CI: 1.1-3.5]), the uptake of less than three doses of sulfadoxine-pyrimethamine for the intermittent preventive treatment of malaria in pregnancy (IPTp-SP) (aOR = 2.2, [95% CI: 1.3-3.9]), the presence of maternal fever at the time of delivery (aOR = 2.8, [95% CI: 1.5-5.3]) and being a female neonate (aOR = 1.9, [95% CI: 1.1-3.3]) were independently associated with an increased risk of LBW occurrence. The number of antenatal visits performed by the mother during her pregnancy did not provide any direct protection for low birth weight. CONCLUSION: The prevalence of LBW remained high in the study area. Maternal malaria, fever and low uptake of sulfadoxine-pyrimethamine doses were significantly associated with LBW and should be adequately addressed by public health interventions.},

keywords = {*Antimalarials/therapeutic use, *Rural Health, Associated factors, Burkina Faso, Burkina Faso/epidemiology, Cross-Sectional Studies, Female, Humans, Infant, Low Birth Weight, Newborn, Pregnancy, Risk Factors, Rural area},

pubstate = {published},

tppubtype = {article}

}

@article{nokey,

title = {Age-modified factors associated with placental malaria in rural Burkina Faso.},

author = {Bi\'{e}bo Bihoun and Serge Henri Zango and Maminata Traor\'{e}-Coulibaly and Innocent Valea and Raffaella Ravinetto and Jean Pierre Van Geertruyden and Umberto D'Alessandro and Halidou Tinto and Annie Robert},

doi = {10.1186/s12884-022-04568-4},

issn = {1471-2393},

year  = {2022},

date = {2022-03-01},

urldate = {2022-03-01},

journal = {BMC pregnancy and childbirth},

volume = {22},

issue = {1},

pages = {248},

abstract = {BACKGROUND: Malaria in pregnancy can result in placental infection with fetal implications. This study aimed at assessing placental malaria (PM) prevalence and its associated factors in a cohort of pregnant women with peripheral malaria and their offspring. METHOD: The data were collected in the framework of a clinical trial on treatments for malaria in pregnant women . Placental malaria (PM) was diagnosed by histopathological detection of parasites and/or malaria pigment on placenta biopsies taken at delivery. Factors associated with PM were assessed using logistic regression. RESULTS: Out of 745 biopsies examined, PM was diagnosed in 86.8 % of women. Acute, chronic and past PM were retrieved in 11 (1.5 %), 170 (22.8 %), and 466 (62.6 %) women, respectively. A modifying effect was observed in the association of gravidity or anemia at the study start with pooled PM (presence of parasites and/or malaria pigment). In women under 30, gravidity ≤ 2 was associated with an increased prevalence of pooled PM but in women aged 30 years or more, gravidity was no more associated with pooled PM (OR 6.81, 95 % CI 3.18 - 14.60; and OR 0.52, 95 % CI 0.10 - 2.76, respectively). Anemia was associated with pooled PM in women under 30 (OR 1.96, 95 % CI 1.03 - 3.72) but not in women aged 30 years or more (OR 0.68, 95 % CI 0.31 - 1.49). Similarly, the association of gravidity with past-chronic PM depended also on age. A higher prevalence of active PM was observed in women under 30 presenting with symptomatic malaria (OR 3.79, 95 % CI 1.55 - 9.27), while there was no significant increase in the prevalence of active PM (presence of parasites only) in women with symptomatic malaria when aged 30 years or more (OR 0.42, 95 % CI 0.10 - 1.75). In women with chronic PM, the prevalence of low birth weight or prematurity was the highest (31.2 %) as compared with past PM or no PM. CONCLUSION: Despite the rapid diagnosis and efficacious treatment of peripheral infection, the prevalence of placental malaria remained high in women with P. falciparum peripheral infection in Nanoro, especially in younger women This underlines the importance of preventive measures in this specific group.},

keywords = {*Malaria, *Malaria/epidemiology, Adult, Burkina Faso, Burkina Faso/epidemiology, Falciparum/parasitology, Female, Gravidity, Humans, Malaria, placenta, Placenta/parasitology, Pregnancy, Risk Factors},

pubstate = {published},

tppubtype = {article}

}

@article{nokey,

title = {Monitoring the elimination of \textit{gambiense} human African trypanosomiasis in the historical focus of Bati\'{e}, South\textendashWest Burkina Faso},

author = {Charlie Franck Alfred Compaor\'{e} and Jacques Kabor\'{e} and Hamidou Ilboudo and Lian Francesca Thomas and Laura Cristina Falzon and Mohamed Bamba and Hassane Sakande and Minay\'{e}gninrin Kon\'{e} and Dramane Kaba and Clarisse Bougouma and Ilboudo Adama and Ouedraogo Amathe and Adrien Marie Gaston Belem and Eric Maurice F\`{e}vre and Philippe B\"{u}scher and Veerle Lejon and Vincent Jamonneau},

url = {https://www.parasite-journal.org/10.1051/parasite/2022024},

doi = {10.1051/parasite/2022024},

issn = {1776-1042},

year  = {2022},

date = {2022-01-01},

journal = {Parasite},

volume = {29},

pages = {25},

abstract = {\<p\> The World Health Organisation has targeted the elimination of human African trypanosomiasis (HAT) as zero transmission by 2030. Continued surveillance needs to be in place for early detection of re-emergent cases. In this context, the performance of diagnostic tests and testing algorithms for detection of the re-emergence of \<italic\>Trypanosoma brucei gambiense\</italic\> HAT remains to be assessed. We carried out a door-to-door active medical survey for HAT in the historical focus of Bati\'{e}, South\textendashWest Burkina Faso. Screening was done using three rapid diagnostic tests (RDTs). Two laboratory tests (ELISA/ \<italic\>T. b. gambiense\</italic\> and immune trypanolysis) and parasitological examination were performed on RDT positives only. In total, 5883 participants were screened, among which 842 (14%) tested positive in at least one RDT. Blood from 519 RDT positives was examined microscopically but no trypanosomes were observed. The HAT Sero- \<italic\>K\</italic\> -Set test showed the lowest specificity of 89%, while the specificities of SD Bioline HAT and rHAT Sero-Strip were 92% and 99%, respectively. The specificity of ELISA/ \<italic\>T. b. gambiense\</italic\> and trypanolysis was 99% (98\textendash99%) and 100% (99\textendash100%), respectively. Our results suggest that \<italic\>T. b. gambiense\</italic\> is no longer circulating in the study area and that zero transmission has probably been attained. While a least cost analysis is still required, our study showed that RDT preselection followed by trypanolysis may be a useful strategy for post-elimination surveillance in Burkina Faso. \</p\>},

keywords = {Burkina Faso, Diagnosis, Dried blood spot, Elimination, Human African trypanosomiasis, Rapid diagnostic test, Specificity, Trypanosoma brucei gambiense},

pubstate = {published},

tppubtype = {article}

}

@article{Sondo2022,

title = {Boosting the impact of seasonal malaria chemoprevention (SMC) through simultaneous screening and treatment of household members of children receiving SMC in Burkina Faso: a protocol for a randomized open label trial},

author = {Paul Sondo and Marc Christian Tahita and Hamidou Ilboudo and Toussaint Rouamba and Karim Derra and Gauthier Tougri and Florence Ou\'{e}draogo and B\'{e}atrice Marie Ad\'{e}la\"{i}de Konseibo and Eli Roamba and Sabina Dahlstr\"{o}m Otienoburu and B\'{e}renger Kabor\'{e} and Kalynn Kennon and Kadija Ou\'{e}draogo and Wend-Timbe-Noma Arlette Ra\"{i}ssa Zongo and Fadima Yaya Bocoum and Kasia Stepniewska and Mehul Dhorda and Philippe J. Gu\'{e}rin and Halidou Tinto},

url = {https://archpublichealth.biomedcentral.com/articles/10.1186/s13690-022-00800-x},

doi = {10.1186/s13690-022-00800-x},

issn = {2049-3258},

year  = {2022},

date = {2022-01-01},

urldate = {2022-01-01},

journal = {Archives of Public Health},

volume = {80},

issue = {1},

pages = {41},

abstract = {BACKGROUND Plasmodium falciparum malaria remains a major public health concern in sub-Sahara Africa. Seasonal malaria chemoprevention (SMC) with amodiaquine + sulfadoxine-pyrimethamine is one of the most important preventive interventions. Despite its implementation, the burden of malaria is still very high in children under five years old in Burkina Faso, suggesting that the expected impact of this promising strategy might not be attained. Development of innovative strategies to improve the efficacy of these existing malaria control measures is essential. In such context, we postulate that screening and treatment of malaria in household members of children receiving SMC could greatly improve the impact of SMC intervention and reduce malaria transmission in endemic settings. METHODS This randomized superiority trial will be carried out in the Nanoro health district, Burkina Faso. The unit of randomisation will be the household and all eligible children from a household will be allocated to the same study group. Households with 3-59 months old children will be assigned to either (i) control group (SMC alone) or (ii) intervention (SMC+ screening of household members with standard Histidin Rich Protein Rapid Diagnostic Test (HRP2-RDT) and treatment if positive). The sample size will be 526 isolated households per arm, i.e., around 1052 children under SMC coverage and an expected 1315 household members. Included children will be followed-up for 24 months to fully cover two consecutive malaria transmission seasons and two SMC cycles. Children will be actively followed-up during the malaria transmission seasons while in the dry seasons the follow-up will be passive. CONCLUSION The study will respond to a major public health concern by providing evidence of the efficacy of an innovative strategy to boost the impact of SMC intervention.},

keywords = {Africa, Amodiaquine, Burkina Faso, Chemoprevention, Dihydro artemisinin Piperaquine, Malaria, Plasmodium falciparum, Sulfadoxine-pyrimethamine},

pubstate = {published},

tppubtype = {article}

}

@article{Lingani2022,

title = {Prevalence and risk factors of malaria among first antenatal care attendees in rural Burkina Faso},

author = {Moussa Lingani and Serge H. Zango and Innocent Val\'{e}a and Ma\"{i}mouna Sanou and Serge Ouoba and S\'{e}kou Samadoulougou and Annie Robert and Halidou Tinto and Mich\`{e}le Dramaix and Philippe Donnen},

url = {https://tropmedhealth.biomedcentral.com/articles/10.1186/s41182-022-00442-3},

doi = {10.1186/s41182-022-00442-3},

issn = {1349-4147},

year  = {2022},

date = {2022-01-01},

journal = {Tropical Medicine and Health},

volume = {50},

issue = {1},

pages = {49},

abstract = {BACKGROUND The WHO recommends continuous surveillance of malaria in endemic countries to identify areas and populations most in need for targeted interventions. The aim of this study was to assess the prevalence of malaria and its associated factors among first antenatal care (ANC) attendees in rural Burkina Faso. METHODS A cross-sectional survey was conducted between August 2019 and September 2020 at the Yako health district and included 1067 first ANC attendees. Sociodemographic, gyneco-obstetric, and medical characteristics were collected. Malaria was diagnosed by standard microscopy and hemoglobin level was measured by spectrophotometry. A multivariate logistic regression analysis was used to identify factors associated with malaria infection. RESULTS Overall malaria infection prevalence was 16.1% (167/1039). Among malaria-positive women, the geometric mean parasite density was 1204 [95% confidence interval (CI) 934-1552] parasites/µL and the proportion of very low (1-199 parasites/µL), low (200-999 parasites/µL), medium (1000-9999 parasites/µL) and high (≥ 10,000 parasites/µL) parasite densities were 15.0%, 35.3%, 38.3% and 11.4%, respectively. Age \< 20 years (adjusted odds ratio (aOR): 2.2; 95% CI 1.4-3.5), anemia (hemoglobin \< 11 g/deciliter) (aOR: 3.4; 95% CI 2.2-5.5), the non-use of bed net (aOR: 1.8; 95% CI 1.1-2.8), and the absence of intermittent preventive treatment with sulfadoxine-pyrimethamine (aOR: 5.8; 95% CI 2.1-24.5) were positively associated with malaria infection. CONCLUSIONS The study showed that one out of six pregnant women had a microscopy-detected P. falciparum malaria infection at their first ANC visit. Strengthening malaria prevention strategies during the first ANC visit is needed to prevent unfavorable birth outcomes.},

keywords = {Burkina Faso, First antenatal care visit, Malaria, Pregnancy},

pubstate = {published},

tppubtype = {article}

}

@article{Duval2022,

title = {Household costs associated with seeking malaria treatment during pregnancy: evidence from Burkina Faso and The Gambia},

author = {Laetitia Duval and Elisa Sicuri and Susana Scott and Maminata Traor\'{e} and Bunja Daabo and Halidou Tinto and Koen Peeters Grietens and Umberto d’Alessando and Henk Schallig and Petra Mens and Lesong Conteh},

url = {https://resource-allocation.biomedcentral.com/articles/10.1186/s12962-022-00376-x},

doi = {10.1186/s12962-022-00376-x},

issn = {1478-7547},

year  = {2022},

date = {2022-01-01},

journal = {Cost Effectiveness and Resource Allocation},

volume = {20},

issue = {1},

pages = {42},

abstract = {BACKGROUND Malaria in pregnancy remains a major health threat in sub-Saharan Africa to both expectant mothers and their unborn children. To date, there have been very few studies focused on the out of pocket costs associated with seeking treatment for malaria during pregnancy. METHODS A cross-sectional survey was undertaken in Burkina Faso and The Gambia to estimate the direct and indirect costs associated with outpatient consultations (OP) and inpatient admissions (IP). Direct costs were broken down into medical (admission fees, drug charges, and laboratory fees), and non-medical (transportation and food). Indirect costs reflected time lost due to illness. In total, 220 pregnant women in Burkina Faso and 263 in The Gambia were interviewed about their treatment seeking decisions, expenditure, time use and financial support associated with each malaria episode. RESULTS In Burkina Faso 6.7% sought treatment elsewhere before their OP visits, and 27.1% before their IP visits. This compares to 1.3% for OP and 25.92% for IP in The Gambia. Once at the facility, the average direct costs (out of pocket) were 3.91US$ for an OP visit and 15.38US$ of an IP visit in Burkina Faso, and 0.80US$ for an OP visit and 9.19US$ for an IP visit in The Gambia. Inpatient direct costs were driven by drug costs (9.27US$) and transportation costs (2.72US$) in Burkina Faso and drug costs (3.44 US$) and food costs (3.44 US$) in The Gambia. Indirect costs of IP visits, valued as the opportunity cost of time lost due to the illness, were estimated at 11.85US$ in Burkina Faso and 4.07US$ in The Gambia. The difference across the two countries was mainly due to the longer time of hospitalization in Burkina Faso compared to The Gambia. In The Gambia, the vast majority of pregnant women reported receiving financial support from family members living abroad, most commonly siblings (65%). CONCLUSIONS High malaria treatment costs are incurred by pregnant women in Burkina Faso and The Gambia. Beyond the medical costs of fees and drugs, costs in terms of transport, food and time are significant drivers. The role of remittances, particularly their effect on accessing health care, needs further investigation.},

keywords = {Burkina Faso, Cost, Gambia, Malaria, Pregnancy, Remittances, sub-Saharan Africa},

pubstate = {published},

tppubtype = {article}

}

@article{Post2022,

title = {Escherichia coli from urine samples of pregnant women as an indicator for antimicrobial resistance in the community: a field study from rural Burkina Faso},

author = {Annelies S. Post and I. Guiraud and M. Peeters and P. Lompo and S. Ombelet and I. Karama and S. Yougbar\'{e} and Z. Garba and E. Rouamba and H. Tinto and Jan Jacobs},

url = {https://aricjournal.biomedcentral.com/articles/10.1186/s13756-022-01142-7},

doi = {10.1186/s13756-022-01142-7},

issn = {2047-2994},

year  = {2022},

date = {2022-01-01},

journal = {Antimicrobial Resistance \& Infection Control},

volume = {11},

issue = {1},

pages = {112},

abstract = {BACKGROUND In low- and middle-income countries, surveillance of antimicrobial resistance (AMR) is mostly hospital-based and, in view of poor access to clinical microbiology, biased to more resistant pathogens. We aimed to assess AMR among Escherichia coli isolates obtained from urine cultures of pregnant women as an indicator for community AMR and compared the AMR results with those from E. coli isolates obtained from febrile patients in previously published clinical surveillance studies conducted within the same population in Nanoro, rural Burkina Faso. We furthermore explored feasibility of adding urine culture to standard antenatal care in a rural sub-Saharan African setting. METHODS Between October 2016-September 2018, midstream urine samples collected as part of routine antenatal care in Nanoro district were cultured by a dipslide method and screened for antibiotic residues. Significant growth was defined as a pure culture of Enterobacterales at counts of ≥ 104 colony forming units/ml. RESULTS Significant growth was observed in 202/5934 (3.4%) cultures; E. coli represented 155 (76.7%) of isolates. Among E. coli isolates, resistance rates to ampicillin, cotrimoxazole and ciprofloxacin were respectively 65.8%, 64.4% 16.2%, compared to 89.5%, 89.5% and 62.5% among E. coli from clinical isolates (n = 48 of which 45 from blood cultures). Proportions of extended spectrum beta-lactamase producers and multidrug resistance were 3.2% and 5.2% among E. coli isolates from urine in pregnant women versus 35.4%, and 60.4% respectively among clinical isolates. CONCLUSIONS The E. coli isolates obtained from healthy pregnant women had significantly lower AMR rates compared to clinical E. coli isolates, probably reflecting the lower antibiotic pressure in the pregnant women population. Adding urine culture to the routine urine analysis (dipstick) of antenatal care was feasible. The dipslide culture method was affordable and user-friendly and allowed on-site inoculation and easy transport; challenges were contamination (midstream urine sampling) and the semi-quantitative reading. Provided confirmation of the present findings in other settings, E. coli from urine samples in pregnant women may be a potential indicator for benchmarking, comparing, and monitoring community AMR rates across populations over different countries and regions.},

keywords = {ANC, Antimicrobial resistance, Asymptomatic bacteriuria, Burkina Faso, Community, Escherichia coli, Pregnancy, Rural Africa},

pubstate = {published},

tppubtype = {article}

}

@article{Sagara2022,

title = {The Anti-Circumsporozoite Antibody Response of Children to Seasonal Vaccination With the RTS,S/AS01E Malaria Vaccine},

author = {Issaka Sagara and Issaka Zongo and Matthew Cairns and Rakiswend\'{e} Serge Yerbanga and Almahamoudou Mahamar and Fr\'{e}d\'{e}ric Niki\`{e}ma and Amadou Tapily and Fr\'{e}d\'{e}ric Sompougdou and Modibo Diarra and Charles Zoungrana and Djibrilla Issiaka and Alassane Haro and Koualy Sanogo and Abdoul Aziz Sienou and Mahamadou Kaya and Seydou Traore 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 Ouedraogo and Alassane Dicko and Daniel Chandramohan and Brian Greenwood},

url = {https://academic.oup.com/cid/article/75/4/613/6459764},

doi = {10.1093/cid/ciab1017},

issn = {1058-4838},

year  = {2022},

date = {2022-01-01},

journal = {Clinical Infectious Diseases},

volume = {75},

issue = {4},

pages = {613-622},

abstract = {BACKGROUND A trial in African children showed that combining seasonal vaccination with the RTS,S/AS01E vaccine with seasonal malaria chemoprevention reduced the incidence of uncomplicated and severe malaria compared with either intervention given alone. Here, we report on the anti-circumsporozoite antibody response to seasonal RTS,S/AS01E vaccination in children in this trial. METHODS Sera from a randomly selected subset of children collected before and 1 month after 3 priming doses of RTS,S/AS01E and before and 1 month after 2 seasonal booster doses were tested for anti-circumsporozoite antibodies using enzyme-linked immunosorbent assay. The association between post-vaccination antibody titer and incidence of malaria was explored. RESULTS A strong anti-circumsporozoite antibody response to 3 priming doses of RTS,S/AS01E was seen (geometric mean titer, 368.9 enzyme-linked immunosorbent assay units/mL), but titers fell prior to the first booster dose. A strong antibody response to an annual, pre-malaria transmission season booster dose was observed, but this was lower than after the primary vaccination series and lower after the second than after the first booster dose (ratio of geometric mean rise, 0.66; 95% confidence interval [CI], .57-.77). Children whose antibody response was in the upper tercile post-vaccination had a lower incidence of malaria during the following year than children in the lowest tercile (hazard ratio, 0.43; 95% CI, .28-.66). CONCLUSIONS Seasonal vaccination with RTS,S/AS01E induced a strong booster antibody response that was lower after the second than after the first booster dose. The diminished antibody response to the second booster dose was not associated with diminished efficacy. CLINICAL TRIALS REGISTRATION NCT03143218.},

keywords = {anti-circumsporozoite antibody, Burkina Faso, Mali, RTS, S/AS01E vaccine, seasonal vaccination},

pubstate = {published},

tppubtype = {article}

}

@article{nokey,

title = {Associations between dental problems and underweight status among rural women in Burkina Faso: results from the first WHO Stepwise Approach to Surveillance (STEPS) survey},

author = {Jeoffray Diend\'{e}r\'{e} and Augustin Nawidimbasba Zeba and Sibraogo Kiemtor\'{e} and Olivier Ouahamin Sombi\'{e} and Philippe Fayemendy and Pierre J\'{e}sus and Athanase Millogo and Aly Savadogo and Halidou Tinto and Jean-Claude Desport},

url = {https://www.cambridge.org/core/product/identifier/S1368980021004080/type/journal_article},

doi = {10.1017/S1368980021004080},

issn = {1368-9800},

year  = {2022},

date = {2022-01-01},

journal = {Public Health Nutrition},

volume = {25},

issue = {8},

pages = {2214-2224},

abstract = {OBJECTIVE To explore the relationships between dental problems and underweight status among rural women in Burkina Faso by using nationally representative data. DESIGN This was a cross-sectional secondary study of primary data obtained by the 2013 WHO Stepwise Approach to Surveillance survey conducted in Burkina Faso. Descriptive and analytical analyses were performed using Student's t test, ANOVA, the χ2 test, Fisher's exact test and logistic regression. SETTING All thirteen Burkinab\`{e} regions were categorised using quartiles of urbanisation rates. PARTICIPANTS The participants were 1730 rural women aged 25-64 years. RESULTS The prevalence of underweight was 16·0 %, and 24·1 % of participants experienced dental problems during the 12-month period. The women with dental problems were more frequently underweight (19·9 % and 14·7 %; P \< 0·05) and had a lower mean BMI (21·1 ± 3·2 and 21·6 ± 3·7 kg/m2, P \< 0·01) than those without dental problems. More risk factors for underweight were observed in less urbanised regions among elderly individuals (\> 49 years old) and smokeless tobacco users. Age \> 49 years, professions with inconsistent income, a lack of education, smokeless tobacco use and low BMI were factors that were significantly associated with dental problems, while residency in a low-urbanisation area was a protective factor. CONCLUSION The prevalence of underweight in rural Burkinab\`{e} women is among the highest in sub-Saharan Africa, and women with dental problems are more frequently affected than those without dental problems. Public health measures for the prevention of these disorders should specifically target women aged over 49 years and smokeless tobacco users.},

keywords = {Burkina Faso, Dental problems, Prevalence, Risk Factors, Rural women, Underweight},

pubstate = {published},

tppubtype = {article}

}

@article{Sawadogo2022,

title = {Genomic Epidemiology of SARS-CoV-2 in Western Burkina Faso, West Africa},

author = {Yacouba Sawadogo and Lokman Galal and Essia Belarbi and Ars\`{e}ne Zongo and Grit Schubert and Fabian Leendertz and Abdoulie Kanteh and Abdul Karim Sesay and Annette Erhart and Anne-Laure Ba\~{n}uls and Z\'{e}kiba Tarnagda and Sylvain Godreuil and Halidou Tinto and Abdoul-Salam Ouedraogo},

url = {https://www.mdpi.com/1999-4915/14/12/2788},

doi = {10.3390/v14122788},

issn = {1999-4915},

year  = {2022},

date = {2022-01-01},

journal = {Viruses},

volume = {14},

issue = {12},

pages = {2788},

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

keywords = {Burkina Faso, COVID-19, genomic epidemiology, SARS-Cov-2, West Africa, Whole Genome Sequencing},

pubstate = {published},

tppubtype = {article}

}

@article{Bonko2022,

title = {Diagnostic Performance of Plasmodium falciparum Histidine-Rich Protein-2 Antigen-Specific Rapid Diagnostic Test in Children at the Peripheral Health Care Level in Nanoro (Burkina Faso)},

author = {Massa Achille Bonko and Marc Christian Tahita and Francois Kiemde and Palpouguini Lompo and Petra F. Mens and Halidou Tinto and Henk. D. F. H. Schallig},

url = {https://www.mdpi.com/2414-6366/7/12/440},

doi = {10.3390/tropicalmed7120440},

issn = {2414-6366},

year  = {2022},

date = {2022-01-01},

journal = {Tropical Medicine and Infectious Disease},

volume = {7},

issue = {12},

pages = {440},

abstract = {\<p\>(1) Background: Malaria control has strongly benefited from the implementation of rapid diagnostic tests (RDTs). The malaria RDTs used in Burkina Faso, as per the recommendation of the National Malaria Control Program, are based on the detection of histidine-rich protein-2 (PfHRP2) specific to Plasmodium falciparum, which is the principal plasmodial species causing malaria in Burkina Faso. However, there is increasing concern about the diagnostic performance of these RDTs in field situations, and so constant monitoring of their accuracy is warranted. (2) Methods: A prospective study was performed in the health district of Nanoro, where 391 febrile children under 5 years with an axillary temperature ≥37.5 °C presenting at participating health facilities were subjected to testing for malaria. The HRP2-based RDT and expert microscopy were used to determine the diagnostic performance of the former. Retrospectively, the correctness of the antimalaria prescriptions was reviewed. (3) Results: Taking expert malaria microscopy as the gold standard, the sensitivity of the employed RDT was 98.5% and the specificity 40.5%, with a moderate agreement between the RDT testing and microscopy. In total, 21.7% of cases received an inappropriate antimalarial treatment based on a retrospective assessment with expert microscopy results. (4) Conclusion: Malaria remains one of the principal causes of febrile illness in Burkina Faso. Testing with HRP2-based RDTs is inaccurate, in particular, due to the low specificity, which results in an over-prescription of antimalarials, with emerging antimalarial drug resistance as an important risk and many children not being treated for potential other causes of fever.\</p\>},

keywords = {Burkina Faso, diagnostics, febrile diseases, Malaria},

pubstate = {published},

tppubtype = {article}

}

@article{Valia2022,

title = {Use of WATCH antibiotics prior to presentation to the hospital in rural Burkina Faso},

author = {Daniel Valia and Brecht Ingelbeen and B\'{e}renger Kabor\'{e} and Ibrahima Karama and Marjan Peeters and Palpouguini Lompo and Erika Vlieghe and Annelies Post and Janneke Cox and Quirijn Mast and Annie Robert and Marianne A. B. Sande and Hector Rodriguez Villalobos and Andre Ven and Halidou Tinto and Jan Jacobs},

url = {https://aricjournal.biomedcentral.com/articles/10.1186/s13756-022-01098-8},

doi = {10.1186/s13756-022-01098-8},

issn = {2047-2994},

year  = {2022},

date = {2022-01-01},

urldate = {2022-01-01},

journal = {Antimicrobial Resistance \& Infection Control},

volume = {11},

issue = {1},

pages = {59},

abstract = {BACKGROUND: In low- and middle-income countries, the prevalence of antimicrobial resistance (AMR) is increasing. To control AMR, WHO recommends monitoring  antibiotic use, in particular Watch antibiotics. These are critically important  antibiotics, with restricted use because at risk of becoming ineffective due to  increasing AMR. We investigated pre-hospital antibiotic use in rural Burkina  Faso. METHODS: During 2016-2017, we collected data from patients aged \> 3 months  presenting with severe acute fever to the rural hospital of Nanoro Health  District, Burkina Faso, including antibiotic use in the two weeks prior to  consultation or hospitalization. We analysed reported antibiotic use by applying  the WHO Access, Watch, Reserve classification. RESULTS: Of 920 febrile  participants (63.0% ≤ 14 years), pre-hospital antibiotic use was reported by 363  (39.5%). Among these 363, microbiological diagnoses were available for 275  (75.8%) patients, of whom 162 (58.9%) were non-bacterial infections. Use of more  than one antibiotic was reported by 58/363 (16.0%) participants. Of 491  self-referred patients who did not previously visit a primary health care center,  131 (26.7%) reported antibiotic use. Of 424 antibiotics reported, 265 (62.5%)  were Access and 159 (37.5%) Watch antibiotics. Watch antibiotic use was more  frequent among patients \> 14 year olds (51.1%) compared to those 0-14 year old  (30.7%, p \< 0.001) and among referrals from the primary health care centers  (42.2%) compared to self-referred patients (28.1%, p = 0.004). Most frequently  reported Watch antibiotics were ceftriaxone (114, 71.7%) and ciprofloxacin (32,  20.1%). CONCLUSION: The reported frequent use of Watch group antibiotics among  febrile patients prior to presentation to the hospital in rural Burkina Faso  highlights the need to develop targeted interventions to improve antibiotic use  in community settings as part of strengthening antibiotic stewardship in low- and  middle-income countries. This should include facilitating referral, access to  qualified prescribers and diagnostic tools in rural primary health care centers.  Trial registration ClinicalTrials.gov identifier: NCT02669823. Registration date  was February 1, 2016.},

keywords = {Antimicrobial resistance, AWaRe, Burkina Faso, Community antibiotic use},

pubstate = {published},

tppubtype = {article}

}

@article{Ouoba2021-ug,

title = {Epidemiologic profile of hepatitis C virus infection and  genotype distribution in Burkina Faso: a systematic review with  meta-analysis},

author = {Serge Ouoba and Jean Claude Romaric Pingdwinde Ouedraogo and Moussa Lingani and Bunthen E and Md Razeen Ashraf Hussain and Ko Ko and Shintaro Nagashima and Aya Sugiyama and Tomoyuki Akita and Halidou Tinto and Junko Tanaka},

doi = {10.1186/s12879-021-06817-x},

issn = {1471-2334},

year  = {2021},

date = {2021-11-01},

urldate = {2021-11-01},

journal = {BMC Infect. Dis.},

volume = {21},

number = {1},

pages = {1126},

publisher = {Springer Science and Business Media LLC},

abstract = {BACKGROUND: Detailed characteristics of Hepatitis C virus (HCV) 

 infection in Burkina Faso are scarce. The main aim of this study 

 was to assess HCV seroprevalence in various settings and 

 populations at risk in Burkina Faso between 1990 and 2020. 

 Secondary objectives included the prevalence of HCV Ribonucleic 

 acid (RNA) and the distribution of HCV genotypes. METHODS: A 

 systematic database search, supplemented by a manual search, was 

 conducted in PubMed, Web of Science, Scopus, and African Index 

 Medicus. Studies reporting HCV seroprevalence data in low and 

 high-risk populations in Burkina Faso were included, and a 

 random-effects meta-analysis was applied. Risk of bias was 

 assessed using the Joanna Briggs institute checklist. RESULTS: 

 Low-risk populations were examined in 31 studies involving a 

 total of 168,151 subjects, of whom 8330 were positive for HCV 

 antibodies. Six studies included a total of 1484 high-risk 

 persons, and 96 had antibodies to HCV. The pooled seroprevalence 

 in low-risk populations was 3.72% (95% CI: 3.20-4.28) and 

 4.75% (95% CI: 1.79-8.94) in high-risk groups. A 

 non-significant decreasing trend was observed over the study 

 period. Seven studies tested HCV RNA in a total of 4759 

 individuals at low risk for HCV infection, and 81 were positive. 

 The meta-analysis of HCV RNA yielded a pooled prevalence of 

 1.65% (95% CI: 0.74-2.89%) in low-risk populations, which is 

 assumed to be indicative of HCV prevalence in the general 

 population of Burkina Faso and suggests that about 301,174 

 people are active HCV carriers in the country. Genotypes 2 and 1 

 were the most frequent, with 60.3% and 25.0%, respectively. 

 CONCLUSIONS: HCV seroprevalence is intermediate in Burkina Faso 

 and indicates the need to implement effective control 

 strategies. There is a paucity of data at the national level and 

 for rural and high-risk populations. General population 

 screening and linkage to care are recommended, with special 

 attention to rural and high-risk populations.},

note = {© 2021. The Author(s).

PMID: 34724902 

PMCID: PMC8561994},

keywords = {Burkina Faso, Burkina Faso/epidemiology, Genotype, Hepacivirus/genetics, Hepatitis C, Hepatitis C/epidemiology, Humans, Prevalence, Seroepidemiologic Studies, Seroprevalence, Systematic review},

pubstate = {published},

tppubtype = {article}

}

@article{Lingani2021-is,

title = {Malaria and curable sexually transmitted and reproductive tract  coinfection among pregnant women in rural Burkina Faso},

author = {Moussa Lingani and Serge H Zango and Innocent Val\'{e}a and Massa Dit A Bonko and S\'{e}kou O Samadoulougou and Toussaint Rouamba and Marc C Tahita and Ma"imouna Sanou and Annie Robert and Halidou Tinto and Philippe Donnen and Mich`ele Dramaix},

doi = {10.1186/s41182-021-00381-5},

issn = {1348-8945 1349-4147},

year  = {2021},

date = {2021-11-01},

urldate = {2021-11-01},

journal = {Trop. Med. Health},

volume = {49},

number = {1},

pages = {90},

publisher = {Springer Science and Business Media LLC},

abstract = {BACKGROUND: Malaria and sexually transmitted/reproductive tract 

 infections (STI/RTI) are leading and preventable causes of low 

 birthweight in sub-Saharan Africa. Reducing their impact on 

 pregnancy outcomes requires efficient interventions that can be 

 easily integrated into the antenatal care package. The paucity 

 of data on malaria and STI/RTI coinfection, however, limits 

 efforts to control these infections. This study aimed to 

 determine the prevalence and associated factors of malaria and 

 STI/RTI coinfection among pregnant women in rural Burkina Faso. 

 METHODS: A cross-sectional survey was conducted among 402 

 pregnant women attending antenatal clinics at the Yako health 

 district. Sociodemographic and behavioral data were collected, 

 and pregnant women were tested for peripheral malaria by 

 microscopy. Hemoglobin levels were also measured by 

 spectrophotometry and curable bacterial STI/RTI were tested on 

 cervico-vaginal swabs using rapid diagnostic test for chlamydia 

 and syphilis, and Gram staining for bacterial vaginosis. A 

 multivariate logistic regression model was used to assess the 

 association of malaria and STI/RTI coinfection with the 

 characteristics of included pregnant women. RESULTS: The 

 prevalence of malaria and at least one STI/RTI coinfection was 

 12.9% (95% confidence interval, CI: [9.8-16.7]), malaria and 

 bacterial vaginosis coinfection was 12.2% (95% CI: 

 [9.3-15.9]), malaria and chlamydial coinfection was 1.6% (95% 

 CI: [0.6-3.8]). No coinfection was reported for malaria and 

 syphilis. The individual prevalence was 17.2%, 7.2%, 0.6%, 

 67.7% and 73.3%, respectively, for malaria infection, 

 chlamydia, syphilis, bacterial vaginosis and STI/RTI 

 combination. Only 10% of coinfections were symptomatic, and 

 thus, 90% of women with coinfection would have been missed by 

 the symptoms-based diagnostic approach. In the multivariate analysis, the first pregnancy (aOR = 2.4 [95% CI: 1.2-4.7]) was 

 the only factor significantly associated with malaria and 

 STI/RTI coinfection. Clinical symptoms were not associated with 

 malaria and STI/RTI coinfection. CONCLUSION: The prevalence of 

 malaria and curable STI/RTI coinfection was high among pregnant 

 women. The poor performance of the clinical symptoms to predict 

 coinfection suggests that alternative interventions are needed.},

note = {© 2021. The Author(s).

PMID: 34736524 

PMCID: PMC8567650},

keywords = {Bacterial vaginosis, Burkina Faso, Chlamydia, Coinfection, Malaria, Pregnancy, Syphilis},

pubstate = {published},

tppubtype = {article}

}

@article{Starck2021-mb,

title = {The effect of malaria on haemoglobin concentrations: a  nationally representative household fixed-effects study of  17,599 children under 5 years of age in Burkina Faso},

author = {Tim Starck and Caroline A Bulstra and Halidou Tinto and Toussaint Rouamba and Ali Sie and Thomas Jaenisch and Till B\"{a}rnighausen},

doi = {10.1186/s12936-021-03948-z},

issn = {1475-2875},

year  = {2021},

date = {2021-10-23},

urldate = {2021-10-23},

journal = {Malar. J.},

volume = {20},

number = {1},

pages = {416},

publisher = {Springer Science and Business Media LLC},

abstract = {BACKGROUND: Although the association between malaria and anaemia 

 is widely studied in patient cohorts, the 

 population-representative causal effects of malaria on anaemia 

 remain unknown. This study estimated the malaria-induced 

 decrease in haemoglobin levels among young children in 

 malaria-endemic Burkina Faso. METHODS: The study was based on 

 pooled individual-level nationally representative health survey 

 data (2010-2011, 2014, 2017-2018) from 17 599 children under 5 

 years of age. This data was used to estimate the effects of 

 malaria on haemoglobin concentration, controlling for household 

 fixed-effects, age, and sex in a series of regression analyses. 

 The fixed-effects controlled for observed and unobserved 

 confounding on the household level and allowed to determine the 

 impact of malaria infection status on haemoglobin levels and 

 anaemia prevalence. Furthermore, the diagnostic results from 

 microscopy and rapid diagnostic tests were leveraged to provide 

 a quasi-longitudinal perspective of acute and prolonged effects 

 after malaria infection. RESULTS: The prevalence of both malaria 

 (survey prevalence ranging from 17.4% to 65.2%) and anaemia 

 (survey prevalence ranging from 74% to 88.2%) was very high in 

 the included surveys. Malaria was estimated to significantly 

 reduce haemoglobin levels, with an overall effect of - 7.5 g/dL 

 (95% CI - 8.5, - 6.5). Acute malaria resulted in a - 7.7 g/dL 

 (95% CI - 8.8, - 6.6) decrease in haemoglobin levels. Recent 

 malaria without current parasitaemia decreased haemoglobin 

 concentration by - 7.1 g/dL (95% CI - 8.3, - 5.9). The 

 in-sample predicted prevalence of severe anaemia was 9.4% among 

 malaria positives, but only 2.2% among children without 

 malaria. CONCLUSION: Malaria infection has a strong detrimental 

 effect on haemoglobin levels among young children in Burkina 

 Faso. This effect seems to carry over even after acute 

 infection, indicating prolonged haemoglobin reductions even 

 after successful parasite-elimination. The quasi-experimental 

 fixed-effect approach adds a population level perspective to 

 existing clinical evidence.},

note = {© 2021. The Author(s).

PMID: 34688294 

PMCID: PMC8542337},

keywords = {Anaemia, Burkina Faso, Haemoglobin, Household fixed-effects, Malaria, Microscopy, Rapid diagnostic tests},

pubstate = {published},

tppubtype = {article}

}

@article{Diendere2021-lc,

title = {Associations between dental problems and underweight status  among rural women in Burkina Faso: results from the first WHO  Stepwise Approach to Surveillance (STEPS) survey},

author = {Jeoffray Diend\'{e}r\'{e} and Augustin Nawidimbasba Zeba and Sibraogo Kiemtor\'{e} and Olivier Ouahamin Sombi\'{e} and Philippe Fayemendy and Pierre J\'{e}sus and Athanase Millogo and Aly Savadogo and Halidou Tinto and Jean-Claude Desport},

doi = {10.1017/S1368980021004080},

issn = {1475-2727 1368-9800},

year  = {2021},

date = {2021-10-07},

urldate = {2021-10-07},

journal = {Public Health Nutr.},

pages = {1--11},

publisher = {Cambridge University Press (CUP)},

abstract = {OBJECTIVE: To explore the relationships between dental problems 

 and underweight status among rural women in Burkina Faso by 

 using nationally representative data. DESIGN: This was a 

 cross-sectional secondary study of primary data obtained by the 

 2013 WHO Stepwise Approach to Surveillance survey conducted in 

 Burkina Faso. Descriptive and analytical analyses were performed 

 using Student's t test, ANOVA, the $chi$2 test, Fisher's exact 

 test and logistic regression. SETTING: All thirteen 

 Burkinab`e regions were categorised using quartiles of 

 urbanisation rates. PARTICIPANTS: The participants were 1730 

 rural women aged 25-64 years. RESULTS: The prevalence of 

 underweight was 16·0 %, and 24·1 % of participants experienced 

 dental problems during the 12-month period. The women with 

 dental problems were more frequently underweight (19·9 % and 

 14·7 %; P 49 years old) and smokeless tobacco users. Age \> 49 

 years, professions with inconsistent income, a lack of 

 education, smokeless tobacco use and low BMI were factors that 

 were significantly associated with dental problems, while 

 residency in a low-urbanisation area was a protective factor. 

 CONCLUSION: The prevalence of underweight in rural Burkinab`e 

 women is among the highest in sub-Saharan Africa, and women with 

 dental problems are more frequently affected than those without 

 dental problems. Public health measures for the prevention of 

 these disorders should specifically target women aged over 49 

 years and smokeless tobacco users.},

note = {Place: England

PMID: 34615560},

keywords = {Burkina Faso, Dental problems, Prevalence, Risk Factors, Rural women, Underweight},

pubstate = {published},

tppubtype = {article}

}

@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}

}

@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}

}

@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}

}

@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}

}

@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}

}

@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}

}