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Nikiema L.,Institute of Research in Health science | Kameli Y.,Institute of Research for Development | Capon G.,Ouagadougou 01 | Sondo B.,Institute of Research in Health science | Martin-Prevel Y.,Ouagadougou 01
Journal of Health, Population and Nutrition | Year: 2010

Improving maternal health is one of the Millennium Development Goals of the United Nations. Despite the efforts to promote maternal and neonatal care to achieve this goal, the use of delivery care remains below expectations in Burkina Faso. This situation raises the question of the quality of care offered in maternity wards. The aim of this study was to identify primary healthcare facility and antenatal care characteristics predictive of an assisted delivery in rural Burkina Faso. A cross-sectional study was carried out in Gnagna province (North-East Burkina Faso) in November 2003. The operational capacities of health facilities were assessed, and a nonparticipating observation of the antenatal care (ANC) procedure was undertaken to evaluate their quality. Scores were established to summarize the information gathered. The rate of professional childbirth (obstetrical coverage) was derived from the number of childbirths registered in the health facility compared to the size of the population. The established scores were related to the obstetrical coverage using nonparametric tests (Kendall). In total, 17 health facilities were visited, and 81 antenatal consultations were observed. Insufficiencies were observed at all steps of ANC (mean total score for the quality of ANC=10.3±3.0, ranging from 6 to 16, out of a maximum of 20). Health facilities are poorly equipped, and the availability of qualified staff remained low (mean total score for the provision of care was 22.9±4.2, ranging from 14 to 33). However, these scores were not significantly related to the rate of professional childbirth (tau Kendall=0.27: p=0.14 and 0.01, p=0.93 respectively). The ability of the primary health centres to provide good antenatal care remains low in rural Burkina Faso. The key factors involved in the limited use of professional childbirth relating to maternal health services may be the quality of ANC. © International Centre for Diarrhoeal Disease Research, Bangladesh.


Roberfroid D.,Institute of Tropical Medicine | Huybregts L.,Center Muraz | Lanou H.,Institute of Research in Health science | Lanou H.,Ghent University | And 5 more authors.
American Journal of Clinical Nutrition | Year: 2012

Background: Although prenatal multiple micronutrients can improve fetal growth, their benefit on postnatal health remains uncertain. Objective: We assessed the effect of the UNICEF/WHO/United Nations University multiple micronutrient supplement for pregnant and lactating women (UNIMMAP) compared with the usual iron and folic acid supplement (IFA) on survival, growth, and morbidity during infancy. Design: In a double-blind, randomized trial, we followed 1294 singleton newborns whose mothers had prenatally received either the UNIMMAP or IFA. We assessed monthly anthropometric measures and health variables up to age 12 mo. Children were assessed again at a mean age of 30 mo. Mixed-effects models accounted for repeated measurements. Results: The UNIMMAP resulted in a 27% (HR: 0.73; 95% CI: 0.60, 0.87; P = 0.002) reduction in the rate of stunting in 15,261 infant-months with a higher length-for-age z score of 0.13 (95% CI: 0.02, 0.24; P = 0.02) over the whole observation period. However, by age 30 mo, this difference was not observed. An effect of the UNIMMAP on weight-for-length (P-interaction = 0.004) and head circumference-for-age (P-interaction = 0.03) became apparent by the end of the first year of life. By the age of 30 mo, children from the UNIMMAP group had a higher weight-for-height z score of 0.20 (95% CI: 0.06, 0.34; P = 0.004). No difference in mortality or morbidity was identified in groups, except a 14% reduction in reported episodes of fever (95% CI: 1%, 28%; P = 0.04). Conclusions: Improved linear fetal growth with continuation into early life and enhanced postnatal growth were 2 mechanisms that mediated the effect of the prenatal UNIMMAP on infant nutritional status. Additional follow-up to assess long-term effects is warranted. This trial was registered at clinicaltrials.gov as NCT00642408. © 2012 American Society for Nutrition.


Sagna T.,University of Ouagadougou | Sagna T.,Institute of Research in Health science | Bisseye C.,University of Ouagadougou | Bisseye C.,Université des Sciences et Techniques de Masuku | And 18 more authors.
Global Health Action | Year: 2015

Background: Vertical human immunodeficiency virus (HIV) transmission is a public health problem in Burkina Faso. The main objective of this study on the prevention of mother-to-child HIV-1 transmission was to determine the residual risk of HIV transmission in infants born to mothers receiving highly active antiretroviral therapy (HAART). Moreover, we detect HIV antiretroviral (ARV) drug resistance among mother-infant pairs and identify subtypes and circulating recombinant forms (CRF) in Burkina Faso. Design: In this study, 3,215 samples of pregnant women were analyzed for HIV using rapid tests. Vertical transmission was estimated by polymerase chain reaction in 6-month-old infants born to women who tested HIV positive. HIV-1 resistance to ARV, subtypes, and CRFs was determined through ViroSeq kit using the ABI PRISM 3,130 sequencer. Results: In this study, 12.26% (394/3,215) of the pregnant women were diagnosed HIV positive. There was 0.52% (2/388) overall vertical transmission of HIV, with rates of 1.75% (2/114) among mothers under prophylaxis and 0.00% (0/274) for those under HAART. Genetic mutations were also isolated that induce resistance to ARV such as M184V, Y115F, K103N, Y181C, V179E, and G190A. There were subtypes and CRF of HIV-1 present, the most common being: CRF06_CPX (58.8%), CRF02_AG (35.3%), and subtype G (5.9%). Conclusions: ARV drugs reduce the residual rate of HIV vertical transmission. However, the virus has developed resistance to ARV, which could limit future therapeutic options when treatment is needed. Resistance to ARV therefore requires a permanent interaction between researchers, physicians, and pharmacists, to strengthen the network of monitoring and surveillance of drug resistance in Burkina Faso. © 2015 Tani Sagna et al.


Ouedraogo H.Z.,Institute of Research in Health science | Traore T.,NutriFaso Project | Zeba A.N.,Institute of Research in Health science | Dramaix-Wilmet M.,Free University of Colombia | And 2 more authors.
Public Health Nutrition | Year: 2010

Objective To assess the effect of an improved local ingredient-based gruel fortified or not with selected multiple micronutrients (MM) on Hb concentration of young children.Design In a nutrition centre that we opened in their villages, children received either MM supplement (containing iron, zinc, vitamin A, vitamin C and iodine) with the improved gruel (MMGG) or the improved gruel only (GG), twice daily, 6 d/week, for 6 months. We assessed baseline and endpoint Hb concentration and anthropometric indices.Setting Kongoussi, a rural and poor district of Burkina Faso.Subjects In a community-based trial, we randomly assigned 131 children aged 6-23 months with Hb concentrations in the range of 80-109 g/l into two groups.Results The groups did not differ significantly at baseline. Mean baseline Hb concentration was 892 (sd 65) g/l and 903 (sd 84) g/l in the GG and the MMGG, respectively (P = 042). It increased to 1041 (sd 114) g/l in the GG (P < 0001) and 1076 (sd 147) g/l in the MMGG (P < 0001). The between-group difference of 35 (95 % CI 10, 81) g/l in mean (sd) endpoint Hb concentration was not significant (P = 013). The endpoint anthropometric indices were not different between the groups.Conclusions This MM supplement had no additional effect on Hb concentration. Thorough studies are needed to evaluate the actual efficacy of the gruel before its introduction into household routine. Copyright © 2010 The Authors.


PubMed | University of Ouagadougou, African Public Health Institute and Institute of Research in Health Science
Type: | Journal: International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics | Year: 2016

To determine the neonatal mortality rate among low birth weight infants, and identify the predictors of mortality during the neonatal period in two health districts in Burkina Faso.A prospective cohort study of live born babies delivered in health centers that weighed less than 2500 g. Their survival status at the end of the neonatal period was measured and analyzed using multivariate analysis in a Cox proportional hazards model.The study included 341 newborns (146 newborns from Kaya health district and 195 from Dori health district). The mean weight was 2158.2287.1g. Neonatal mortality was 53 per 1000 live births (18 deaths and 323 survivors), while the incidence density was 1.93 per 1000 persons/days (95% CINeonatal mortality among low birth weight infants in the study population was 53 per 1000 live births. This is higher than the 28 per 1000 live births reported by the 2010 Demographic Health Survey for the general population. Therefore, it is necessary to follow infants with low birth weight after they leave health centers.


PubMed | Institute of Research in Health science
Type: Journal Article | Journal: Public health nutrition | Year: 2010

To assess the effect of an improved local ingredient-based gruel fortified or not with selected multiple micronutrients (MM) on Hb concentration of young children.In a nutrition centre that we opened in their villages, children received either MM supplement (containing iron, zinc, vitamin A, vitamin C and iodine) with the improved gruel (MMGG) or the improved gruel only (GG), twice daily, 6 d/week, for 6 months. We assessed baseline and endpoint Hb concentration and anthropometric indices.Kongoussi, a rural and poor district of Burkina Faso.In a community-based trial, we randomly assigned 131 children aged 6-23 months with Hb concentrations in the range of 80-109 g/l into two groups.The groups did not differ significantly at baseline. Mean baseline Hb concentration was 892 (sd 65) g/l and 903 (sd 84) g/l in the GG and the MMGG, respectively (P = 042). It increased to 1041 (sd 114) g/l in the GG (P < 0001) and 1076 (sd 147) g/l in the MMGG (P < 0001). The between-group difference of 35 (95 % CI -10, 81) g/l in mean (sd) endpoint Hb concentration was not significant (P = 013). The endpoint anthropometric indices were not different between the groups.This MM supplement had no additional effect on Hb concentration. Thorough studies are needed to evaluate the actual efficacy of the gruel before its introduction into household routine.

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