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Mariamawit Negatou,1 Mady Ouedraogo,2 Philippe Donnen,3 Elisabeth Paul,3 Sekou Samadoulougou,4,5,* Fati Kirakoya-Samadoulougou1,* 1Centre de Recherche en Epidémiologie, Biostatistiques et Recherche Clinique, École de Santé Publique, Université Libre de Bruxelles, Bruxelles, Belgique; 2Institut National de la Statistique et de la Démographie (INSD), Ouagadougou, Burkina Faso; 3Centre de Recherche en Politiques et Systèmes de Santé – Santé Internationale, École de Santé Publique, Université Libre de Bruxelles, Bruxelles, Belgique; 4Centre for Research on Planning and Development (CRAD), Laval University, Quebec City, Quebec, G1V 0A6, Canada; 5Evaluation Platform on Obesity Prevention, Quebec Heart and Lung Institute, Quebec City, Quebec, G1V 4G5, Canada*These authors contributed equally to this workCorrespondence: Mariamawit NegatouCentre de Recherche en Épidémiologie, Biostatistique et Recherche Clinique, École de Santé Publique, Université Libre de Bruxelles, Bruxelles, BelgiqueTel +251911747363Email mariamawitbrouk@gmail.comBackground: In 2016, a free healthcare policy (FHP) was implemented in Burkina Faso for children under the age of five. In our study, we aimed to determine the prevalence of care-seeking for a fever in children under the age of five before and after the implementation of the FHP and to analyze the determinants of not seeking care under the FHP.Methods: The data of three nationally representative surveys were used to evaluate the trends of the prevalence of care-seeking. We performed a modified Poisson regression using a generalized estimating equation to determine the factors associated with not seeking care.Results: The prevalence for care seeking increased from 57.5% (95% CI, 54.2– 60.8) in 2014 to 72.3% (95% CI, 68.1– 76.2) in 2017. Children from the poor quintile were less likely to seek care when compared to children from the poorest quintile (prevalence ratio (PR) = 0.7 (95% CI, 0.5– 0.9)). Caregivers who did not have messages regarding malaria in the past six months were more likely not to seek care (PR = 0.8 (95% CI, 0.7– 0.9)). Caregivers of children aged 36– 59 months were more likely not to seek care compared to those aged < 12 months (PR = 1.6 (95% CI, 1.2– 2.1)). Children from the Boucle du Mouhoun region (PR = 1.9 (95% CI, 1.2– 3.2)) and the Centre-Est region (PR = 1.9 (95% CI, 1.2– 3.0)) were more likely not to seek care compared to children from the Sud Ouest region.Conclusion: Our study showed an increase in the prevalence of care-seeking after the implementation of the FHP. Even if this is encouraging, these findings highlight the critical importance of non-financial barriers to care-seeking. Maintaining FHP and tackling the barriers should be considered by policy makers to increase care-seeking.Keywords: fever, free healthcare policy, care-seeking, children under-five, Burkina Faso

Malnutrition, including deficiencies in micronutrients, stunting, wasting and underweight, is a public health concern among children under-five years in developing countries. Inadequate complementary feeding consisting of giving monotonous, low-energy and low-micronutrients dense cereal porridge is a common cause of malnutrition. The objective of this study was to identify and to assess the nutritional quality and the energy content of infant and young child homemade blended flours in the rural settings of Southwest Burkina Faso in order to promote blended flour recipes whose composition would be suitable as complementary foods for breastfed infants and young children in Burkina Faso. Cereal-based local blended flours were recorded through a survey in 10 villages. Five (5) recipes that contained at least one protein source (like beans or animal product) were selected for improvement and nutrient content analysis. Sensory evaluation of the porridge made from the blended flours was conducted using the infants, young children and mothers. The feasibility (cost and workload involved) have been also assessed among mothers. The energy content of analyzed blended flours ranged from 430 to 454 kcal/100g, with 11.5 to 14 g of protein. Flours were well accepted by children. The time required to prepare a blended flour recipe was estimated at 2 hours per week for one child, and all women interviewed found it acceptable. Flours recipes that used sugar were found costly and unaffordable by 40 to 50% of women according to the blended flour. Taking into account the cost, two blended flours recipes were preferred: Flour recipe A: Pearl millet (48%), beans (7%), peanuts (23%), sumbala (fermented seed of Parkia biglobosa) (7%), and monkey bread (15%). Flour recipe B: Pearl millet (48%), beans (7%), peanuts (26%), small fish powder (4%), and monkey bread (15%). All the five blended flours met the minimum recommended energy density for complementary food of 400 kcal/100g. However, except for vitamin C, the micronutrients contents were insufficient. To address micronutrients deficiencies in this rural setting of Burkina Faso, additional sources of micronutrients should be given to children. Key words: Child nutrition, complementary feeding, local foods, sub-Saharan Africa, INTRODUCTION Malnutrition, including deficiencies in micronutrients, stunting, wasting, and underweight, is a public health concern in developing countries. In 2011, more than 92% and 96% of stunted and wasted children [...]

ABSTRACT Repositioning nutrition is central to development. Childcare practices, which include feeding practices, appear in the conceptual framework of malnutrition. The objective of this study was to analyze the nutritional [...]

Deficiency of hepatic vitamin A and protein-energy malnutrition are seen in a significant population of pre-school children in the Kivu province, Zaire. Relative Dose Response tests reveal that the mean serum albumin concentration and nutritional status of most children compare well with global values. The vitamin A deficiency produces few clinical cases of night blindness. The possible reasons for the absence of clinical signs of the deficiency are discussed.

Introduction: To reverse the trends of the acquired immune deficiency syndrome (AIDS) epidemic, reinforcement of personal protection and antiretroviral treatment (ART) initiation at right time are needed. The aim of the study was, a decade after expanding AIDS medical care, to explore facilitating factors or those contributing to uptake or delay of human immunodeficiency virus (HIV) testing among individuals who access voluntary counselling and testing (VCT) in an urban area of the Democratic Republic of Congo (DRC). Material and methods: A cross-sectional survey carried out among individuals attending three VCT centres in Kinshasa, DRC. Results: A total of 388 individuals with mean age 42 (9.4) years were included. Among them 34% were married, and 96% were living at home. Morbid and social events were the most important reasons cited for uptake of HIV testing in urban areas. Among the most common barriers of the HIV testing observed, stigma was the first reason significantly prevalent cited among man while fear to know the HIV status, ignorance of seropositivity concepts and the existence of VCT screening were prevalent among females. Conclusions: Two main events influencing the uptake of HIV testing and commonly known barriers to this were cited. These results generate questions about a fringe of the population, and call for further research for improved prevention policy. [ABSTRACT FROM AUTHOR]

Background: DR Congo has adopted universal salt iodization to reduce disorders due to iodine deficiency. Since 1994, only iodized salt can be imported, but there is currently no routine monitoring of the iodine content of distributed salt. It is therefore unclear if iodine deficiency remains a health problem, particularly in pregnant women.Objective: To evaluate the iodine content of salt in households of pregnant women in Lubumbashi.Methods: We conducted a survey of the iodine content of salt consumed by 375 women presenting at prenatal consultations in three socially different areas of Lubumbashi: urban, semiurban, and rural. The women were questioned about where they purchased salt, how it was packaged, and how they stored the salt, and each woman provided a sample of salt for determination of its iodine content by the iodometric method.Results: Most women (84.3%) bought salt in the public markets, mainly in bulk (93.6%); 80.0% stored salt in plastic boxes. The median iodine content was 27.5 ppm (IQR, 16.0-38.1) in urban areas, 19.0 ppm (IQR, 7.4-31.7) in semiurban areas, and 20.1 ppm (IQR, 5.3-31.7) in rural areas. The iodine content was less than 15 ppm (minimum threshold) in 36.3% of samples, including 13.9% without any detectable iodine. The iodine content was above 40 ppm (maximum limit) in 18.9% of samples. Only 44.8% of salt samples had adequate iodine content.Conclusions: The population of Lubumbashi remain at risk for hypothyroidism and hyperthyroidism. A effective and regular system for the control of iodin content in distributed salt is needed in DR Congo. [ABSTRACT FROM AUTHOR]

Background: Food technology transfer to rural households, based on local ingredients, is a relevant and sustainable strategy to ensure better nutrition of young children. Objective. To develop an improved mush based on local ingredients and evaluate the potential for transferring its technology to rural housewives.Methods: We developed a flour-based food using Alicom software and performed laboratory trials to evaluate its actual nutritional quality. Then we recruited housewives from each of the 27 project villages and trained them in flour production and mush preparation twice daily, 6 days a week, for 26 weeks. Mush was sampled during the training session and at weeks 4, 12, and 22 and evaluated for actual flow distance and dry matter content, which served to estimate energy density and iron and zinc contents.Results: The laboratory trials reported average energy densities of 103 kcal/l00 g, iron contents of 2.6 mg/100 kcal, and zinc contents of 1.2 mg/100 kcal. The average (+/- SD) energy densities of the mush samples obtained during the training session and at weeks 4, 12, and 22 were 103.0 +/- 5.6, 103.3 +/- 5.2, 107.9 +/- 11.5, and 101.3 +/- 8.7 kcal/100 g, respectively. The average iron contents were 2.3 +/- 0.5, 2.3 +/- 0.5, 2.6 +/- 0.3, and 1.8 +/- 0.8 mg/ 100 kcal, respectively, and the average zinc contents were 1.6 +/- 0.1, 1.6 +/- 0.1, 1.7 +/- 0.1, and 1.6 +/- 0.2 mg/100 kcal.Conclusions: Developing a suitable complementary food from local ingredients and educating households in nutrition and use of local products are feasible. Such education should come with measures aimed at improving the accessibility of some ingredients to ensure feasibility and sustainability. [ABSTRACT FROM AUTHOR]

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