Acceptability and feasibility of infant-feeding options: experiences of HIV-infected mothers in the World Health Organization Kesho Bora mother-to-child transmission prevention (PMTCT) trial in Burkina Faso.

In Burkina Faso, prolonged breastfeeding with introduction of ritual fluids from birth is a deep-seated norm. We explored HIV-infected mothers' views and experiences of the acceptability and feasibility of the World Health Organization's recommended infant-feeding options within a mother-to-child-transmission prevention trial. A qualitative study was conducted on 17 formula-feeding and 19 breastfeeding mothers, from a larger cohort of 51 eligible HIV-infected women, consenting to participate in separate focus group discussions in early post-partum.

Epidemiology of herpes simplex virus type 2 infection in rural and urban Burkina Faso.

Background: Herpes simplex virus type 2 (HSV-2) infection enhances human immunodeficiency virus (HIV) susceptibility and may increase sexual transmission, but few data on HSV-2 prevalence are available from West Africa. The main objective of this study was to describe the prevalence and determinants of HSV-2 among adults in urban and rural Burkina Faso.

Methods: We conducted (i) a 2-stage clustered population-based survey among adults aged 15 to 49 years in Ouagadougou (N = 883 women and 791 men), the capital city of Burkina Faso, and (ii) a cross-sectional study among attendees (N = 2018) of all 98 antenatal clinics from 4 provinces of the country.

In vitro antioxidant, xanthine oxidase and acetylcholinesterase inhibitory activities of Balanites aegyptiaca (L.) Del. (Balanitaceae).

The present study aimed to test the validity of Balanites aegyptiaca remedies used for the treatment of rheumatisms and mental disorders by examining the antioxidant, xanthine oxidase and acetylcholinesterase inhibitory activities of galls and leaves extracts and fractions. The total phenolics and flavonoids were measured using Folin-Ciocalteu and AlCl3 reagents, respectively. Two methods i.

Perinatal mortality in rural Burkina Faso: a prospective community-based cohort study.

Background: There is a scarcity of reliable data on perinatal mortality (PNM) in Sub-Saharan Africa. The PROMISE-EBF trial, during which we promoted exclusive breastfeeding, gave us the opportunity to describe the epidemiology of PNM in Banfora Health District, South-West in Burkina Faso.

Study Objectives: To measure the perinatal mortality rate (PNMR) in the PROMISE-EBF cohort in Banfora Health District and to identify potential risk factors for perinatal death.

Dried blood spot HIV-1 RNA quantification using open real-time systems in South Africa and Burkina Faso.

There is an urgent need to assess the accuracy/feasibility of using dried blood spots (DBS) for monitoring of HIV-1 viral load in resource-limited settings. A total of 892 DBS from HIV-1-positive pregnant women and their neonates enrolled in the Kesho Bora prevention of mother-to-child transmission trial conducted in Durban (South Africa) and Bobo-Dioulasso (Burkina Faso) between May 2005 and July 2008 were tested for HIV-1 RNA. The combination Nuclisens extraction method (BioMérieux)/Generic HIV Viral Load assay (Biocentric) was performed using one DBS (in Durban) versus 2 DBS (in Bobo-Dioulasso) on 2 distinct open real-time polymerase chain reaction instruments.

Low seroprevalence of syphilis in Burkina Faso.

Background: Little information is available on the epidemiology of syphilis in West Africa, where this infection is routinely screened in antenatal clinics to prevent congenital infection. In order to inform control programmes, the burden of active syphilis was estimated among pregnant women and adults in Burkina Faso.

Methods: This study enrolled 2136 pregnant women from 98 healthcare facilities and 1679 consenting women and men from the general population of Ouagadougou, the capital city.

Effect of maternal multiple micronutrient supplements on cord blood hormones: a randomized controlled trial.

Background: Fetal growth improves in pregnant women who take daily maternal multiple micronutrients [United Nations International Multiple Micronutrient Preparation (UNIMMAP)] rather than iron and folic acid (IFA) alone.

Objective: Our objective was to test whether such an effect was mediated by changes in concentrations of cord hormones.

Design: In a double-blind, controlled trial carried out in Burkina Faso, we randomly assigned 1426 pregnant women to receive UNIMMAP or IFA supplements.

Universal antiretroviral therapy for pregnant and breast-feeding HIV-1-infected women: towards the elimination of mother-to-child transmission of HIV-1 in resource-limited settings.

Prevention of mother-to-child transmission (MTCT) of human immunodeficiency virus type 1 (HIV-1) remains a challenge in most resource-limited settings, particularly in Africa. Single-dose and short-course antiretroviral (ARV) regimens are only partially effective and have failed to achieve wide coverage despite their apparent simplicity. More potent ARV combinations are restricted to pregnant women who need treatment for themselves and are also infrequently used.

Prenatal food supplementation fortified with multiple micronutrients increases birth length: a randomized controlled trial in rural Burkina Faso.

Background: Prenatal multiple micronutrient (MMN) or balanced energy and protein supplementation has a limited effect on birth size of the offspring.

Objective: The objective was to determine whether a prenatal MMN-fortified food supplement (FFS) improves anthropometric measures at birth compared with supplementation with an MMN pill alone.

Design: We conducted a nonblinded, individually randomized controlled trial in 1296 pregnant women in 2 villages in rural Burkina Faso.

[Epidemiology and prognostic factors for sickle cell retinopathy in Ouagadougou (Burkina Faso)].

Introduction: The frequency of sickle cell disease varies from 5% to 20% in Africa.

Patients And Method: This retrospective study investigated 173 patients in an ambulatory setting from August 2000 to July 2006. The study included 98 women and 75 men, aged 15-62 years, with a mean age of 26.

Human milk-derived B cells: a highly activated switched memory cell population primed to secrete antibodies.

While secretory Abs have been extensively explored in human breast milk, the existence, features, and functions of B lymphocytes remain largely unexplored in this compartment. We analyzed breast milk and blood lymphocytes from 21 lactating women, including 12 HIV-1-infected mothers. Breast milk B cells displayed a phenotype of class-switched memory B cells, with few IgD(+) memory and naive B cells.

A cost-effectiveness study of caesarean-section deliveries by clinical officers, general practitioners and obstetricians in Burkina Faso.

Background: The aim of this paper was to evaluate the effectiveness and cost-effectiveness of alternative training strategies for increasing access to emergency obstetric care in Burkina Faso.

Methods: Case extraction forms were used to record data on 2305 caesarean sections performed in 2004 and 2005 in hospitals in six out of the 13 health regions of Burkina Faso. Main effectiveness outcomes were mothers' and newborns' case fatality rates.

From evaluating a Skilled Care Initiative in rural Burkina Faso to policy implications for safe motherhood in Africa.

Evaluation findings from a particular setting need to be generalized into policy implications if they are to find widespread use. Skilled attendance at delivery is widely regarded as one of the most important intervention strategies for safe motherhood in low-resource settings, particularly in Africa, but implementations of such strategies are often not rigorously evaluated or interpreted into future policy. Initiative for Maternal Mortality Programme Assessment (Immpact) has applied a package of research-based monitoring and evaluation tools to assess the Family Care International Skilled Care Initiative in Ouargaye District, Burkina Faso.

[Lacquer cracks complicated with choroidal neovascularization in pseudoxanthoma elasticum: the first case report in Burkina Faso].

Lacquer cracks are breaks in the Bruch membrane by alteration of the elastic layer. They are often associated with pseudoxanthoma elasticum. The authors report the first case in Burkina Faso involving a 51-year-old woman who was seen for visual acuity loss.

Effects of a Skilled Care Initiative on pregnancy-related mortality in rural Burkina Faso.

Objective: The aim of this paper is to assess to what extent a Skilled Care Initiative (SCI) was associated with pregnancy-related mortality in Ouargaye district, Burkina Faso.

Methods: We used a quasi-experimental design to compare pregnancy-related mortality within the intervention district (health facility areas covered by the SCI vs. areas not covered) and between the intervention district (Ouargaye) and a comparison district (Diapaga).

Accessibility and utilisation of delivery care within a Skilled Care Initiative in rural Burkina Faso.

Objectives: The Skilled Care Initiative (SCI) was a comprehensive skilled attendance at delivery strategy implemented by the Ministry of Health and Family Care International in Ouargaye district (Burkina Faso) from 2002 to 2005. We aimed to evaluate the relationships between accessibility, functioning of health centres and utilisation of delivery care in the SCI intervention district (Ouargaye) and compare this with another district (Diapaga).

Methods: Data were collected on staffing, equipment, water and energy supply for all health centres and a functionality index for health centres were constructed.

Direct data capture using hand-held computers in rural Burkina Faso: experiences, benefits and lessons learnt.

Objectives: To assess our experiences of using hand-held computers (personal digital assistants, PDAs) for direct data capture in a large community-based geo-referenced survey in rural Burkina Faso, highlighting benefits and lessons learnt from their use.

Methods: A population-based geo-referenced survey of over 500 000 people was undertaken using PDAs with in-built GPS receivers and the resulting database analysed in terms of successful completion, error rates and interview durations.

Results: Surveys were successfully completed for 84 861 households (98.

Methods for evaluating effectiveness and cost-effectiveness of a Skilled Care Initiative in rural Burkina Faso.

Introduction: This paper aims to describe the design, methods and approaches used to assess the effectiveness and cost-effectiveness of the Skilled Care Initiative in reducing pregnancy-related and perinatal mortality in Ouargaye district, Burkina Faso.

Methods: The evaluation used a quasi-experimental design, mixed methods and a composite of tools to compare mortality and severe morbidity (near-miss) of women in reproductive age, perinatal mortality, facility functionality, perceived quality of care, utilisation of maternal health services, and costs borne by families and the health care system for maternal health care in Ouargaye and Diapaga districts. Structured questionnaires and interview guides were developed, pre-tested and piloted prior to the main survey.

Evaluating skilled care at delivery in Burkina Faso: principles and practice.

There are strong expectations of what could be achieved by skilled care at delivery for maternal and newborn survival and health. Meeting these expectations involves the translation of the concepts and principles of skilled attendance into the reality of routine programmes. This process of translation brings to light some of the tensions which lie behind the consensus on the ideal package and particularly the alternative configurations of provider and place necessary in the immediate term.

Undertaking a complex evaluation of safe motherhood in rural Burkina Faso.

Evaluations of composite health interventions, such as those attempting to make motherhood safer, are by definition complex, but nevertheless regarded as essential to informing progress in global health. This paper introduces a series of reports which set out the basis of Family Care International's Skilled Care Initiative in rural Burkina Faso, go on to describe strategies and methods for evaluating it, and present evaluation findings in terms of pregnancy outcomes, utilisation and effects of the intervention and economics. Although there were encouraging findings, no 'magic bullets' emerged from these studies, illustrating the reality that sustained and increasing resources are needed to achieve safe motherhood for all.

Effects of maternal multiple micronutrient supplementation on fetal growth: a double-blind randomized controlled trial in rural Burkina Faso.

Background: Intrauterine growth retardation is a major predictor of child health in developing countries.

Objective: We tested whether providing pregnant women with the UNICEF/WHO/UNU international multiple micronutrient preparation (UNIMMAP), rather than iron and folic acid alone, improved fetal growth and its correlates.

Design: An intention-to-treat, double-blind, randomized controlled trial including 1426 pregnancies was carried out in rural Burkina Faso.