ISRCTN71468410.

Where malaria is endemic, there is an unexpected association between haemoglobinopathies and glucose-6-phosphate dehydrogenase (G-6-PD) deficiency. Their coexistence in a patient with sickle cell disease (SCD) can lead to hemolytic anemia, hemoglobinuria, sepsis, renal failure and vaso-occlusive attacks (VOA). The aim of this research was to determine the impact of G-6-PD deficiency in SCD patients. That is why, we screened haemoglobinopathies and G-6-PD deficiency in 7 villages and at 10 primary schools in Kadiogo Province, Burkina Faso. Hemoglobin electrophoresis was performed on blood from 18,383 people. From these results, we chose 342 subjects for a hemogram and the measure of the G-6-PD activity. The results were analyzed with Epilnfo-6 and Spss-10. Statistical significance was set at p < 0.05. We found a prevalence of 28.9% of Sickle Cell Trait (SCT), 1.3% of Major Sickle Cell Syndromes (MSCS), 12.3% of G-6-PD deficiency among women and 20.5% among men. We did not detect a statistically significant difference for counts of erythrocytes (p = 0.773), leucocytes (p = 0.227) and reticulocytes (0.292); hemoglobin levels (p = 0.998); annual vasoocclusive attacks (p = 0.869) between persons with SCD having a G-6-PD deficiency and those with normal G-6-PD activity. According to this study, G-6-PD deficiency does not seem to increase the severity of SCD. However, these patients should know their G-6-PD genotype in order to avoid consuming oxidative drugs that might provoke oxidative stress.

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BackgroundAim of our study is to investigate the clinical and immunological outcomes according to first-line HAART adherence in a large cohort of HIV-infected patients in Burkina Faso.MethodsA retrospective study was conducted between 2001 and 2009 among patients from two urban medical centers [St. Camille Medical Center (CMSC) and “Pietro Annigoni” Biomolecular Research Center (CERBA)] and 1 in the rural District of Nanoro (St. Camille District Hospital). Socio-demographical and clinical data were analyzed. Adherence was evaluated through a questionnaire investigating 5 key points related to drugs, consultations and blood exams, by assigning 0 to 2 points each up to 10 points overall. Data were collected at baseline and regularly thereafter. Adherence score was considered as a continuous variable and classified in optimal (8–10 points) and sub-optimal (0–7 points). Immunological outcome was evaluated as modification in CD4+ T-cell count over time, while predictors of death were explored by a univariate and multivariate Cox model considering adherence score as a time-varying covariate.ResultsA total of 625 patients were included: 455 (72.8%) were females, the median age was 33.3 (IQR 10.2) years, 204 (32.6.%) were illiterates, the median CD4+ T-cell count was 149 (IQR 114) cells/μl at baseline. At the end of the observation period we recorded 60/625 deaths and 40 lost to follow-up. The analysis of immunological outcomes showed a significant variation in CD4+ T-cell count between M12 and M24 only for patients with optimal adherence (Δ=78.2, p<0.001), with a significant Δ between the two adherence groups at M24 (8–10 vs 0–7, Δ=53.8, p=0.004). Survival multivariate analysis revealed that covariates significantly related to death included being followed at CERBA (urban area) or Nanoro (rural area), and receiving a regimen not including fixed dose combinations, (p=0.024, p=0.001 and p<0.001 respectively); conversely, an increasing adherence score as well as an optimal adherence score were significantly related to survival (p<0.001).ConclusionsAdherence to HAART remains pivotal to build up a good therapeutic outcome. Our results confirm that, according to our adherence system evaluation, less adherent patients have a higher risk of death and of inadequate CD4+ count recovery.

Background: Hepatitis B virus (HBV) can cause chronic hepatitis, cirrhosis, and hepatocellular carcinoma. Coinfection with hepatitis C virus (HCV)/HBV leads to a higher risk of liver damage. Development of HBV awareness campaigns could reduce the prevalence of this disease and limit the consequences. Objectives: The aim of this study was to sensitize, detect, and identify HBV markers and propose vaccination for people not infected with HBV. Methods: With the support of "SOS Hepatitis Burkina" association, an HBV screening program, available for all volunteers, was implemented in several localities of Ouagadougou and the surroundings. A rapid HBsAg detection test was performed on 2207 subjects, who voluntarily answered a series of questions. A rapid detection test of HCV antibodies was performed in HBsAg-positive cases. HBV markers were also determined in HBsAg-positive cases.Results: In a sample of 2207 individuals, aged 1 -85 years (mean age, 31.4 ± 15.7 years), the prevalence of HBsAg was 9.8% (217/2207) after screening. Before screening, 6.8% (150/2207) of the participants claimed that they were vaccinated against HBV. Also, multivariate analysis revealed that HBV infection was significantly associated with age (21 -30 years) and vaccination status (P = 0.03; OR, 1.67; 95% CI, 1.04 to 2.69 and P = 0.003; OR, 5.69; 95% CI, 1.80 to 18.00, respectively). Among 217 HBsAg-positive cases, the prevalence of HBV markers was reported as follows: AbHBs (0.9%), HBeAg (6.0%), AbHBe (87.6%), and AbHBc (100.0%). Based on the findings, HCV was detected in 0.9% (2/217) of HBsAg-positive subjects. In this study, 628 out of 1990 HBsAg-negative subjects were vaccinated for three doses, resulting in a vaccination rate of 31.6%. Conclusions: The present study reported an HBsAg prevalence of 9.8% in the study population. This intervention could contribute to major vaccination coverage against HBV after screening. Therefore, raising awareness and development of screening campaigns on HBV can increase the vaccination coverage of the population. The findings also showed that absence of vaccination against HBV constitutes a high-risk factor for HBV infection.