Silene Casari, Monica Di Paola, Elena Banci, Salou Diallo, Luca Scarallo, Sara Renzo, Agnese Gori, Sonia Renzi, Monica Paci, Quirijn Mast, Tal Pecht, Karim Derra, Berenger Kaboré, Halidou Tinto, Duccio Cavalieri, Paolo Lionetti
In: Nutrients, vol. 14, iss. 9, 2022, ISSN: 2072-6643.
(Tags: *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)| | |
(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.
Laetitia Duval, Elisa Sicuri, Susana Scott, Maminata Traoré, Bunja Daabo, Halidou Tinto, Koen Peeters Grietens, Umberto d’Alessando, Henk Schallig, Petra Mens, Lesong Conteh
In: Cost Effectiveness and Resource Allocation, vol. 20, iss. 1, pp. 42, 2022, ISSN: 1478-7547.
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.
Marie Jaspard, Mamadou Saliou Sow, Sylvain Juchet, Eric Dienderé, Beatrice Serra, Richard Kojan, Billy Sivahera, Caroline Martin, Moumouni Kinda, Hans-Joerg Lang, Fodé Bangaly Sako, Fodé Amara Traoré, Eudoxie Koumbem, Halidou Tinto, Adama Sanou, Apoline Sondo, Flavien Kaboré, Joseph Donamou, Jean-Paul-Yassa Guilavogui, Fanny Velardo, Brice Bicaba, Olivier Marcy, Augustin Augier, Sani Sayadi, Armel Poda, Sakoba Keita, Xavier Anglaret, Denis Malvy, COVISTA group
In: Int. J. Infect. Dis., vol. 108, pp. 45–52, 2021, ISSN: 1878-3511 1201-9712, (Copyright © 2021 The Authors. Published by Elsevier Ltd.. All rights reserved. PMID: 34000419 PMCID: PMC8120805).
(Tags: Adult, Aged, Burkina Faso/epidemiology, Comorbidities, COVID-19, Female, Hospitalization, Humans, Male, Mortality, Prospective Studies, Referral and Consultation, SARS-Cov-2, sub-Saharan Africa)| | |
OBJECTIVES: The overall death toll from COVID-19 in Africa is
reported to be low but there is little individual-level evidence
on the severity of the disease. This study examined the clinical
spectrum and outcome of patients monitored in COVID-19 care
centres (CCCs) in two West-African countries. METHODS: Burkina
Faso and Guinea set up referral CCCs to hospitalise all
symptomatic SARS-CoV-2 carriers, regardless of the severity of
their symptoms. Data collected from hospitalised patients by
November 2020 are presented. RESULT: A total of 1,805 patients
(64% men, median age 41 years) were admitted with COVID-19.
Symptoms lasted for a median of 7 days (IQR 4-11). During
hospitalisation, 443 (25%) had a SpO2 < 94% at least once, 237
(13%) received oxygen and 266 (15%) took corticosteroids.
Mortality was 5% overall, and 1%, 5% and 14% in patients
aged <40, 40-59 and $geq$60 years, respectively. In
multivariable analysis, the risk of death was higher in men (aOR
2.0, 95% CI 1.1; 3.6), people aged $geq$60 years (aOR 2.9,
95% CI 1.7; 4.8) and those with chronic hypertension (aOR 2.1,
95% CI 1.2; 3.4). CONCLUSION: COVID-19 is as severe in Africa
as elsewhere, and there must be more vigilance for common risk
factors such as older age and hypertension.
Engelbert A Nonterah, Michiel L Bots, Abraham Oduro, Godfred Agongo, Cassandra C Soo, Lisa K Micklesfield, Felistas Mashinya, Palwendé R Boua, Shukri F Mohamed, Alisha N Wade, Catherine Kyobutungi, Halidou Tinto, Shane A Norris, Stephen M Tollman, Mich`ele Ramsay, Diederick E Grobbee, Kerstin Klipstein-Grobusch, Nigel J Crowther, AWI-Gen, H3Africa Consortium
In: Glob. Heart, vol. 16, no. 1, pp. 19, 2021, ISSN: 2211-8179 2211-8160, (Copyright: © 2021 The Author(s). PMID: 33833943 PMCID: PMC7977036).
(Tags: adiposity, Adult, Body Mass Index, cardiovascular disease, Carotid intima-media thickness, Cross-Sectional Studies, Female, Ghana, Humans, Male, Middle Aged, obesity, Obesity/complications/epidemiology, Phenotype, Risk Factors, sub-Saharan Africa, subclinical atherosclerosis)| | |
Background: Obesity and adipose tissue distribution contribute
to an increased risk of cardiovascular disease (CVD) by
promoting atherosclerosis. This association has been poorly
studied in sub-Saharan Africa (SSA) despite the rising
prevalence of cardiovascular disease. Objectives: We determined
the association between various adiposity phenotypes and carotid
intima-media thickness (CIMT), a proxy of subclinical
atherosclerosis, in a large SSA population. Methods: A
population-based cross-sectional study was performed from
2013-2016 in Burkina Faso, Ghana, Kenya and South Africa. Body
mass index (BMI), waist (WC), hip circumferences (HC), visceral
(VAT) and subcutaneous adipose tissue (SCAT) using B-mode
ultrasound were measured. Ultrasonography of left and right far
wall CIMT of the common carotid artery was used as an indicator
of subclinical atherosclerosis. Individual participant data
meta-analyses were used to determine the associations between
adiposity phenotypes and CIMT in the pooled sample while
adjusted multivariable linear regression analyses were used for
site specific analyses. Results: Data were obtained from 9,010
adults (50.3% women and a mean age of 50$pm$ 6years). Men had
higher levels of visceral fat than women while women had higher
BMI, waist and hip circumference and subcutaneous fat than men
at all sites except Burkina Faso. In the pooled analyses, BMI
($beta$-value [95% CIs]: 19.5 [16.8, 22.3] $mu$m) showed the
strongest relationship with CIMT followed by VAT (5.86 [4.65,
7.07] $mu$m), SCAT (5.00 [2.85, 7.15] $mu$m), WC (1.27 [1.09,
1.44] $mu$m) and HC (1.23 [1.04, 1.42] $mu$m). Stronger
associations were observed in men than in women. Conclusion:
Obesity within SSA will likely result in higher levels of
atherosclerosis and promote the occurrence of cardio- and
cerebrovascular events, especially in males, unless addressed
through primary prevention of obesity in both rural and urban
communities across Africa. The inverse association of VAT with
CIMT in Burkina Faso and Ghana requires further investigation.
Highlights: All adiposity phenotypes were positively associated
with common carotid intima-media thickness (CIMT) in the entire
cohort (pooled analyses).BMI had the strongest association with
CIMT compared to other phenotypes.The magnitude of association
between adiposity phenotypes and CIMT was higher in men than in
women.Subcutaneous adipose tissue was inversely associated with
CIMT only in women.An unexpected finding was the inverse
association of visceral adipose tissue with CIMT in Burkina Faso
Laura Skrip, Karim Derra, Mikaila Kaboré, Navideh Noori, Adama Gansané, Innocent Valéa, Halidou Tinto, Bicaba W Brice, Mollie Van Gordon, Brittany Hagedorn, Hervé Hien, Benjamin M Althouse, Edward A Wenger, André Lin Ouédraogo
In: Int. J. Infect. Dis., vol. 101, pp. 194–200, 2020, ISSN: 1878-3511 1201-9712, (Copyright © 2020 The Authors. Published by Elsevier Ltd.. All rights reserved. PMID: 32987177 PMCID: PMC7518969).
(Tags: Adolescent, Adult, Africa South of the Sahara, Aged, Antiviral Agents/administration & dosage, Asia/epidemiology, Burkina Faso, Burkina Faso/epidemiology, Child, Clinical management of SARS-CoV-2 infection: convalescent plasma, COVID-19/drug therapy/epidemiology/mortality/therapy, Europe/epidemiology, Female, Health systems strengthening, Humans, Immunization, Infant, Male, Mortality, Oxygen therapy, Pandemics, Passive, Preschool, Retrospective Studies, SARS-CoV-2 infection, SARS-CoV-2/drug effects/physiology, sub-Saharan Africa, Young Adult)| | |
BACKGROUND: Absolute numbers of COVID-19 cases and deaths
reported to date in the sub-Saharan Africa (SSA) region have
been significantly lower than those across the Americas, Asia
and Europe. As a result, there has been limited information
about the demographic and clinical characteristics of deceased
cases in the region, as well as the impacts of different case
management strategies. METHODS: Data from deceased cases
reported across SSA through 10 May 2020 and from hospitalized
cases in Burkina Faso through 15 April 2020 were analyzed.
Demographic, epidemiological and clinical information on
deceased cases in SSA was derived through a line-list of
publicly available information and, for cases in Burkina Faso,
from aggregate records at the Centre Hospitalier Universitaire
de Tengandogo in Ouagadougou. A synthetic case population was
probabilistically derived using distributions of age, sex and
underlying conditions from populations of West African countries
to assess individual risk factors and treatment effect sizes.
Logistic regression analysis was conducted to evaluate the
adjusted odds of survival for patients receiving oxygen therapy
or convalescent plasma, based on therapeutic effectiveness
observed for other respiratory illnesses. RESULTS: Across SSA,
deceased cases for which demographic data were available were
predominantly male (63/103, 61.2%) and aged >50 years (59/75,
78.7%). In Burkina Faso, specifically, the majority of deceased
cases either did not seek care at all or were hospitalized for a
single day (59.4%, 19/32). Hypertension and diabetes were often
reported as underlying conditions. After adjustment for sex, age
and underlying conditions in the synthetic case population, the
odds of mortality for cases not receiving oxygen therapy were
significantly higher than for those receiving oxygen, such as
due to disruptions to standard care (OR 2.07; 95% CI
1.56-2.75). Cases receiving convalescent plasma had 50% reduced
odds of mortality than those who did not (95% CI 0.24-0.93).
CONCLUSIONS: Investment in sustainable production and
maintenance of supplies for oxygen therapy, along with messaging
around early and appropriate use for healthcare providers,
caregivers and patients could reduce COVID-19 deaths in SSA.
Further investigation into convalescent plasma is warranted
until data on its effectiveness specifically in treating
COVID-19 becomes available. The success of supportive or
curative clinical interventions will depend on earlier treatment
seeking, such that community engagement and risk communication
will be critical components of the response.
Francois Kiemde, René Spijker, Petra F. Mens, Halidou Tinto, Michael Boele, Henk D. F. H. Schallig
Aetiologies of non-malaria febrile episodes in children under 5 years in sub-Saharan Africa. (Journal Article)
In: Tropical medicine & international health : TM & IH, vol. 21, iss. 8, pp. 943-955, 2016.
OBJECTIVES: To provide an overview of the most frequent aetiologies found in febrile episodes of children under 5 years from sub-Saharan Africa. METHODS: MEDLINE and EMBASE were searched for publications in English and French on non-malaria fever episodes in African children under 5 years of age, which were published between January 1990 and July 2015. Case reports and conference abstracts were excluded. RESULTS: In total, 3851 titles and abstracts were reviewed, and 153 were selected for full screening of which 18 were included in the present review. Bloodstream infection (BSI) was most commonly investigated (nine of 18) followed by urinary tract infection (UTI) (four of 18) and respiratory tract infection (RTI) (two of 18). Few studies investigated BSI and UTI in the same children (two of 18), or BSI and gastrointestinal infection (GII) (one of 18). As for BSI, the most frequently isolated bacteria were E. coli (four of 12), Streptococcus pneumonia (four of 12), Salmonella spp (three of 12) and Staphylococcus aureus (two of 12) with a positive identification rate of 19.7-33.3%, 5.2-27.6%, 11.7-65.4% and 23.5-42.0%, respectively. As for UTI, the main bacteria isolated were E. coli (six of six) and Klebsiella spp (six of six) with a positive rate of 20.0-72.3% and 10.0-28.5%, respectively. No bacterium was isolated in RTI group, but Human influenzae A and B were frequently found, with the highest positive identification rate in Tanzania (75.3%). Dengue virus (two of 12) was the most frequently reported viral infection with a positive identification rate of 16.7-30.8%. Finally, only rotavirus/adenovirus (69.2% positive identification rate) was found in GII and no bacterium was isolated in this group. CONCLUSIONS: The high prevalence of treatable causes of non-malaria fever episodes requires a proper diagnosis of the origin of fever followed by an appropriate treatment, thereby reducing the under-5 mortality in sub-Saharan Africa and preventing the overprescription of antibiotics and thus circumventing the rise of antibiotic resistance.
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