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Background: Burkina Faso is one of the countries in West Africa most affected by the HIV/AIDS pandemic, despite the implementation of a mother-to-child HIV transmission prevention program as a strategy to reduce the risk of vertical transmission of the disease. Objective: To assess the current risk of mother-to-child transmission of HIV in Burkina Faso. Materials and methods: A prospective study was conducted between December 2014 and July 2016, in the 13 health regions of Burkina Faso. Women who were screened HIV-positive during a prenatal consultation were followed until delivery. Their babies received dry blood spot (DBS) at birth, at week 6 and at 1year, to screen for HIV. Results: Overall, 186 pregnant women were included in the study, with a mean age of 29.17±6.13 years. Of their children, 430 DBS actually received a PCR test, giving a 91.1% PCR implementation rate. After analyses, 6 (1.3%) babies were identified as carriers of HIV1. The newborn’s serological status was associated with delivery pattern (p=0.000), the administration of antiretroviral drugs to the mother after delivery (p=0.0064), the administration of Nevirapine to the newborn at birth (p=0.022), the use of contraceptive methods after delivery (p=0.028) and the presence of breast affections/infections since delivery (p=0.013). Conclusion: The results of our study are encouraging and demonstrate the effectiveness of interventions in the mother-tochild prevention program (PMTCT) for HIV-positive pregnant women can be improved through early initiation of triple therapy in early pregnancy and improved adherence to antiretroviral (ARV) therapy. Keywords: Burkina Faso, HIV/AIDS, mother-to-child transmission, antiretroviral drugs, pregnant women

Study objective The protocol for the use of the automated external defibrillator calls for a period of "hands-off" time, during which no cardiopulmonary resuscitation (CPR) can be performed. We assessed the actual interruption time of CPR during the use of the automated external defibrillator in patients in out-of-hospital cardiac arrest. Methods This study included 184 patients experiencing out-of-hospital cardiac arrest in which an automated external defibrillator was applied by first responders. ECG and voice recordings from the automated external defibrillator were downloaded and analyzed. Start and end times of CPR were recorded, as were intervals measured from the recordings concerning the programmed interruption time and the interruption time related to performance. Results The automated external defibrillators were connected for a median time of 4 minutes 47 seconds (range 31 to 1,404 seconds). CPR was performed during 45%±15% (mean±SD) of the connected time or until return of spontaneous circulation. During the automated external defibrillator connection time in the 96 patients with a shockable rhythm, CPR was performed 36%±20% of the time. Programmed interruption of CPR took 40%±15% of the automated external defibrillator connection time, and no CPR was performed related to performance during 23%±15% of the time. A palpable pulse was never present immediately after a shock, and return of spontaneous circulation was observed in 3 of 184 patients before arrival of the ambulance. Ultimately, return of spontaneous circulation occurred in 87 of 184 patients. Conclusion First responders using automated external defibrillator voice prompts provide CPR less than half the time that the automated external defibrillator is connected to the patient. Technical improvements in automated external defibrillator rhythm analysis, more efficient resuscitation algorithms, and first-responder education could increase CPR delivery and, perhaps, improve outcome.

To determine the prevalence of HIV infection among pregnant women in Burkina Faso and to identify factors associated with HIV infection in this population, we performed in 4 antenatal clinics in 4 urban centres located in the centre, the north, the east and the south-west of the country cross-sectional serological surveys between 7 October 1994 and 7 February 1995 using unlinked anonymous HIV screening method. In the towns included in the study more than 94% of pregnant women attend at least 2 antenatal consultations. In each centre all pregnant women attending an antenatal consultation during a 2-week period were invited to take part in a study to measure the prevalence of syphilis. Women with positive syphilis serology were offered treatment free of charge. A total of 1294 pregnant women were recruited into the study. There were no refusals. Thirty-two women (2.5%) had positive syphilis serology. The overall seroprevalence of HIV infection was 8% (95% confidence interval [CI]: 6.6-9.6). There was no evidence that the prevalence of syphilis or HIV infection varied between the 4 towns ( P =0.12 and 0.52 respectively). In logistic regression analyses only the presence of syphilis infection was associated with risk of HIV (odds ratio=3.4; 95% CI: 1.4-7.9). The prevalence of syphilis among pregnant women in Burkina Faso is relatively low compared with that of HIV infection. These results suggest that HIV epidemic in Burkina Faso is important and that there is an urgent need to intensify HIVprevention activities. The need for HIV surveillance in this sentinel population is urgent to follow the course of the epidemic and to measure the impact of interventions. One of the consequences of the high prevalence of HIV infection among pregnant women which requires greater attention in Burkina Faso is the increasing number of children who will be infected with HIV by vertical transmission.

Objective: The objective of this study was to develop comprehensive guidelines for medical care during mass gatherings based on the experience of providing medical support during rave parties.Methods: Study design was a prospective, observational study of self-referred patients who reported to First Aid Stations (FASs) during Dutch rave parties. All users of medical care were registered on an existing standard questionnaire. Health problems were categorized as medical, trauma, psychological, or miscellaneous. Severity was assessed based on the Emergency Severity Index. Qualified nurses, paramedics, and doctors conducted the study after training in the use of the study questionnaire. Total number of visitors was reported by type of event.Results: During the 2006–2010 study period, 7,089 persons presented to FASs for medical aid during rave parties. Most of the problems (91.1%) were categorized as medical or trauma, and classified as mild. The most common medical complaints were general unwell-being, nausea, dizziness, and vomiting. Contusions, strains and sprains, wounds, lacerations, and blisters were the most common traumas. A small portion (2.4%) of the emergency aid was classified as moderate (professional medical care required), including two cases (0.03%) that were considered life-threatening. Hospital admission occurred in 2.2% of the patients. Fewer than half of all patients presenting for aid were transported by ambulance. More than a quarter of all cases (27.4%) were related to recreational drugs.Conclusions: During a five-year field research period at rave dance parties, most presentations on-site for medical evaluation were for mild conditions. A medical team of six healthcare workers for every 10,000 rave party visitors is recommended. On-site medical staff should consist primarily of first aid providers, along with nurses who have event-specific training on advanced life support, event-specific injuries and incidents, health education related to self-care deficits, interventions for psychological distress, infection control, and disaster medicine. Protocols should be available for treating common injuries and other minor medical problems, and for registration, triage, environmental surveillance and catastrophe management and response.

Our objective was to propose a strategy to screen HIV-infected African people for biological immunodeficiency easily. In a cross-sectional study, we analysed the patterns of diseases and of CD4 counts among 266 HIV-infected adults. Peripheral facial paralysis and chronic cutaneo-mucous diseases were the earlier B-stage diseases. Pulmonary tuberculosis was close to B-stage diseases, and chronic diarrhoea was borderline between B and C stages. Cachexia was the most frequent C-stage symptom (47.8%). Ninety per cent of CDC-C stage people had CD4 counts below 350/microliter, whereas only 75% had CD4 counts below 200/microliter. Regression analysis identified the lymphocyte count, clinical stage and platelet count as predictors of CD4 count below 350/microliter. A simple score (lymphocyte countor = 2500/microliter and clinical stageor = B) is proposed to determine this CD4 threshold (positive predictive value: 83%) and to determine those patients needing treatment to prevent wasting and opportunistic infections.Findings are presented from a cross-sectional study conducted in 1995 in Bobo-Dioulasso, Burkina Faso, in which the patterns of diseases and CD4 counts among 266 HIV-infected adults of mean age 33 years were analyzed. The bioclinical spectrum of subjects' HIV disease is described and a simple alternative proposed to CD4 enumeration for screening and monitoring HIV-infected Africans. Dermatological symptoms and diarrhea were the most frequent signs associated with B-stage disease, while cachexia and digestive candidosis were the most frequent AIDS-defining diseases (ADD). Peripheral facial paralysis and cutaneo-mucous diseases were associated with weak immune deficiency. Pulmonary tuberculosis (TB) was close to B-stage diseases, and chronic diarrhea was borderline between B and C stages. Cachexia was the most frequent C-stage symptom (47.8%). 90% of CDC C-stage subjects had CD4 counts of less than 350 per mcl, while only 75% had CD4 counts under 200/mcl. Regression analysis identified the lymphocyte count, clinical stage, and platelet count as predictors of CD4 count below 350/mcl. A lymphocyte count of less than or equal to 2500/mcl and clinical stage of B or higher is proposed to determine the CD4 threshold and to determine those patients in need of treatment to prevent wasting and opportunistic infections.

Summary: Little information is available regarding human immunodeficiency virus (HIV) infection among female sex workers (FSW) in Burkina Faso, West Africa. A cross-sectional study was conducted in Ouagadougou and Bobo-Dioulasso, the 2 largest cities of the country, to determine the prevalence of HIV infection and other sexually transmitted diseases (STDs) among FSWs, and to investigate the factors which were associated with HIV infection in this population. From October to November 1994, 426 FSWs were recruited. The method of anonymous and unlinked HIV screening recommended by the World Health Organization (WHO) was used. The overall HIV seroprevalence was 58.2% (95% confidence interval: 53.4-62.9) and 52.6% of FSWs had at least one STD agent. The most common STDs were trichomoniasis (23%), syphilis (15%) and gonorrhoea (13%). In a logistic regression analysis, risk factors for HIV infection were high gravidity ( 2 pregnancies), low perception of personal risk of HIV infection, syphilis and the presence of genital warts. These results suggest that FSWs in Burkina Faso need better information about HIV transmission and prevention and then need better access to STD detection and management services.

We evaluated the immunoglobulin G (IgG) antibody response to the 45/47-kDa secreted protein of Mycobacterium tuberculosis by immunoblot assay, to assess its potential value for serological diagnosis. Control subjects consisted of healthy volunteers with negative or positive tuberculin skin tests. Most (>98%) scored negative in an immunoblot test when the sera were analyzed at a 1:400 dilution. Approximately 40% of sera (diluted 1 in 400) from tuberculous patients (positive smears) recognized the antigen complex. The sensitivity of the test for patients suffering from extrapulmonary tuberculosis was similar to that for patients suffering from pulmonary tuberculosis but who had negative smears. The frequency of positive reactions among the patients suffering from other pulmonary diseases was similar to that among the control subjects. In tuberculous patients infected with human immunodeficiency virus, the sensitivity of the immunoblot test was significantly lower. Thus, this test based on an antigen complex used in an immunoblot assay to detect the presence of IgG antibody has a specificity of 98% and a sensitivity of 40%. The simultaneous use of different purified antigens, selected at the same high specificity level, may improve the sensitivity of such an assay.