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. DBS HIV-1 RNA results were compared with plasma HIV-1 RNA and HIV serology results used as the gold standards. The limits of detection of assays on DBS were 3100 and 1550 copies per milliliter in Durban and Bobo-Dioulasso, respectively. DBS HIV-1 RNA values correlated significantly with plasma levels (n = 327; R = 0.7351) and were uniformly distributed according to duration of DBS storage at -20°C (median duration, 280 days). For early infant diagnosis, the sensitivity and specificity were 100% (95% confidence interval: 97.2 to 100.0 and 96.5 to 100.0, respectively). HIV-1 viral load kinetics in DNase-pretreated DBS were similar to those obtained in plasma specimens among 13 patients receiving antiretroviral treatment. HIV-1 RNA findings from serial infant DBS collected prospectively (n = 164) showed 100% concordance with HIV serology at 18 months of life. Our findings strongly advocate the implementation of DBS HIV-1 RNA testing in remote areas from low-income and middle-income countries.

BackgroundSnakebite is a common neglected public health issue, especially in poor rural areas of sub-Saharan Africa, Asia and Latin America. Passive immunotherapy with safe and effective antivenom is the only approved treatment for it. This study aimed to determine the incidence of snakebites, and to assess the availability and accessibility of antivenoms, from 2010 to 2014, in Burkina Faso.MethodsThe assessment of snakebite cases managed in all health facilities from 2010 to 2014 was performed from the Statistical Yearbook of the Ministry of Health. Antivenom consumption data were collected from the drug wholesalers established in Burkina Faso.ResultsSnakebites are among the five leading causes of consultations in health districts. From 2010 to 2014, 114,126 envenomation cases occurred in Burkina Faso, out of which 62,293 (54.6 %) victims have been hospitalized resulting in 1,362 (2 %) deaths. The annual incidence and mortality were respectively 130 bites and 1.75 deaths per 100,000 inhabitants. The amount of antivenom sold by wholesalers were 5,738 vials with a total cost of US$ 539,055 (annual average = US$ 107,811). The high cost of these antivenoms (between US$ 42 and 170 per dose according to brand) limited their use by rural people, the main victims of snakebites, whose income is insufficient. Thus, only 4 % of patients received antivenom treatment over the past five years. The price of antivenom was reduced in 2015 to US$ 3.4 by a public drug wholesaler.ConclusionThe study confirmed the high burden of snakebites in Burkina Faso. To better manage envenomation, Burkina Faso implemented a strategy consisting in seeking affordable sources of antivenom supply of good quality and innovative mechanisms of subsidy.

In sub-Saharan Africa, rapid testing for human immunodeficiency virus (HIV) is the most efficient and sometimes the only feasible way to quickly provide information about HIV status among adults and children Ն18 months of age (6,29). In contrast to enzyme immunoassays (EIAs) and Western blot assays (WBs), HIV rapid tests are relatively cheap, easy to use, and fast to perform. Most of them do not require refrigeration, sophisticated laboratory equipment, skilled technicians, and an electricity supply. Results from serum, plasma, whole-blood, urine, or saliva samples are obtained by visual reading after a few minutes. Some of the rapid tests can distinguish HIV type 1 (HIV-1) from HIV type 2 (HIV-2). They are also accurate and reliable as a result of applying a quality system approach recommended by the World Health Organization (WHO) (36). Due to their low cost and technical advantages, they have been adopted into national HIV voluntary counseling and testing (VCT) guidelines in many African countries. Their sensitivity and specificity have been studied in Kenya (12), Tanzania (22), Uganda (15), Zambia (30), South Africa (25), Cameroon (1), Central African Republic (24), Democratic Republic of Congo (19), Ghana (2), Ivory Coast (32), and Burkina Faso (23, 28).One objective for rapid HIV testing is to minimize the occurrence of indeterminate results (i.e., discordant results when using at least two different rapid tests). It is often quite difficult for HIV counselors and health care providers to disclose such indeterminate results. In the context of interventions for prevention of mother-to-child transmission (PMTCT) of HIV-1 (which can require immediate decisions, notably during labor), medical staff need to know rapidly the HIV status of the woman from the laboratory in order to provide her, or not, antiretroviral (ARV) prophylaxis (5,26,27). The prolonged delay in the decision (by performing additional tests or by retesting women 14 days later) can be inappropriate in the clinical routine since women may deliver before obtaining definitive results.The aims of this study conducted among pregnant women from Burkina Faso (West Africa) with a low risk of early HIV-1 seroconversion were (i) to determine the prevalence rates of indeterminate results by using two rapid tests in a sequential algorithm, as recommended in Burkina Faso, and (ii) to assess, using additional tests, the biological significance of indeterminate results in order to define a more rational strategy at the individual and public health levels.(This work was presented in part at the

Background and Aim Severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) particularly the variants of concern coinfections with influenza is a public health concern in Africa. We aimed to characterize the SARS‐CoV‐2 variants and determine the rate of coinfections with influenza in Burkina Faso. Methods COVID‐19 surveillance study was conducted between August 2021 and January 2022 using reverse transcription polymerase chain reaction (RT‐PCR). Positive specimens were further screened for SARS‐CoV‐2 variants using the multiple variants real‐time PCR kits. In addition, influenza virus strains were detected by RT‐PCR in SARS‐CoV‐2 positive specimens using the CDC primers, probes, and protocols. Results Of 324 specimens assessed, the Omicron and Delta variants of SARS‐CoV‐2 were the most prevalent with 27.2% [95% confident interval (CI): 22.5–32.4] and 22.2% [95% CI: 17.9–27.2], respectively. The Beta and Gamma variants were detected in 4.3% [95% CI: 2.4–7.1] and 0.3% [95% CI: 0.0–1.7], respectively. Coinfections of Omicron and Beta variants were reported in 21.3% [95% CI: 17.0–26.2], Omicron and Delta variants in 1.2% [95% CI: 0.3–3.1] of specimens, and the Omicron–Gamma variants' coinfections in 0.6% [95% CI: 0.1–2.2]. One COVID‐19 specimen with an undetected SARS‐CoV‐2 variant was also tested positive for the seasonal influenza A (H 3 N 2 ) virus. No cases of pandemic influenza A (H 1 N 1 )pdm09, seasonal A/H 1 N 1 , and influenza B were detected. Conclusions The current World Health Organization SARS‐CoV‐2 variants of concern were prevalent and their coinfections with influenza were uncommon. Continuous surveillance of both pathogens is, however, needed because of their public health implications.

Introduction:In Sub-Saharan Africa, the data on the mutations and variants of circulating SARS-CoV-2 is limited. This study aimed to screen specific mutations and variants of SARS-CoV-2 circulating in Burkina Faso. Methods: This study included symptomatic and asymptomatic individuals who underwent diagnostic testing for SARS-CoV-2 by RT-PCR on nasopharyngeal and oropharyngeal swabs from 7 December 2021 to 12 January 2022. Samples from individuals with a Ct value ≤ 33 were selected for the variants-specific mutation screening. The screening was performed using two kits, "SNPsig ® SARS-COV-2 (Escape PLEX)" and "SNPsig® VariPLEX™ (COVID-19) Real-Time PCR Assay". Results: SARS-CoV-2 prevalence was 18.9% (332/1758). A total of 113 samples (34.04%) had a Ct value less than (≤ 33), with only 20.35% (23/113) belonging to symptomatic patients. The mean age was 39.01±13 years. The Beta variant (B.1.351) was the most detected one comprising 78.8% (89/113) of variants. Gamma and Delta variants were detected at a low proportion of 0.9% (1/113). No mutation or variant was detected in seven (6.2%) samples. Conclusion: Specific mutation screening detected Beta (B.1.351), Gamma (P.1), and Delta (B.1.617.2) variants of SARS-CoV-2 circulating in Burkina Faso. The absence of mutations in some samples might suggest variants other than those detected.