Prevalence of Wuchereria bancrofti infection in human and vector populations from Center-East, East and South-West regions of Burkina Faso: preliminary results

2020 ◽  
Author(s):  
Sanata Coulibaly ◽  
Aristide Sawdetouo Hien ◽  
Rabila Bamogo ◽  
Fabrice A. Some ◽  
Abdoulaye Diabaté ◽  
...  

Abstract Background To eliminate lymphatic filariasis (LF), since 2001, Burkina Faso adopted a community-based treatment with annual mass drug administration (MDA) of ivermectin-abendazole. However, after more than 11 rounds of MDA, it remained some hotpots where transmission is still being active. Therefore, to better scale up elimination measures toward 2030, it seems necessary to assess the prevalence of Wuchereria bancrofti both in human and vector populations. Methods Parasitological and entomological surveys were conducted in August 2014 and in September 2015, in six hotpots areas dispersed in Centre-East, East and South-West health regions for blood and vector’s collections. Nocturnal finger-prick blood samples and microscopic observations were performed to determine the prevalence of W. bancrofti in humans. Mosquitoes were collected by human landing catches and indoor spraying collections. They were identified morphologically and those of the Anopheles gambiae s.l. were confirmed by PCR. Then the W. bancrcofti prevalence within such vector populations was determined by conventional and LAMP PCR technique using the DNA of pooled mosquitoes grouped by species. Results The results highlighted the persistence of W. bancrofti infection both in human and vector populations after multiple rounds of MDA in the sites. The prevalence of W. bancrofti in human populations was reduced in 2015 compared to 2014. Within the An. gambiae s.l., only An. coluzzii was found infected by W. bancrofti respectively in Centre-East and East health regions, whereas An. nili was the most infected vector in Saptan in the South-West health region. Some specimens of An. funestus s.l. were tested positive to W. bancrofti with the LAMP PCR but failed to be confirmed by the conventional technique. Conclusions Despite the MDA campaigns supplied by vector control interventions relied on the mass coverage of insecticide treated nets, the incidence of LF is still effective in these hotspots but luckily in decreasing trend. The novelty is that An. nili was found infected by W. bancrofti that increased the number of potential vectors of W. bancfrofti in Burkina Faso.

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Sovannary Tuot ◽  
Alvin Kuo Jing Teo ◽  
Kiesha Prem ◽  
Pheak Chhoun ◽  
Chamroen Pall ◽  
...  

Abstract Background Multi-month dispensing (MMD) is the mainstay mechanism for clinically stable people living with HIV in Cambodia to refill antiretroviral therapy (ART) every 3-6 months. However, less frequent ART dispensing through the community-based ART delivery (CAD) model could further reduce the clients’ and health facilities’ burden. While community-based services have been recognized as an integral component of HIV response in Cambodia, their role and effectiveness in ART delivery have yet to be systematically assessed. This study aims to evaluate the CAD model’s effectiveness on the continuum of care and treatment outcomes for stable people living with HIV in Cambodia. Methods We will conduct this quasi-experimental study in 20 ART clinics across the capital city and nine provinces between May 2021 and April 2023. Study sites were purposively selected based on the availability of implementing partners, the number of people living with HIV each clinic serves, and the accessibility of the clinics. In the intervention arm, approximately 2000 stable people living with HIV will receive ART and services from the CAD model. Another 2000 stable people living with HIV in the control arm will receive MMD—a standard care model for stable people living with HIV. The primary outcomes will be retention in care, viral load suppression, and adherence to ART. The secondary endpoints will include health providers’ work burden, the model’s cost-effectiveness, quality of life, mental health, social support, stigma, and discrimination. We will compare the outcome indicators within each arm at baseline, midline, and endline using descriptive and inferential statistics. We will evaluate the differences between the intervention and control arms using the difference-in-differences method. We will perform economic evaluations to determine if the intervention is cost-effective. Discussion This study will build the evidence base for future implementation and scale-up of CAD model in Cambodia and other similar settings. Furthermore, it will strengthen engagements with community stakeholders and further improve community mobilization, a vital pillar of the Cambodian HIV response. Trial registration ClinicalTrials.gov, NCT04766710. Registered 23 February 2021, Version 1.


2021 ◽  
pp. 1-12
Author(s):  
David Y Zombré ◽  
Manuela De Allegri ◽  
Valéry Ridde ◽  
Kate Zinszer

Abstract Objective: To examine the effect of an intervention combining user fees removal with community-based management of undernutrition on the nutrition status in children under 5 years of age in Burkina Faso. Design: The study was a non-equivalent control group post-test-only design based on household survey data collected 4 years after the intervention onset in the intervention and comparison districts. Additionally, we used propensity score weighting to achieve balance on covariates between the two districts, followed by logistic multilevel modelling. Setting: Two health districts in the Sahel region. Participants: Totally, 1116 children under 5 years of age residing in 41 intervention communities and 1305 from 51 control communities. Results: When comparing children living in the intervention district to children living in a non-intervention district, we determined no differences in terms of stunting (OR = 1·13; 95 % CI 0·83, 1·54) and wasting (OR = 1·21; 95 % CI 0·90, 1·64), nor in severely wasted (OR = 1·27; 95 % CI 0·79, 2·04) and severely stunted (OR = 0·99; 95 % CI 0·76, 1·26). However, we determined that 3 % of the variance of wasting (95 % CI 1·25, 10·42) and 9·4 % of the variance of stunting (95 % CI 6·45, 13·38) were due to systematic differences between communities of residence. The presence of the intervention in the communities explained 2 % of the community-level variance of stunting and 3 % of the community-level variance of wasting. Conclusions: With the scaling-up of the national free health policy in Africa, we stress the need for rigorous evaluations and the means to measure expected changes in order to better inform health interventions.


BMJ Open ◽  
2021 ◽  
Vol 11 (7) ◽  
pp. e040352
Author(s):  
Avinash Sharma ◽  
Olusegun Isaac Alatise ◽  
Kelli O'Connell ◽  
Samson Gbenga Ogunleye ◽  
Adewale Abdulwasiu Aderounmu ◽  
...  

Background/aimsCancer burden is predicted to double by 2030 in sub-Saharan Africa; access to healthcare services for cancer management is a priority in the region. In Nigeria, National Cancer Control Plan aims to ensure >50% cancer screening of eligible populations by 2022 for all Nigerians. We describe healthcare utilisation, cancer screening activities and potential barriers to accessing cancer care within an understudied rural community-based adult population in South West Nigeria.MethodsIn April 2018, we conducted a cross-sectional study of community-based adults (>18 years) ~130 km east of Ibadan, 250 km from Lagos in Osun State, South West Nigeria. Participants completed a face-to-face survey in local dialect. We used a questionnaire to assess demographics, health status, income, medical expenditures, doctor visits and cancer screening history.ResultsWe enrolled 346 individuals: with median age of 52 years and 75% women. Of the entire cohort, 4% had medical insurance. 46% reported a major medical cost in the last year. Cancer screening activities were infrequent in eligible participants: 1.5% reported having had cervical cancer screening, 3.3% mammogram and 5% colonoscopy screening. Cancer screening assessment was less frequent in those with less income and lower education levels. Using a multivariable logistic regression model including personal income, insurance status and education, higher personal income was associated with more cancer screening activity (OR 2.7, 95% CI 1.3 to 5.7, p<0.01). Despite this, most individuals had contact with a primary healthcare doctor (52% in the last year), and over 70% access to radio and TV suggesting the opportunity to expand community-based screening interventions and awareness exists.ConclusionsDespite national increases in cancer cases, we highlight a deficiency in cancer screening and universal healthcare coverage within a community-based adult Nigerian population. Subject to availability of governmental resources, increasing financial risk protection, awareness and targeted resource allocation may help expand access in Nigeria.


Parasitology ◽  
1990 ◽  
Vol 101 (3) ◽  
pp. 429-434 ◽  
Author(s):  
P. K. Das ◽  
A. Manoharan ◽  
A. Srividya ◽  
B. T. Grenfell ◽  
D. A. P. Bundy ◽  
...  

SUMMARYThis paper examines the effects of host age and sex on the frequency distribution of Wuchereria bancrofti infections in the human host. Microfilarial counts from a large data base on the epidemiology of bancroftian filariasis in Pondicherry, South India are analysed. Frequency distributions of microfilarial counts divided by age are successfully described by zero-truncated negative binomial distributions, fitted by maximum likelihood. Parameter estimates from the fits indicate a significant trend of decreasing overdispersion with age in the distributions above age 10; this pattern provides indirect evidence for the operation of density-dependent constraints on microfilarial intensity. The analysis also provides estimates of the proportion of mf-positive individuals who are identified as negative due to sampling errors (around 5% of the total negatives). This allows the construction of corrected mf age–prevalence curves, which indicate that the observed prevalence may underestimate the true figures by between 25% and 100%. The age distribution of mf-negative individuals in the population is discussed in terms of current hypotheses about the interaction between disease and infection.


Author(s):  
Dominique Ouédraogo ◽  
Salifou Ouédraogo‐Koné ◽  
Bernadette Yougbaré ◽  
Albert Soudré ◽  
Bienvenue Zoma‐Traoré ◽  
...  

Author(s):  
Sabrina T. Wong ◽  
Julia M. Langton ◽  
Alan Katz ◽  
Martin Fortin ◽  
Marshall Godwin ◽  
...  

AbstractAimTo describe the process by which the 12 community-based primary health care (CBPHC) research teams worked together and fostered cross-jurisdictional collaboration, including collection of common indicators with the goal of using the same measures and data sources.BackgroundA pan-Canadian mechanism for common measurement of the impact of primary care innovations across Canada is lacking. The Canadian Institutes for Health Research and its partners funded 12 teams to conduct research and collaborate on development of a set of commonly collected indicators.MethodsA working group representing the 12 teams was established. They undertook an iterative process to consider existing primary care indicators identified from the literature and by stakeholders. Indicators were agreed upon with the intention of addressing three objectives across the 12 teams: (1) describing the impact of improving access to CBPHC; (2) examining the impact of alternative models of chronic disease prevention and management in CBPHC; and (3) describing the structures and context that influence the implementation, delivery, cost, and potential for scale-up of CBPHC innovations.FindingsNineteen common indicators within the core dimensions of primary care were identified: access, comprehensiveness, coordination, effectiveness, and equity. We also agreed to collect data on health care costs and utilization within each team. Data sources include surveys, health administrative data, interviews, focus groups, and case studies. Collaboration across these teams sets the foundation for a unique opportunity for new knowledge generation, over and above any knowledge developed by any one team. Keys to success are each team’s willingness to engage and commitment to working across teams, funding to support this collaboration, and distributed leadership across the working group. Reaching consensus on collection of common indicators is challenging but achievable.


2021 ◽  
Author(s):  
Anne L Wilson ◽  
Steve W Lindsay ◽  
Alfred Tiono ◽  
Jean Baptiste Yaro ◽  
Hilary Ranson ◽  
...  

Abstract Background Burkina Faso has one of the highest malaria burdens in sub-Saharan Africa despite the mass deployment of insecticide-treated nets (ITNs) and use of seasonal malaria chemoprevention (SMC) in children aged up to 5 years. Identification of risk factors for Plasmodium falciparum infection in rural Burkina Faso could help to identify and target malaria control measures. Methods A cross-sectional survey of 1,199 children and adults was conducted during the peak malaria transmission season in south-west Burkina Faso in 2017. Logistic regression was used to identify risk factors for microscopically confirmed P. falciparum infection. A malaria transmission dynamic model was used to determine the impact on malaria cases averted of administering SMC to children aged 5–15 year old. Results P. falciparum prevalence was 32.8% in the study population. Children aged 5 to < 10 years old were at 3.74 times the odds (95% CI = 2.68–5.22, p < 0.001) and children aged 10 to 15 years old at 3.14 times the odds (95% CI = 1.20–8.21, p = 0.02) of P. falciparum infection compared to children aged less than 5 years old. Administration of SMC to children aged up to 10 years is predicted to avert an additional 57 malaria cases per 1000 population per year (9.4% reduction) and administration to children aged up to 15 years would avert an additional 89 malaria cases per 1000 population per year (14.6% reduction) in the Cascades Region, assuming coverage of pyrethroid-piperonyl butoxide ITNs. Conclusion Malaria infections were high in all age strata, although highest in children aged 5 to 15 years, despite roll out of core malaria control interventions. Given the burden of infection in school-age children, extension of the eligibility criteria for SMC could help reduce the burden of malaria in Burkina Faso and other countries in the region.


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