BackgroundPrevious research on determinants of malaria in Burkina Faso has largely focused on individual risk factors. Malaria risk, however, is also shaped by community, health system, and climatic/environmental characteristics. The aims of this study were: i) to identify such individual, household, community, and climatic/environmental risk factors for malaria in children under five years of age, and ii) to produce a parasitaemia risk map of Burkina Faso.MethodsThe 2010 Demographic and Health Survey (DHS) was the first in Burkina Faso that tested children for malaria parasitaemia. Multilevel and geo-statistical models were used to explore determinants of malaria using this nationally representative database.ResultsParasitaemia was collected from 6,102 children, of which 66.0% (95% confidence interval (CI): 64.0-68.0%) were positive for Plasmodium spp. Older children (>23 months) were more likely to be parasitaemic than younger ones, while children from wealthier households and whose mother had higher education were at a lower risk. At the community level, living in a district with a rate of attendance to health facilities lower than 2 visits per year was significantly associated with greater odds of being infected. Malaria prevalence was also associated with higher normalized difference vegetation index, lower average monthly rainfall, and lower population densities. Predicted malaria parasitaemia was spatially variable with locations falling within an 11%-92% prevalence range. The number of parasitaemic children was nonetheless concentrated in areas of high population density, albeit malaria risk was notably higher in the sparsely populated rural areas.ConclusionMalaria prevalence in Burkina Faso is considerably higher than in neighbouring countries. Our spatially-explicit population-based estimates of malaria risk and infected number of children could be used by local decision-makers to identify priority areas where control efforts should be enhanced.Electronic supplementary materialThe online version of this article (doi:10.1186/1756-3305-7-350) contains supplementary material, which is available to authorized users.
HIV/AIDS is a leading cause of death in most of sub-Saharan countries. HIV/AIDS impact on the quality of life of persons living with HIV in Burkina Faso hasn't been well documented. The aim of the study was to assess the quality of life in persons living with HIV and its associated factors.A cross-sectional study was conducted in Ouagadougou. 424 persons living with HIV were included in the study according to their status with regard to Highly Active Anti Retroviral Treatment: 115 were not yet under treatment, 21 started the treatment within the three months preceding the enrolment and 288 were under treatment for at least 12 months. The quality of life was assessed through the WHOQOL HIV-BREF. Statistical comparisons were made using Mann Whitney U test, Kruskal-Wallis H test, Pearson's khi2 or Fisher's exact test. Correlations were appreciated using Spearman's rho. Logistic regression was used to examine associations between the quality of life scores and sociodemographic or clinical variables.The mean global score of quality of life in all patients was 82.4. Better scores were recorded in the spiritual domain and worst scores in the environmental domain. Men had a higher global score than women (p < 0.001). Illiteracy was significantly associated with a lower quality of life (p = 0.001). Patients having support for medical treatment had a significantly better quality of life (p < 0.01). In multivariate analysis, being a man, having a support for medical care, getting older and self-perceived as healthy, were associated with a global score of quality of life higher than 77, that corresponds to the mid-range of the score in our data.These findings suggest the importance of the socio-psychological support and of a good environment in order to improve the quality of life of people living with HIV, especially in women, in younger and in those having no support for medical care. In the environmental domain, actions of HIV services providers should focus on better accessibility to social and health care, promotion of income-generating activities especially for women and youth living with HIV.
BackgroundVaginal fistula (VF) is one of the most severe maternal morbidities with the immediate consequence of chronic urinary and/or fecal incontinence. The epidemiological evidence regarding risk factors for VF is dominated by facility-based studies. Our aim is to estimate the effect size of selected risk factors for VF using population-based survey data.MethodsWe pooled all available Demographic and Health Surveys and Multiple Indicators Cluster Surveys carried out in sub-Saharan Africa that collected information on VF symptoms. Bayesian matched logistic regression models that accounted for the imperfect sensitivity and specificity of self-reports of VF symptoms were used for effect size estimation.ResultsUp to 27 surveys were pooled, including responses from 332,889 women. Being able to read decreased the odds of VF by 13 % (95 % Credible Intervals (CrI): 1 % to 23 %), while higher odds of VF symptoms were observed for women of short stature (<150 cm) (Odds Ratio (OR) = 1.31; 95 % CrI: 1.02-1.68), those that had experienced intimate partner sexual violence (OR = 2.13; 95 % CrI: 1.60-2.86), those that reported sexual debut before the age of 14 (OR = 1.41; 95 % CrI: 1.16-1.71), and those that reported a first birth before the age of 14 (OR = 1.39; 95 % CrI: 1.04-1.82). The effect of post-primary education, female genital mutilation, and having problems obtaining permission to seek health care were not statistically significant.ConclusionsIncreasing literacy, delaying age at first sex/birth, and preventing sexual violence could contribute to the elimination of obstetric fistula. Concomitant improvements in access to quality sexual and reproductive healthcare are, however, required to end fistula in sub-Saharan Africa.Electronic supplementary materialThe online version of this article (doi:10.1186/s12884-016-0871-6) contains supplementary material, which is available to authorized users.
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