LogoLogoMSF Science Portal
  • My saved items
logo

© Médecins Sans Frontières

MSF Science Portal
About MSF Science Portal
About MSF
Contact Us
Frequently Asked Questions (FAQs)
Privacy Policy
Terms of Use

v2.1.4829.produseast1

49 result(s)
Filter and sort
49 result(s)
Journal Article > ResearchFull Text

Determinants of attendance in antenatal care clinics in rural settings in Mali and Burkina Faso: a cross-sectional study

BMC Pregnancy Childbirth. 14 April 2025; Volume 25 (Issue 1); DOI:10.1186/s12884-025-07568-2
Bognini JD, Koita K, N’takpe JB, Bihoun B, Dembélé M,  et al.
BMC Pregnancy Childbirth. 14 April 2025; Volume 25 (Issue 1); DOI:10.1186/s12884-025-07568-2

BACKGROUND

Since 2016, the World Health Organization (WHO) has recommended a minimum of eight antenatal care (ANC) contacts during pregnancy, replacing the previous recommendation of four focused ANC visits. In Mali and Burkina Faso, the four ANC visits are still recommended and their coverage remains low or insufficient. To anticipate possible obstacles to the implementation of the new recommendations, this study aimed to identify the individual determinants of ANC attendance in two study districts, with a representative sample of women recruited from the community.


METHODS

Data were collected in June 2022 through a three-stage household survey with a representative sample of women who delivered in the previous 12 months in the health districts of Kangaba (Mali) and Boussé (Burkina Faso). Country-specific analyses were performed using self-reported data. Women’s sociodemographic and clinical characteristics, as well as attitudes towards ANC attendance, were described to account for clustering. Multivariable logistic regression models using generalized estimating equations were used to identify the determinants of four or more ANC uptakes. A p-value < 0.05 was considered statistically significant in the adjusted model.


RESULTS

Overall, 1590 women participated (780 in Mali; 810 in Burkina Faso) in the study. Women in Burkina Faso were older and less educated than women in Mali. The proportions of women with at least four ANC visits were 80% and 54%, and that of ANC in the first trimester was 38.7% and 43.8% in Burkina Faso and Mali respectively. Factors significantly associated with a greater probability of women attending ANC4 + visits were found only in Mali: a history of stillbirth and time spent at ANC. Factors reducing the use of ANC4 + were the lack of transportation/distance in Burkina Faso, travel time of less than 1 h to reach the maternity clinic, women’s nonrecognition of the importance of ANC visits, and the perceived high cost of the ANC visit in both countries.


CONCLUSION

ANC was lower in Mali than in Burkina Faso. Health policies aimed at achieving the WHO recommendation of 8 ANC contacts should prioritize health information and sensitization of pregnant women to improve their knowledge of the importance of attending ANC several times.


TRIAL REGISTRATION

Retrospectively registered on August 11th, 2022 registration # PACTR202208844472053. Protocol v4.0 dated September 04, 2023.


More
Journal Article > ResearchFull Text

Serum insulin-like growth factor 1 in young children with moderate acute malnutrition: Secondary analysis of a randomised trial in Burkina Faso

British Journal of Nutrition. 13 February 2025; Volume 133 (Issue 4); 481-490.; DOI:10.1017/S0007114525000212
Helt TW, Cichon B, Fabiansen C, Iuel-Brockdorff AS, Yaméogo CW,  et al.
British Journal of Nutrition. 13 February 2025; Volume 133 (Issue 4); 481-490.; DOI:10.1017/S0007114525000212

Insulin-like growth factor 1 (IGF-1) is an important growth factor in childhood. We aimed to investigate the impact of food supplements for the treatment of moderate acute malnutrition (MAM) on serum IGF-1 (sIGF-1). Secondary analysis of a randomised 2 × 2 × 3 factorial nutrition trial was performed. Children aged 6–23 months with MAM received 2093 kJ/d as lipid-based nutrient supplement (LNS) or corn soy blend (CSB), containing either dehulled soya or soya isolate and different quantities of dried skimmed milk (0 %, 20 % or 50 % of total protein) for 12 weeks. The trial was double-blind with regard to soya and milk but not to matrix (LNS v. CSB). sIGF-1 was measured at inclusion and after 12 weeks of supplementation. Of 1609 children enrolled, 1455 (90 %) had sIGF-1 measured at both time points. During supplementation, sIGF-1 increased 6·7 (95 % CI 6·1, 7·3) ng/ml compared with an expected age-dependent decrease of 0·3 (95 % CI 0·2, 0·4) ng/ml. Children who received LNS v. CSB had a lower increase in sIGF-1 (–8 %, 95 % CI − 12, −3). The effect of LNS was partly attenuated when sIGF-1 was corrected for inflammation. Children who received soya isolate compared with dehulled soya had a higher increase in sIGF-1 (6 %, 95 % CI 1, 12). Milk content did not affect sIGF-1. Overall, sIGF-1 increased during supplementation. The lower increase with LNS v. CSB was only partly explained by increased inflammation with LNS and needs further investigation. Isolate v. dehulled soya led to a higher increase which may be due to antinutrients in dehulled soya.

More
Journal Article > ResearchFull Text

Serum insulin-like growth factor 1 in young children with moderate acute malnutrition: Secondary analysis of a randomized trial in Burkina Faso

British Journal of Nutrition. 13 February 2025; Online ahead of print; 1-22.; DOI:10.1017/S0007114525000212
Helt TW, Cichon B, Fabiansen C, Iuel-Brockdorff AS, Yaméogo CW,  et al.
British Journal of Nutrition. 13 February 2025; Online ahead of print; 1-22.; DOI:10.1017/S0007114525000212

Insulin-like growth factor 1 (IGF-1) is an important growth factor in childhood. We aimed to investigate the impact of food supplements for treatment of moderate acute malnutrition (MAM) on serum IGF-1 (sIGF-1). Secondary analysis of a randomized 2×2×3 factorial nutrition trial was performed. Children aged 6-23 months with MAM received 2093 kJ/day as lipid-based nutrient supplement (LNS) or corn-soy blend (CSB), containing either dehulled soy or soy isolate and different quantities of dried skimmed milk (0%, 20% or 50% of total protein) for 12 weeks. The trial was double-blind with regard to soy and milk, but not to matrix (LNS vs. CSB). sIGF-1 was measured at inclusion and after 12 weeks supplementation. Of 1609 children enrolled, 1455 (90%) had sIGF-1 measured at both time points. During supplementation sIGF-1 increased 6.7 (95%CI 6.1; 7.3) ng/ml compared with an expected age-dependent decrease of 0.3 (95%CI 0.2; 0.4) ng/ml. Children who received LNS vs. CSB had lower increase in sIGF-1 (-8%, 95%CI -12; -3). The effect of LNS was partly attenuated when sIGF-1 was corrected for inflammation. Children who received soy isolate compared with dehulled soy had higher increase in sIGF-1 (6%, 95%CI 1; 12). Milk content did not affect sIGF-1. Overall, sIGF-1 increased during supplementation. The lower increase with LNS vs. CSB was only partly explained by increased inflammation with LNS, and needs further investigation. Isolate vs. dehulled soy led to a higher increase which may be due to antinutrients in dehulled soy.


More
Conference Material > Video

PaED Talk - Voices from MSF Projects: Implementation of ‘zero separation’, Bobo, Burkina Faso

Cabral S
MSF Paediatric Days 2024. 3 May 2024
English
Français
Journal Article > ReviewFull Text

Antimicrobial resistance in Enterobacterales infections among children in sub-Saharan Africa: a systematic review and meta-analysis

E Clinical Medicine. 8 March 2024; Volume 70; 102512.; DOI:10.1016/j.eclinm.2024.102512
Kowalski M, Minka Obama B, Catho G, Dewez JE, Merglen A,  et al.
E Clinical Medicine. 8 March 2024; Volume 70; 102512.; DOI:10.1016/j.eclinm.2024.102512
BACKGROUND
The burden of antimicrobial resistance (AMR) has been estimated to be the highest in sub-Saharan Africa (SSA). The current study estimated the proportion of drug-resistant Enterobacterales causing infections in SSA children.

METHODS
We searched MEDLINE/PubMed, Embase and the Cochrane Library to identify retrospective and prospective studies published from 01/01/2005 to 01/06/2022 reporting AMR of Enterobacterales causing infections in sub-Saharan children (0-18 years old). Studies were excluded if they had unclear documentation of antimicrobial susceptibility testing methods or fewer than ten observations per bacteria. Data extraction and quality appraisal were conducted by two authors independently. The primary outcome was the proportion of Enterobacterales resistant to antibiotics commonly used in paediatrics. Proportions were combined across studies using mixed-effects logistic regression models per bacteria and per antibiotic. Between-study heterogeneity was assessed using the I2 statistic. The protocol was registered with PROSPERO (CRD42021260157).

FINDINGS
After screening 1111 records, 122 relevant studies were included, providing data on more than 30,000 blood, urine and stool isolates. Escherichia coli and Klebsiella spp. were the predominant species, both presenting high proportions of resistance to third-generation cephalosporins, especially in blood cultures: 40.6% (95% CI: 27.7%-55%; I2: 85.7%, number of isolates (n): 1032) and 84.9% (72.8%-92.2%; I2: 94.1%, n: 2067), respectively. High proportions of resistance to other commonly used antibiotics were also observed. E. coli had high proportions of resistance, especially for ampicillin (92.5%; 95% CI: 76.4%-97.9%; I2: 89.8%, n: 888) and gentamicin (42.7%; 95% CI: 30%-56.5%; I2: 71.9%, n: 968). Gentamicin-resistant Klebsiella spp. were also frequently reported (77.6%; 95% CI: 65.5%-86.3%; I2: 91.6%, n: 1886).

INTERPRETATION
High proportions of resistance to antibiotics commonly used for empirical treatment of infectious syndromes were found for Enterobacterales in sub-Saharan children. There is a critical need to better identify local patterns of AMR to inform and update clinical guidelines for better treatment outcomes.
More
Journal Article > ResearchFull Text

Effects of the Covid-19 pandemic on ART initiation and access to HIV viral load monitoring in adults living with HIV in West Africa: a regression discontinuity analysis

J Acquir Immune Defic Syndr; JAIDS. 1 March 2024; Online ahead of print; DOI:10.1097/QAI.0000000000003404
Ben Farhat J, TiendrebeogoMD T, Malateste K, Poda A, Minga A,  et al.
J Acquir Immune Defic Syndr; JAIDS. 1 March 2024; Online ahead of print; DOI:10.1097/QAI.0000000000003404
Français
OBJECTIVES
Efforts to control the COVID-19 pandemic have potentially compromised the availability and/or quality of HIV services. We aimed to assess the pandemic’s impact on ART initiation and HIV viral load (VL) monitoring in three West African countries.

METHODS
We used routinely collected data from five clinics contributing to the IeDEA collaboration in Burkina Faso, Côte d'Ivoire and Nigeria. We included ART-naïve adults living with HIV (ALWH) initiating ART from 01/01/2018. We conducted regression discontinuity analysis to estimate changes in the number of ART initiations and VL measures per week, before and during the pandemic period in each country.

RESULTS
In clinics in Burkina Faso and Côte d’Ivoire, ART initiations per week remained constant throughout the studied periods (-0.24 points (p) of ART initiations/week 95%CI -5.5, 5.9, -0.9 p 95%CI -8.5,8.6, respectively), whereas in Nigeria’s clinic, they decreased significantly (-6.3 p, 95% CI -10.8, -1.7) after the beginning of the pandemic. The volume of VL tests performed decreased significantly in all three countries (-17.0 p 95%CI -25.3, -8.6 in Burkina Faso, -118.4 p 95%CI -171.1, -65.8 in Côte d’Ivoire and -169.1p 95%CI-282.6, -55.6 in Nigeria).

CONCLUSIONS
Access to ART was maintained for newly diagnosed ALWH despite pandemic-related physical/social distancing measures. However, VL monitoring was severely disrupted and did not return to pre-pandemic levels approximately one year after the beginning of the pandemic. While HIV services in West Africa appear rather resilient, the impact of disruptions in VL monitoring on virological and clinical outcomes should continue to be monitored.
More
Journal Article > ReviewFull Text

Using clinical vignettes to understand the complexity of diagnosing type 1 diabetes in Sub-Saharan Africa

Res Rep Trop Med Journal of research and reports in tropical medicine. 13 November 2023; Volume 14; 111-120.; DOI:10.2147/RRTM.S397127
Le Bec E, Kam M, Aebischer Perone S, Boulle P, Cikomola J,  et al.
Res Rep Trop Med Journal of research and reports in tropical medicine. 13 November 2023; Volume 14; 111-120.; DOI:10.2147/RRTM.S397127
Lack of awareness, access to insulin and diabetes care can result in high levels of morbidity and mortality for children with type 1 diabetes (T1DM) in sub-Saharan Africa (SSA). Improvements in access to insulin and diabetes management have improved outcomes in some settings. However, many people still present in diabetic ketoacidosis (DKA) in parallel to misdiagnosis of children with T1DM in contexts with high rates of communicable diseases. The aim of this study was to highlight the complexity of diagnosing pediatric T1DM in a healthcare environment dominated by infectious diseases and lack of adequate health system resources. This was done by developing clinical vignettes and recreating the hypothetico-deductive process of a clinician confronted with DKA in the absence of identification of pathognomonic elements of diabetes and with limited diagnostic tools. A non-systematic literature search for T1DM and DKA in SSA was conducted and used to construct clinical vignettes for children presenting in DKA. A broad differential diagnosis of the main conditions present in SSA was made, then used to construct a clinician's medical reasoning, and anticipate the results of different actions on the diagnostic process. An examination of the use of the digital based Integrated Management of Childhood Illness diagnostic algorithm was done, and an analysis of the software's efficiency in adequately diagnosing DKA was assessed. The main obstacles to diagnosis were low specificity of non-pathognomonic DKA symptoms and lack of tools to measure blood or urine glucose. Avenues for improvement include awareness of T1DM symptomatology in communities and health systems, and greater availability of diagnostic tests. Through this work clinical vignettes are shown to be a useful tool in analyzing the obstacles to underdiagnosis of diabetes, a technique that could be used for other pathologies in limited settings, for clinical teaching, research, and advocacy.More
Conference Material > Slide Presentation

Qualité de la mise en œuvre des programmes de chimioprévention paludisme saisonnier (FR)

Lasmi K, Elimian K, Baker K
MSF Paediatric Days 2022. 1 December 2022; DOI:10.57740/0kgr-rw67
Conference Material > Video

SMC in Burkina Faso: National roll out and combining strategies

Sondo P
MSF Paediatric Days 2022. 30 November 2022
English
Français
Conference Material > Poster

Integrating pulse oximetry into IMCI consultations to improve health care of under-5 children in Primary Health Centres in West Africa

Hedible GB, Neboua D, Peters Bokol L, Anago G, Zair Z,  et al.
MSF Paediatric Days 2022. 30 November 2022; DOI:10.57740/j4yx-es02