Biébo Bihoun, Serge Henri Zango, Maminata Traoré-Coulibaly, Innocent Valea, Raffaella Ravinetto, Jean Pierre Van Geertruyden, Umberto D’Alessandro, Halidou Tinto, Annie Robert
In: BMC pregnancy and childbirth, vol. 22, iss. 1, pp. 248, 2022, ISSN: 1471-2393.
(Tags: *Malaria, *Malaria/epidemiology, Adult, Burkina Faso, Burkina Faso/epidemiology, Falciparum/parasitology, Female, Gravidity, Humans, Malaria, placenta, Placenta/parasitology, Pregnancy, Risk Factors)| | | |
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.
Moussa Lingani, Serge Henri Zango, Innocent Valéa, Georges Somé, Maïmouna Sanou, Sékou O. Samadoulougou, Serge Ouoba, Eli Rouamba, Annie Robert, Michèle Dramaix, Philippe Donnen, Halidou Tinto
In: BMC pregnancy and childbirth, vol. 22, iss. 1, pp. 228, 2022, ISSN: 1471-2393.
(Tags: *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)| | | |
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.
Moussa Lingani, Serge H Zango, Innocent Valéa, Massa Dit A Bonko, Sékou O Samadoulougou, Toussaint Rouamba, Marc C Tahita, Ma"imouna Sanou, Annie Robert, Halidou Tinto, Philippe Donnen, Mich`ele Dramaix
In: Trop. Med. Health, vol. 49, no. 1, pp. 90, 2021, ISSN: 1348-8945 1349-4147, (© 2021. The Author(s). PMID: 34736524 PMCID: PMC8567650).
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.
Serge Henri Zango, Moussa Lingani, Innocent Valea, Ouindpanga Sekou Samadoulougou, Biebo Bihoun, Diagniagou Lankoande, Phillipe Donnen, Michele Dramaix, Halidou Tinto, Annie Robert
In: BMC Pregnancy Childbirth, vol. 21, no. 1, pp. 722, 2021, ISSN: 1471-2393, (© 2021. The Author(s). PMID: 34706705 PMCID: PMC8549350).
BACKGROUND: Malaria and curable sexually transmitted infections
(STIs) are severe infections associated with poor pregnancy
outcomes in sub-Saharan countries. These infections are
responsible for low birth weight, preterm birth, and
miscarriage. In Burkina Faso, many interventions recommended by
the World Health Organization were implemented to control the
impact of these infections. After decades of intervention, we
assessed the impact of these infections on pregnancy outcomes in
rural setting of Burkina Faso. METHODS: Antenatal care and
delivery data of pregnant women attending health facilities in
2016 and 2017 were collected in two rural districts namely
Nanoro and Yako, in Burkina Faso. Regression models with
likelihood ratio test were used to assess the association
between infections and pregnancy outcomes. RESULTS: During the
two years, 31639 pregnant women received antenatal care. Malaria
without STI, STI without malaria, and their coinfections were
reported for 7359 (23.3%), 881 (2.8 %), and 388 (1.2%) women,
respectively. Low birth weight, miscarriage, and stillbirth were
observed in 2754 (10.5 %), 547 (2.0 %), and 373 (1.3 %)
women, respectively. Our data did not show an association
between low birth weight and malaria [Adjusted OR: 0.91 (0.78 –
1.07)], STIs [Adjusted OR: 0.74 (0.51 – 1.07)] and coinfection
[Adjusted OR: 1.15 (0.75 – 1.78)]. Low birth weight was strongly
associated with primigravidae [Adjusted OR: 3.53 (3.12 – 4.00)].
Both miscarriage and stillbirth were associated with malaria
[Adjusted OR: 1.31 (1.07 – 1.59)], curable STI [Adjusted OR:
1.65 (1.06 – 2.59)], and coinfection [Adjusted OR: 2.00 (1.13 –
3.52)]. CONCLUSION: Poor pregnancy outcomes remained frequent in
rural Burkina Faso. Malaria, curable STIs, and their
coinfections were associated with both miscarriage and
stillbirth in rural Burkina. More effort should be done to
reduce the proportion of pregnancies lost associated with these
curable infections by targeting interventions in primigravidae
Stephen A Roberts, Loretta Brabin, Halidou Tinto, Sabine Gies, Salou Diallo, Bernard Brabin
In: BMC Public Health, vol. 21, no. 1, pp. 1764, 2021, ISSN: 1471-2458, (© 2021. The Author(s). PMID: 34579679 PMCID: PMC8477466).
(Tags: Abnormal vaginal flora, Adolescents, Bacterial vaginosis, Body Mass Index, Burkina Faso/epidemiology, Child, Female, Humans, Iron, iron biomarkers, Malaria, Malaria/drug therapy/epidemiology, MUAC, Pregnancy, Seasons, Vagina)| | | |
BACKGROUND: Adolescents are considered at high risk of developing iron deficiency. Studies in children indicate that the prevalence of iron deficiency increased with malaria transmission, suggesting malaria seasonally may drive iron deficiency. This paper examines monthly seasonal infection patterns of malaria, abnormal vaginal flora, chorioamnionitis, antibiotic and antimalarial prescriptions, in relation to changes in iron biomarkers and nutritional indices in adolescents living in a rural area of Burkina Faso, in order to assess the requirement for seasonal infection control and nutrition interventions. METHODS: Data collected between April 2011 and January 2014 were available for an observational seasonal analysis, comprising scheduled visits for 1949 non-pregnant adolescents (≤19 years), (315 of whom subsequently became pregnant), enrolled in a randomised trial of periconceptional iron supplementation. Data from trial arms were combined. Body Iron Stores (BIS) were calculated using an internal regression for ferritin to allow for inflammation. At recruitment 11% had low BIS (< 0 mg/kg). Continuous outcomes were fitted to a mixed-effects linear model with month, age and pregnancy status as fixed effect covariates and woman as a random effect. Dichotomous infection outcomes were fitted with analogous logistic regression models. RESULTS: Seasonal variation in malaria parasitaemia prevalence ranged between 18 and 70% in non-pregnant adolescents (P < 0.001), peaking at 81% in those who became pregnant. Seasonal variation occurred in antibiotic prescription rates (0.7-1.8 prescriptions/100 weekly visits, P < 0.001) and chorioamnionitis prevalence (range 15-68%, P = 0.026). Mucosal vaginal lactoferrin concentration was lower at the end of the wet season (range 2-22 μg/ml, P < 0.016), when chorioamnionitis was least frequent. BIS fluctuated annually by up to 53.2% per year around the mean BIS (5.1 mg/kg(2), range 4.1-6.8 mg/kg), with low BIS (< 0 mg/kg) of 8.7% in the dry and 9.8% in the wet seasons (P = 0.36). Median serum transferrin receptor increased during the wet season (P < 0.001). Higher hepcidin concentration in the wet season corresponded with rising malaria prevalence and use of prescriptions, but with no change in BIS. Mean Body Mass Index and Mid-Upper-Arm-Circumference values peaked mid-dry season (both P < 0.001). CONCLUSIONS: Our analysis supports preventive treatment of malaria among adolescents 15-19 years to decrease their disease burden, especially asymptomatic malaria. As BIS were adequate in most adolescents despite seasonal malaria, a requirement for programmatic iron supplementation was not substantiated.
Adéla"ide Compaoré, Kadija Ouedraogo, Palwende R Boua, Daniella Watson, Sarah H Kehoe, Marie-Louise Newell, Halidou Tinto, Mary Barker, Hermann Sorgho, INPreP group
In: Public Health Nutr., vol. 24, no. 12, pp. 3780–3790, 2021, ISSN: 1475-2727 1368-9800, (Place: England PMID: 33000717).
(Tags: Burkina Faso, Child, Child nutrition, Child Nutritional Physiological Phenomena, Community perceptions, Empowerment, Female, Humans, Male, Maternal nutrition, Mothers, Nutritional Status, Pregnancy, Qualitative research)| | | |
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.
Toussaint Rouamba, Sékou Samadoulougou, Mady Ouédraogo, Hervé Hien, Halidou Tinto, Fati Kirakoya-Samadoulougou
Asymptomatic malaria and anaemia among pregnant women during high and low malaria transmission seasons in Burkina Faso: household-based cross-sectional surveys in Burkina Faso, 2013 and 2017 (Journal Article)
In: Malar. J., vol. 20, no. 1, pp. 211, 2021, ISSN: 1475-2875.
(Tags: Adult, Anemia/epidemiology/parasitology, Asymptomatic carriage, Asymptomatic Infections/epidemiology, Burkina Faso/epidemiology, Community, Cross-Sectional Studies, Female, Haemoglobin, Humans, Malaria/epidemiology/parasitology, Parasitic/epidemiology/parasitology, Plasmodium, Pregnancy, Pregnancy Complications, Pregnant, Pregnant Women, Prevalence, Young Adult)| | | |
BACKGROUND: Malaria in endemic countries is often asymptomatic
during pregnancy, but it has substantial consequences for both
the mother and her unborn baby. During pregnancy, anaemia is an
important consequence of malaria infection. In Burkina Faso, the
intensity of malaria varies according to the season, albeit the
prevalence of malaria and anaemia as well as their risk factors,
during high and low malaria transmission seasons is
underexplored at the household level. METHODS: Data of 1751
pregnant women from October 2013 to March 2014 and 1931 pregnant
women from April 2017 to June 2017 were drawn from two
cross-sectional household surveys conducted in 24 health
districts of Burkina Faso. Pregnant women were tested for
malaria in their household after consenting. Asymptomatic
carriage was defined as a positive result from malaria rapid
diagnostic tests in the absence of clinical symptoms of malaria.
Anaemia was defined as haemoglobin level less than 11 g/dL in
the first and third trimester and less than 10.5 g/dL in the
second trimester of pregnancy. RESULTS: Prevalence of
asymptomatic malaria in pregnancy was estimated at 23.9% (95%
CI 20.2-28.0) during the high transmission season
(October-November) in 2013. During the low transmission season,
it was 12.7% (95% CI 10.9-14.7) between December and March in
2013-2014 and halved (6.4%; 95% CI 5.3-7.6) between April and
June 2017. Anaemia prevalence was estimated at 59.4% (95% CI
54.8-63.8) during the high transmission season in 2013. During
the low transmission season, it was 50.6% (95% CI 47.7-53.4)
between December and March 2013-2014 and 65.0% (95% CI
62.8-67.2) between April and June, 2017. CONCLUSION: This study
revealed that the prevalence of malaria asymptomatic carriage
and anaemia among pregnant women at the community level remain
high throughout the year. Thus, more efforts are needed to
increase prevention measures such as IPTp-SP coverage in order
to reduce anaemia and contribute to preventing low birth weight
and poor pregnancy outcomes.
Sabine Gies, Stephen A Roberts, Salou Diallo, Olga M Lompo, Halidou Tinto, Bernard J Brabin
In: Matern. Child Nutr., vol. 17, no. 2, pp. e13106, 2021, ISSN: 1740-8709 1740-8695, (© 2020 The Authors. Maternal & Child Nutrition published by John Wiley & Sons Ltd. PMID: 33236840 PMCID: PMC7988873).
This study in Burkina Faso investigated whether offspring of young mothers who had received weekly periconceptional iron supplementation in a randomised controlled trial were at increased risk of malaria. A child safety survey was undertaken in the peak month of malaria transmission towards the end of the trial to assess child iron biomarkers, nutritional status, anaemia and malaria outcomes. Antenatal iron biomarkers, preterm birth, fetal growth restriction and placental pathology for malaria and chorioamnionitis were assessed. Data were available for 180 babies surviving to the time of the survey when their median age was 9 months. Prevalence of maternal iron deficiency in the last trimester based on low body iron stores was 16%. Prevalence of active placental malaria infection was 24.8%, past infection 59% and chorioamnionitis 55.6%. Babies of iron supplemented women had lower median gestational age. Four out of five children ≥ 6 months were iron deficient, and 98% were anaemic. At 4 months malaria prevalence was 45%. Child iron biomarkers, anaemia and malaria outcomes did not differ by trial arm. Factors associated with childhood parasitaemia were third trimester C-reactive protein level (OR 2.1; 95% CI 1.1-3.9), active placental malaria (OR 5.8; 1.0-32.5, P = 0.042) and child body iron stores (OR 1.13; 1.04-1.23, P = 0.002). Chorioamnionitis was associated with reduced risk of child parasitaemia (OR 0.4; 0.1-1.0, P = 0.038). Periconceptional iron supplementation of young women did not alter body iron stores of their children. Higher child body iron stores and placental malaria increased risk of childhood parasitaemia.
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