Quality Of Antenatal Care In Rural Southern Tanzania: A Reality Check.

Counselling on the danger signs of unpredictable obstetric complications and the appropriate management of such complications are crucial in reducing maternal mortality. The objectives of this study were to identify gaps in the provision of ANC services and knowledge of danger signs as well as the quality of care women receive in case of complications. The study took place in the Rufiji District of Tanzania in 2008 and was conducted in seven health facilities. The study used (1) observations from 63 antenatal care (ANC) sessions evaluated with an ANC checklist, (2) self-assessments of 11 Health workers, (3) interviews with 28 pregnant women and (4) follow-up of 12 women hospitalized for pregnancy-related conditions.Blood pressure measurements and abdominal examinations were common during ANC visits while urine testing for albumin or sugar or haemoglobin levels was rare which was often explained as due to a lack of supplies. The reasons for measuring blood pressure or abdominal examinations were usually not explained to the women. Only 15/28 (54%) women were able to mention at least one obstetric danger sign requiring medical attention. The outcomes of ten complicated cases were five stillbirths and three maternal complications. There was a considerable delay in first contact with a health professional or the start of timely interventions including checking vital signs, using a partograph, and detailed record keeping. Linking danger signs to clinical and laboratory examination results during ANC with the appropriate follow up and avoiding delays in emergency obstetric care are crucial to the delivery of coordinated, effective care interventions

Effets de l'incorporation de la biomasse d'azolla (azolla pinnata) sechee dans les rations du poulet en aviculture traditionnelle amelioree

Une étude sur l’effet de l’incorporation de la farine de l’Azolla pinnata dans la ration alimentaire des poulets de chair en vue d’évaluer leurs performances de croissance a été conduite sur 120 poussins âgés de 21 jours. Le soja torréfié utilisé comme témoin a été substitué partiellement par la farine d’A. pinnata à des taux de 0 ; 5,5 et 12 % correspondant à trois (3) traitements (T0, T1 et T2). Les résultats ont montré que la substitution partielle a eu un effet sur les poids vifs, les gains moyens quotidiens, la consommation alimentaire, l’indice de consommation des sujets, Les Poids vifs moyens étaient de 1393,00 ± 24,17g pour T2 comparable aux poids vifs moyens de T1 qui étaient de 1314,53 ± 21g et T0 qui étaient de 1251,67 ± 23,7g. Les indices de consommation étaient de 3,56 ± 0,32 ; 3,78 ± 0,33 ; 3,55 ± 0,26 respectivement pour T2, T1 et T0. Il n’y a pas eu de différence statistiquement significative (P >0,05) entre les différents traitements au seuil de 5 %. Le coût de l’alimentation / kg de poulet de chair et le coût total / kg de poulet de chair étaient les plus bas au niveau de T2. Dans cette expérience l’incorporation d’Azolla jusqu’à 12 % dans la ration a amélioré le gain de poids corporel et la consommation d’aliments chez le poulet de chair. ABSTRACTEFFECTS OF INCORPORATING DRIED AZOLLA (AZOLLA PINNATA) BIOMASS IN CHICKEN RATIONS IN IMPROVEDTRADITIONAL POULTRY FARMINGA study on the effect of incorporating flour from Azolla pinnata in the feed ration of broilers to assess their growth performance was carried out on 120 chicks aged 21 days. The roasted soybean used as a control was partially substituted with A. pinnata flour at levels of 0; 5.5 and 12% corresponding to three (3) treatments (T0, T1, T2). Results showed that partial substitution had an effect on body weight, meandaily gain, food consumption, subjects consumption index, mean body weight was 1393.00 ± 24.17g for comparable T2 the mean live weights of T1 which were 1314.53 ± 21g and T0 which were 1251.67 ± 23.7g. The consumption indices were 3.56 ± 0.32; 3.78 ± 0.33; 3.55 ± 0.26 respectively for T2, T1 and T0. There was no statistically significant difference (P> 0.05) between the different treatments at the5% level. Feed cost / kg broiler and total cost / kg broiler were the lowest at T2 level. In this experiment, incorporating Azolla up to 12% into the ration improved body weight gain and feed consumption in broilers

Community quality control monitoring of latrines and boreholes in the Central North Region of Burkina Faso

With funding from the Leona M. and Harry B. Helmsley Charitable Trust, Catholic Relief Services implemented the Kom-Yilma project, “Happy and Healthy Children.” The program served 118 schools in two provinces in the Central North region of Burkina Faso, Bam and Sanmatenga, from March 2014 to August 2017. The purpose of the program was to encourage the adoption of key hygiene practices by the teachers, students, as well as to facilitate access to water and sanitation through social behavior change strategies and by building sex segregated, child-friendly latrines and boreholes. The Kom-Yilma team developed a community accountability approach to more effectively empower and involve local communities in the process of constructing sound infrastructure. This strategy not only ensures the construction quality of the latrines and boreholes, but also sustainable buy-in and community ownership of these new latrines and boreholes so the communities maintain them after the project

Optimisation de la production de biométhane à partir des déchets organiques municipaux

La gestion des déchets municipaux est devenue une préoccupation majeure dans les pays en développement, due au manque de politique et de stratégie adaptées. L’étude réalisée a porté sur la valorisation biotechnologique de la fraction biodégradable des déchets au Burkina Faso. Une analyse physico-chimique des déchets échantillonnés dans trois (3) centres de précollecte de déchets municipaux de Ouagadougou a été réalisée. L’influence du type d’inoculum (eaux usées, bouse bovine, flux de broyat de termites et une mixture de ces 3 inocula) et de la charge en substrat (déchets organiques) a été évaluée au cours d’essais de fermentation méthanique. Les résultats obtenus ont montré que les déchets organiques municipaux constituent un substrat de prédilection pour la méthanisation avec un ratio C/N de 31,65. Les essais de fermentation ont permis de noter que la bouse bovine comme inoculum avec une charge en déchets municipaux de 2% donnait la meilleure production de biométhane (297,65 l CH4 / Kg MSV). Il ressort de cette étude que les déchets municipaux peuvent être traités par la voie de la biométhanisation car présentant un potentiel de bioconversion intéressant.© 2015 International Formulae Group. All rights reserved.Mots clés: Déchets organiques, digestion anaérobie, biométhane, environnement, Burkina FasoEnglish Title: Optimization of biomethane production from municipal solid organic wastesEnglish AbstractMunicipal solid organic wastes management became a major preoccupation. The achieved study focuses the biotechnological valorization of the biodegradable fraction of solid organic wastes in Burkina Faso.  Physicochemical characterization analysis of solid wastes sampled in 03 Ouagadougou’s centers of municipal wastes deposits was achieved. The influence of inoculum source (wastewater, bovine dung, termites’ homogenate and mixture) and substrate concentration (municipal solid waste) were evaluated during biomethane production tests. Results showed that organic fraction of solid wastes represent a source of predilection for methanization with 31.65 C/N cow. Fermentation tests showed that bovine dung used as inoculum in 2% of municipal solid waste gave the highest rate of biomethane production (297.65 l CH4 / Kg vs). The results demonstrate that municipal wastes can be valorized by biomethanization way because presenting interesting bioconversion potential.© 2015 International Formulae Group. All rights reserved.Keywords: Organic wastes, anaerobic digestion, biomethane, environment, Burkina Fas

Contribution à la biométhanisation de la biomasse végétale: cas des résidus de légumes au Burkina Faso

La matière organique constitue une source de bioénergie par la voie de la digestion anaérobie. Le but de cette étude est de déterminer les paramètres physico-chimiques et les effets de l’inoculation ainsi que de la température sur la biométhanisation des résidus de légumes. Des échantillons de résidus de légumes collectés dans des localités différentes (restaurants universitaires et marchés de légumes) à Ouagadougou ont servi de substrat. L’étude des paramètres physico-chimiques a été réalisé à l’aide des méthodes standard (AOAC, APHA) et le biogaz produit a été analysé par chromatographie en phase gazeuse. Le pH, la matière sèche, la matière sèche volatile, les cendres, le carbone organique, les protéines, les lipides et les carbohydrates totaux ont été respectivement de 5,87; 11,78%; 80,46%; 1,3%; 46,68%; 10,02%; 9,95%; 60,67%. La composition en minéraux exprimée en mg/g de matière sèche était de 12,69 (Ca2+) ; 19,44 (Ka+) ; 11,05 (Na+) ; 1,608 (N) ; 3,92 (p) ; 0,97 (SO4 2-). L’effet de l’inoculum a été mis en évidence par une production nulle de CH4 à partir d’un temoin non inoculé. La température optimale de production de biométhane a été de 44 °C avec un rendement de 238 ml CH4/g de MS.© 2016 International Formulae Group. All rights reserved.Mots clés: Déchets, légume, valorisation, biogaz, Burkina FasoEnglish Title: Contribution to the biometanation of plant biomass: case of vegetable residues in Burkina FasoEnglish AbstractOrganic material is a source of bioenergy through anaerobic digestion. The purpose of this study is to determine the physico-chemical parameters and the effects of inoculation as well as temperature on biomethanation of vegetable wastes. Samples of vegetable residues collected in different localities (canteens  and vegetable markets) in Ouagadougou were used as substrate. The study of physico-chemical parameters was performed using standard methods (AOAC, APHA) and biogas produced was analyzed by gas chromatography. pH, solids , volatile solids , ash, organic carbon , proteins , lipids and total carbohydrates were respectively 5.87 ; 11.78% ; 80.46 % ; 1.3% ; 46.68 % ; 10.02% ; 9.95% ; 60.67 %. The mineral composition expressed as mg/g dry matter was 12.69 (Ca2+); 19.44 (K+) ; 11.05 (Na+); 1.608 (N); 3.92 (p); 0.97 (SO42-). Inoculum effect was evidenced by no production of CH4 using an uninoculated control. The optimum temperature for biogas production was 44 °C in a yield of 238 ml CH4/g DM.© 2016 International Formulae Group. All rights reserved.Keywords: Waste, vegetables, valorization, Biogas, Burkina Fas

Contribution of clinical pharmacy to the rational and safe use of medicines in the neonatology unit of the pediatric university hospital Charles de Gaulle of Ouagadougou, Burkina Faso

Background: Newborns are exposed to drug therapeutic risks due to off-label prescribing and immaturity. The purpose of this study is to identify drug-related problems through the prescription and administration of drugs in the neonatology Unit and identify the need for pharmaceutical interventions. Methods: To assess drug-related problems, a cross-sectional observational study was conducted over five days at the neonatology Unit of the Pediatric University Hospital Charles de Gaulle in Burkina Faso. The study population consisted of newborns receiving drug prescriptions and treatment for five days. Results: Prematurity (50%) and early neonatal infection (53.3%) were the most common reasons for admission. A total of 380 prescription lines were recorded. Injectable and oral forms represented 72.1% and 26.3% respectively. Prescription lines in 16.8% were off-label medicines. An accuracy of drug dosages at 6.1% and an accuracy of prescribed doses at 52.7%, characterized therapeutic regimens. The prescribed drug administrations were performed in 80.0% with compliant doses and administration scheduled time 1 hour in 53.4 % and 54.6 %, respectively. Prescribers and nurses accepted 92.6% and 93.9% of proposed pharmaceutical interventions to solve drug-related problems. Conclusion. Our study emphasizes the importance of a clinical pharmacist within the health care team for the safe and efficient prescription and administration of newborn medication

Phytochemical screening of Saye, a traditional herbal remedy for malaria

phytochemical assay was conducted to establish the chemical profile of “Saye”, a mixture of leaf of Cassia alata, root of Cochlospermum planchonii and whole plant of Phyllantus amarus, used as antimarial remedy. Water and organic extracts were prepared. Characterization of phytoconstituents using specific chemical reagents was performed in tubes, by thin layer chromatography and by high performance liquid chromatography. Steroids and/or triterpenes, cathechic tannins were identified in the decocted and the macerated water extracts of “Saye”. An anthraquinone with a retention time Rt corresponding to 3.34 min was identified by the HPLC analysis.© 2015 International Formulae Group. All rights reserved.Keywords: Chemical profile, anthraquinones, steroids, triterpenes, tannins

The effect of dose on the antimalarial efficacy of artemether-lumefantrine: a systematic review and pooled analysis of individual patient data

Background: Artemether-lumefantrine is the most widely used artemisinin-based combination therapy for malaria, although treatment failures occur in some regions. We investigated the effect of dosing strategy on efficacy in a pooled analysis from trials done in a wide range of malaria-endemic settings. Methods: We searched PubMed for clinical trials that enrolled and treated patients with artemether-lumefantrine and were published from 1960 to December, 2012. We merged individual patient data from these trials by use of standardised methods. The primary endpoint was the PCR-adjusted risk of Plasmodium falciparum recrudescence by day 28. Secondary endpoints consisted of the PCR-adjusted risk of P falciparum recurrence by day 42, PCR-unadjusted risk of P falciparum recurrence by day 42, early parasite clearance, and gametocyte carriage. Risk factors for PCR-adjusted recrudescence were identified using Cox's regression model with frailty shared across the study sites. Findings: We included 61 studies done between January, 1998, and December, 2012, and included 14 327 patients in our analyses. The PCR-adjusted therapeutic efficacy was 97·6% (95% CI 97·4-97·9) at day 28 and 96·0% (95·6-96·5) at day 42. After controlling for age and parasitaemia, patients prescribed a higher dose of artemether had a lower risk of having parasitaemia on day 1 (adjusted odds ratio [OR] 0·92, 95% CI 0·86-0·99 for every 1 mg/kg increase in daily artemether dose; p=0·024), but not on day 2 (p=0·69) or day 3 (0·087). In Asia, children weighing 10-15 kg who received a total lumefantrine dose less than 60 mg/kg had the lowest PCR-adjusted efficacy (91·7%, 95% CI 86·5-96·9). In Africa, the risk of treatment failure was greatest in malnourished children aged 1-3 years (PCR-adjusted efficacy 94·3%, 95% CI 92·3-96·3). A higher artemether dose was associated with a lower gametocyte presence within 14 days of treatment (adjusted OR 0·92, 95% CI 0·85-0·99; p=0·037 for every 1 mg/kg increase in total artemether dose). Interpretation: The recommended dose of artemether-lumefantrine provides reliable efficacy in most patients with uncomplicated malaria. However, therapeutic efficacy was lowest in young children from Asia and young underweight children from Africa; a higher dose regimen should be assessed in these groups. Funding: Bill and Melinda Gates Foundation

Quality of Antenatal Care and Obstetrical Coverage in Rural Burkina Faso

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 non-participating 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 non-parametric 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\ub13.0, 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\ub14.2, 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