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Grossman A, Prata N, Williams N, Ganatra B, Lavelanet A, Läser L, Asmani C, Elamin H, Ouedraogo L, Rahman MM, Conneh-Duworko MJ, Tehoungue BZ, Chanza H, Phiri H, Bhattarai B, Dhakal NP, Ojo OA, Afolabi K, Kabuteni TJ, Hailu BG, Moses F, Dlamini-Nqeketo S, Zulu T, Rehnström Loi U. Correction: Availability of medical abortion medicines in eight countries: a descriptive analysis of key findings and opportunities. Reprod Health 2023; 20:160. [PMID: 37884974 PMCID: PMC10604516 DOI: 10.1186/s12978-023-01691-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2023] Open
Affiliation(s)
- Amy Grossman
- Venture Strategies for Health & Development/OASIS, Berkeley, CA, USA
| | - Ndola Prata
- Venture Strategies for Health & Development/OASIS, Berkeley, CA, USA
- Bixby Center for Population, Health & Sustainability, School of Public Health, University of California, Berkeley, CA, USA
| | - Natalie Williams
- Venture Strategies for Health & Development/OASIS, Berkeley, CA, USA
| | - Bela Ganatra
- UNDP-UNFPA-UNICEF-WHO-World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP), Department of Sexual and Reproductive Health and Research, World Health Organization, 20 Avenue Appia, 1211, Geneva, Switzerland
| | - Antonella Lavelanet
- UNDP-UNFPA-UNICEF-WHO-World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP), Department of Sexual and Reproductive Health and Research, World Health Organization, 20 Avenue Appia, 1211, Geneva, Switzerland
| | - Laurence Läser
- UNDP-UNFPA-UNICEF-WHO-World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP), Department of Sexual and Reproductive Health and Research, World Health Organization, 20 Avenue Appia, 1211, Geneva, Switzerland
| | - Chilanga Asmani
- World Health Organization, Regional Office for Africa, Brazzaville, Republic of Congo
| | - Hayfa Elamin
- World Health Organization, Regional Office for Africa, Brazzaville, Republic of Congo
| | - Leopold Ouedraogo
- World Health Organization, Regional Office for Africa, Brazzaville, Republic of Congo
| | | | | | | | - Harriet Chanza
- World Health Organization, Malawi Country Office, Lilongwe, Republic of Malawi
| | - Henry Phiri
- Ministry of Health, Lilongwe, Republic of Malawi
| | - Bharat Bhattarai
- Department of Drug Administration, Ministry of Health and Population, Kathmandu, Nepal
| | | | | | - Kayode Afolabi
- Reproductive Health, Federal Ministry of Health, Abuja, Federal Republic of Nigeria
| | | | | | - Francis Moses
- Reproductive Health/Family Planning Programme Manager, Ministry of Health, Freetown, Sierra Leone
| | | | - Thembi Zulu
- National Department of Health, Pretoria, Republic of South Africa
| | - Ulrika Rehnström Loi
- UNDP-UNFPA-UNICEF-WHO-World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP), Department of Sexual and Reproductive Health and Research, World Health Organization, 20 Avenue Appia, 1211, Geneva, Switzerland.
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Ahmed W, Gebretsadik E, Gbenou D, Hien Y, Dramou B, Ambelu H, Hussein H, Lavussa J, Mamo A, Cherono M, Kessi M, El Hennawy H, Gholbzouri K, Ouedraogo L, Chilanga A, Elamin H, Pallitto C. Lessons learnt in scaling up evidence-based comprehensive health sector responses addressing female genital mutilation in highly prevalent settings. BMJ Glob Health 2023; 8:e012270. [PMID: 37308264 PMCID: PMC10277070 DOI: 10.1136/bmjgh-2023-012270] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Accepted: 05/02/2023] [Indexed: 06/14/2023] Open
Abstract
Female genital mutilation (FGM) affects over 200 million girls and women. Its health complications include acute and potentially lifelong urogenital, reproductive, physical, mental health complications with estimated health treatment costs of US$1.4 billion per year. Moreover, there is a concerning rise in the trend of FGM medicalisation with almost one in five FGM cases being performed by a health worker.The WHO developed several evidence-based resources to apply a comprehensive health approach to strengthen FGM prevention and care services. However, there has been limited uptake of this comprehensive approach in FGM prevalent settings. To address this, a three-step multicountry participatory process was used to engage health sector players from FGM prevalent settings to develop comprehensive action plans, implement foundational activities and harness the learnings to inform subsequent planning and implementation. Support to adapt evidence-based resources and seed funding were also provided to initiate foundational activities that had potential for scale up.A total of 15 countries participated in this three-step this approach between 2018 and 2022. Ten countries developed comprehensive national action plans and eight WHO resources were adapted for foundational activities.This scale up approach can be strengthened by increasing the frequency of multicountry experience sharing meetings, identifying in-country champions to continuously advocate for FGM integration within (public and private) health services and securing stable funding to implement foundational activities. Documentation of each country's experience as case studies including monitoring and evaluation are essential to expand the learning and quality of the health interventions addressing FGM.
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Affiliation(s)
- Wisal Ahmed
- Sexual and Reproductive Health and Research, World Health Organization, Geneva, Switzerland
| | - Eyob Gebretsadik
- Maternal and Child Health, World Health Organization, Addis Ababa, Ethiopia
| | - Dina Gbenou
- Sexual and Reproductive Health, World Health Organization, Ouagadougou, Burkina Faso
| | - Yelmali Hien
- Sexual and Reproductive Health, World Health Organization, Ouagadougou, Burkina Faso
| | - Bernadette Dramou
- La Santé de la Reproduction, de la Mère, du Nouveau-Né, de l'Enfant, de l'Adolescent-Jeune, des Personnes Agées et de la Nutrition, World Health Organization, Conakry, Guinea
| | - Haimanot Ambelu
- Maternal and Child Health, World Health Organization, Addis Ababa, Ethiopia
| | - Hiba Hussein
- Reproductive Maternal Neonatal Child and Adolescent Health, World Health Organization, Khartoum, Sudan
| | - Joyce Lavussa
- Reproductive Maternal Neonatal Child and Adolescent Health, World Health Organization, Nairobi, Kenya
| | - Anabay Mamo
- Reproductive Maternal Neonatal Child and Adolescent Health, World Health Organization, Nairobi, Kenya
| | - Matilda Cherono
- Reproductive Maternal Neonatal Child and Adolescent Health, World Health Organization, Mogadishu, Somalia
| | - Mary Kessi
- Violence and Injuries Prevention, World Health Organization, Dar es Salaam, United Republic of Tanzania
| | | | - Karima Gholbzouri
- Reproductive Health and Research, World Health Organization Eastern Mediterranean Regional Office, Cairo, Egypt
| | - Leopold Ouedraogo
- Sexual and Reproductive Health, World Health Organization African Regional Office, Brazzaville, Democratic Republic of Congo
| | - Asmani Chilanga
- Reproductive and Maternal Health, World Health Organization Africa Regional Office, Brazzaville, Republic of Congo
| | - Hayfa Elamin
- Reproductive and Maternal Health, World Health Organization Africa Regional Office, Brazzaville, Republic of Congo
| | - Christina Pallitto
- Sexual and Reproductive Health and Research, World Health Organization, Geneva, Switzerland
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Grossman A, Prata N, Williams N, Ganatra B, Lavelanet A, Läser L, Asmani C, Elamin H, Ouedraogo L, Rahman MM, Conneh-Duworko MJ, Tehoungue BZ, Chanza H, Phiri H, Bhattarai B, Dhakal NP, Ojo OA, Afolabi K, Kabuteni TJ, Hailu BG, Moses F, Dlamini-Nqeketo S, Zulu T, Rehnström Loi U. Availability of medical abortion medicines in eight countries: a descriptive analysis of key findings and opportunities. Reprod Health 2023; 20:58. [PMID: 37041543 PMCID: PMC10091522 DOI: 10.1186/s12978-023-01574-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/25/2023] [Indexed: 04/13/2023] Open
Abstract
BACKGROUND In recent years a growing number of manufacturers and medical abortion products have entered country markets and health systems, with varying degrees of quality and accessibility. An interplay of factors including pharmaceutical regulations, abortion laws, government policies and service delivery guidelines and provider's knowledge and practices influence the availability of medical abortion medicines. We assessed the availability of medical abortion in eight countries to increase understanding among policymakers of the need to improve availability and affordability of quality-assured medical abortion products at regional and national levels. METHODS Using a national assessment protocol and an availability framework, we assessed the availability of medical abortion medicines in Bangladesh, Liberia, Malawi, Nepal, Nigeria, Rwanda, Sierra Leone and South Africa between September 2019 and January 2020. RESULTS Registration of abortion medicines-misoprostol or a combination of mifepristone and misoprostol-was established in all countries assessed, except Rwanda. Mifepristone and misoprostol regimen for medical abortion was identified on the national essential medicines list/standard treatment guidelines for South Africa as well as in specific abortion care service and delivery guidelines for Bangladesh, Nepal, Nigeria, and Rwanda. In Liberia, Malawi, and Sierra Leone-countries with highly restrictive abortion laws and no abortion service delivery guidelines or training curricula-no government-supported training on medical abortion for public sector providers had occurred. Instead, training on medical abortion was either limited in scope to select private sector providers and pharmacists or prohibited. Community awareness activities on medical abortion have been limited in scope across the countries assessed and where abortion is broadly legal, most women do not know that it is an option. CONCLUSION Understanding the factors that influence the availability of medical abortion medicines is important to support policymakers improve availability of these medicines. The landscape assessments documented that medical abortion commodities can be uniquely impacted by the laws, policies, values, and degree of restrictions placed on service delivery programs. Results of the assessments can guide actions to improve access.
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Affiliation(s)
- Amy Grossman
- Venture Strategies for Health & Development/OASIS, Berkeley, CA, USA
| | - Ndola Prata
- Venture Strategies for Health & Development/OASIS, Berkeley, CA, USA
- Bixby Center for Population, Health & Sustainability, School of Public Health, University of California, Berkeley, CA, USA
| | - Natalie Williams
- Venture Strategies for Health & Development/OASIS, Berkeley, CA, USA
| | - Bela Ganatra
- UNDP-UNFPA-UNICEF-WHO-World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP), Department of Sexual and Reproductive Health and Research, World Health Organization, 20 Avenue Appia, 1211, Geneva, Switzerland
| | - Antonella Lavelanet
- UNDP-UNFPA-UNICEF-WHO-World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP), Department of Sexual and Reproductive Health and Research, World Health Organization, 20 Avenue Appia, 1211, Geneva, Switzerland
| | - Laurence Läser
- UNDP-UNFPA-UNICEF-WHO-World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP), Department of Sexual and Reproductive Health and Research, World Health Organization, 20 Avenue Appia, 1211, Geneva, Switzerland
| | - Chilanga Asmani
- World Health Organization, Regional Office for Africa, Brazzaville, Republic of Congo
| | - Hayfa Elamin
- World Health Organization, Regional Office for Africa, Brazzaville, Republic of Congo
| | - Leopold Ouedraogo
- World Health Organization, Regional Office for Africa, Brazzaville, Republic of Congo
| | | | | | | | - Harriet Chanza
- World Health Organization, Malawi Country Office, Lilongwe, Republic of Malawi
| | - Henry Phiri
- Ministry of Health, Lilongwe, Republic of Malawi
| | - Bharat Bhattarai
- Department of Drug Administration, Ministry of Health and Population, Kathmandu, Nepal
| | | | | | - Kayode Afolabi
- Reproductive Health, Federal Ministry of Health, Abuja, Federal Republic of Nigeria
| | | | | | - Francis Moses
- Reproductive Health/Family Planning Programme Manager, Ministry of Health, Freetown, Sierra Leone
| | | | - Thembi Zulu
- National Department of Health, Pretoria, Republic of South Africa
| | - Ulrika Rehnström Loi
- UNDP-UNFPA-UNICEF-WHO-World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP), Department of Sexual and Reproductive Health and Research, World Health Organization, 20 Avenue Appia, 1211, Geneva, Switzerland.
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Ryan CS, Belizaire MRD, Nanyunja M, Olu OO, Ahmed YA, Latt A, Kol MT, Bamuleke B, Tusiime J, Nsabimbona N, Conteh I, Nyashanu S, Ramadan PO, Woldetsadik SF, Nkata JPM, Ntwari JT, Nzeyimana SD, Ouedraogo L, Batona G, Ndahindwa V, Mgamb EA, Armah M, Wamala JF, Guyo AG, Freeman AYS, Chimbaru A, Komakech I, Kuku M, Firmino WM, Saguti GE, Msemwa F, O-Tipo S, Kalubula PC, Nsenga N, Talisuna AO. Sustainable strategies for Ebola virus disease outbreak preparedness in Africa: a case study on lessons learnt in countries neighbouring the Democratic Republic of the Congo. Infect Dis Poverty 2022; 11:118. [PMID: 36461100 PMCID: PMC9716502 DOI: 10.1186/s40249-022-01040-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Accepted: 11/02/2022] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND From May 2018 to September 2022, the Democratic Republic of Congo (DRC) experienced seven Ebola virus disease (EVD) outbreaks within its borders. During the 10th EVD outbreak (2018-2020), the largest experienced in the DRC and the second largest and most prolonged EVD outbreak recorded globally, a WHO risk assessment identified nine countries bordering the DRC as moderate to high risk from cross border importation. These countries implemented varying levels of Ebola virus disease preparedness interventions. This case study highlights the gains and shortfalls with the Ebola virus disease preparedness interventions within the various contexts of these countries against the background of a renewed and growing commitment for global epidemic preparedness highlighted during recent World Health Assembly events. MAIN TEXT Several positive impacts from preparedness support to countries bordering the affected provinces in the DRC were identified, including development of sustained capacities which were leveraged upon to respond to the subsequent coronavirus disease 2019 (COVID-19) pandemic. Shortfalls such as lost opportunities for operationalizing cross-border regional preparedness collaboration and better integration of multidisciplinary perspectives, vertical approaches to response pillars such as surveillance, over dependence on external support and duplication of efforts especially in areas of capacity building were also identified. A recurrent theme that emerged from this case study is the propensity towards implementing short-term interventions during active Ebola virus disease outbreaks for preparedness rather than sustainable investment into strengthening systems for improved health security in alignment with IHR obligations, the Sustainable Development Goals and advocating global policy for addressing the larger structural determinants underscoring these outbreaks. CONCLUSIONS Despite several international frameworks established at the global level for emergency preparedness, a shortfall exists between global policy and practice in countries at high risk of cross border transmission from persistent Ebola virus disease outbreaks in the Democratic Republic of Congo. With renewed global health commitment for country emergency preparedness resulting from the COVID-19 pandemic and cumulating in a resolution for a pandemic preparedness treaty, the time to review and address these gaps and provide recommendations for more sustainable and integrative approaches to emergency preparedness towards achieving global health security is now.
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Affiliation(s)
| | | | | | | | - Yahaya Ali Ahmed
- grid.463718.f0000 0004 0639 2906WHO Regional Office for Africa, Brazzaville, Congo
| | - Anderson Latt
- grid.452949.7WHO Sub-Regional Office for Africa, Dakar, Senegal
| | - Matthew Tut Kol
- grid.508167.dAfrica Centres for Disease Control and Prevention, Addis Ababa, Ethiopia
| | - Bertrand Bamuleke
- grid.463718.f0000 0004 0639 2906WHO Country Office, Brazzaville, Congo
| | - Jayne Tusiime
- grid.463718.f0000 0004 0639 2906WHO Regional Office for Africa, Brazzaville, Congo
| | - Nadia Nsabimbona
- grid.463718.f0000 0004 0639 2906WHO Regional Office for Africa, Brazzaville, Congo
| | - Ishata Conteh
- grid.463718.f0000 0004 0639 2906WHO Regional Office for Africa, Brazzaville, Congo
| | | | - Patrick Otim Ramadan
- grid.463718.f0000 0004 0639 2906WHO Regional Office for Africa, Brazzaville, Congo
| | | | | | | | | | | | - Georges Batona
- grid.463718.f0000 0004 0639 2906WHO Country Office, Brazzaville, Congo
| | | | | | - Magdalene Armah
- grid.463718.f0000 0004 0639 2906WHO Regional Office for Africa, Brazzaville, Congo
| | | | | | | | | | | | | | | | | | | | - Shikanga O-Tipo
- grid.439056.d0000 0000 8678 0773WHO Country Office, Lusaka, Zambia
| | | | - Ngoy Nsenga
- WHO Country Office, Bangui, Central African Republic
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Compaoré R, Millogo T, Ouedraogo AM, Tougri H, Ouedraogo L, Tall F, Kouanda S. Maternal and neonatal death surveillance and response in Liberia: An assessment of the implementation process in five counties. Int J Gynaecol Obstet 2022; 158 Suppl 2:46-53. [PMID: 35434804 DOI: 10.1002/ijgo.14174] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
OBJECTIVE To evaluate the implementation of the maternal and neonatal death surveillance and response (MNDSR) system at county level in Liberia. METHODS Secondary analysis of data from a cross-sectional study carried out in March 2016, using both quantitative and qualitative methods to collect data in five counties based on set criteria. Three health facilities were selected in each county through the Health Management Information System (HMIS) by random sampling. The evaluation was also carried out in one catchment community per health facility and at the county referral hospital. Primary data were collected through individual interviews and a review of MNDSR tools and structure. Data were analyzed using thematic analysis. RESULTS Implementation of the MNDSR system was very low in the five counties. Only two out of the five counties were currently conducting MNDSR. MNDSR guidelines and standard operating procedures were not available at the county level. Only 12 (23.5%) health facilities had a maternal and neonatal death review committee. Less than a quarter of the assessed community members could correctly give the definition of a maternal or neonatal death. CONCLUSION The MNDSR system is weak in Liberia, at county, health facility, and community levels. Strong national commitment is needed in collaboration with diverse partners for successful implementation of the system.
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Affiliation(s)
- Rachidatou Compaoré
- Institut de Recherche en Sciences de la Santé (IRSS), Ouagadougou, Burkina Faso
| | - Tieba Millogo
- Institut Africain de Santé Publique (IASP), Ouagadougou, Burkina Faso
| | - Adja M Ouedraogo
- Institut de Recherche en Sciences de la Santé (IRSS), Ouagadougou, Burkina Faso
| | - Halima Tougri
- Institut de Recherche en Sciences de la Santé (IRSS), Ouagadougou, Burkina Faso
| | - Leopold Ouedraogo
- Reproductive, Maternal Health and Ageing, WHO Regional Office for Africa, Brazzaville, Congo
| | - Fatim Tall
- Reproductive, Maternal Health and Ageing, WHO IST Office for Central Africa, Libreville, Gabon
| | - Seni Kouanda
- Institut de Recherche en Sciences de la Santé (IRSS), Ouagadougou, Burkina Faso.,Institut Africain de Santé Publique (IASP), Ouagadougou, Burkina Faso
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Kouanda S, Ouedraogo OMA, Tchonfiene PP, Lhagadang F, Ouedraogo L, Conombo Kafando GS. Analysis of the implementation of maternal death surveillance and response in Chad. Int J Gynaecol Obstet 2022; 158 Suppl 2:67-73. [PMID: 35322874 DOI: 10.1002/ijgo.14150] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE To analyze implementation of the maternal death surveillance and response (MDSR) strategy in Chad. METHODS Secondary data analysis of results from a cross-sectional study involving semistructured interviews with decision-makers at central, regional, and district levels, health providers, and technical and financial partners, and a document review. Data collection took place from June-July 2017. RESULTS Maternal death reporting was incorporated into the Integrated Disease Surveillance and Response system but did not include neonatal deaths nor maternal and neonatal deaths in communities. Underreporting of maternal deaths owing to fear of repercussions was evident, likely associated with maternal deaths reported at monthly meetings held by the country's President with stakeholders in the health sector. Maternal death reviews were only undertaken between 2015 and 2016 in four regions of Chad and ceased in mid-August 2016. Reasons include the departure of foreign obstetricians, lack of motivation among health workers, weak accountability at all levels of the health system, organizational issues, and nonimplementation of review recommendations. CONCLUSION Strong action is needed by the Ministry of Health to revive implementation of the MDSR system.
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Affiliation(s)
- Seni Kouanda
- Institut de Recherche en Sciences de la Santé (IRSS), Ouagadougou, Burkina Faso.,Institut Africain de Santé Publique (IASP), Ouagadougou, Burkina Faso
| | | | - Passiri P Tchonfiene
- Faculté des Sciences de la Santé Humaine, Université de N'Djaména, N'Djaména, Chad
| | - Foumsou Lhagadang
- Faculté des Sciences de la Santé Humaine, Université de N'Djaména, N'Djaména, Chad
| | - Leopold Ouedraogo
- Reproductive, Maternal Health and Ageing, WHO Regional Office for Africa, Brazzaville, Congo
| | - Ghislaine S Conombo Kafando
- Reproductive, Maternal Health and Ageing, WHO Intercountry Support Team (WHO/IST) Office for Central Africa, Libreville, Gabon
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Narasimhan M, Logie CH, Gauntley A, Gomez Ponce de Leon R, Gholbzouri K, Siegfried N, Abela H, Ouedraogo L. Self-care interventions for sexual and reproductive health and rights for advancing universal health coverage. Sex Reprod Health Matters 2021; 28:1778610. [PMID: 32530386 PMCID: PMC7887951 DOI: 10.1080/26410397.2020.1778610] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
WHO's normative guidance on self-care interventions for sexual and reproductive health and rights (SRHR) promotes comprehensive, integrated and people-centred approaches to health service delivery. Implementation of self-care interventions within the context of human rights, gender equality, and a life course approach, offers an underused opportunity to improve universal health coverage (UHC) for all. Results from an online global values and preferences survey provided lay persons' and healthcare providers' perspectives on access, acceptability, and implementation considerations. This analysis examines 326 qualitative responses to open-ended questions from healthcare providers (n = 242) and lay persons (n = 70) from 77 countries. Participants were mostly women (66.9%) and were from the Africa (34.5%), America (32.5%), South-East Asia (5.6%), European (19.8%), Eastern Mediterranean (4.8%), and Western Pacific regions (2.8%). Participants perceived multiple benefits of self-care interventions for SRHR, including: reduced exposure to stigma, discrimination and access barriers, increased confidentiality, empowerment, self-confidence, and informed decision-making. Concerns include insufficient knowledge, affordability, and possible side-effects. Implementation considerations highlighted the innovative approaches to linkages with health services. Introduction of self-care interventions is a paradigm shift in health care delivery bridging people and communities through primary health care to reach UHC. Self-care interventions can be leveraged by countries as gateways for reaching more people with quality, accessible and equitable services that is critical for achieving UHC. The survey results underscored the urgent need to reduce stigma and discrimination, increase access to and improve knowledge of self-care interventions for SRHR for laypersons and healthcare providers to advance SRHR.
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Affiliation(s)
- Manjulaa Narasimhan
- Scientist, Department of Sexual and Reproductive Health and Research; UNDP/UNFPA/UNICEF/WHO/World Bank Special Programme, World Health Organization, Geneva, Switzerland
| | - Carmen H Logie
- Associate Professor, Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Canada
| | - Alice Gauntley
- Research Assistant, Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Canada
| | | | | | - Nandi Siegfried
- Independent Clinical Epidemiologist, Cape Town, South Africa
| | - Heather Abela
- Research Assistant, Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Canada
| | - Leopold Ouedraogo
- Regional Advisor, Reproductive and Women's Health (RWH), AFRO, Brazzaville, Congo
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Mongbo Y, Sombie I, Dao B, Johnson EA, Ouedraogo L, Tall F, Asmani C, Busia K, Ogbureke N, Ndour M, Sinkondo IY. Maintaining continuity of essential reproductive, maternal, neonatal, child and adolescent health services during the COVID-19 pandemic in Francophone West Africa. Afr J Reprod Health 2021; 25:76-85. [PMID: 37585755 DOI: 10.29063/ajrh2021/v25i2.7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/18/2023]
Abstract
The study aimed to analyse the challenges and solutions for maintaining the continuity of essential health services during the COVID-19 pandemic in Francophone West Africa. A cross-sectional study involving the managers of Reproductive, Maternal, Neonatal, Child and Adolescent Health (RMNCAH) and vaccination programmes in Francophone West Africa was designed. The challenges that limited the supply and use of RMNCAH services included: lack of standardized guides and procedures for appropriate care, limited knowledge of health workers on the new coronavirus disease, lack of diagnostic materials and kits, ineffective organization of services, anxieties of health workers and populations, and postponement of immunisation mass campaigns. The solutions proposed to address these challenges, included better organization of services to respect the physical distance, provision of adapted guides and care procedures, enhanced communication, training of health workers, effective use of social media and information and communication technologies. This study showed that the managers of RMNCAH programmes are aware of the challenges that could limit the supply and use of essential services during the COVID-19 pandemic.
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Affiliation(s)
- Yves Mongbo
- West African Health Organization; Bobo-Dioulasso, Burkina Faso
| | - Issiaka Sombie
- West African Health Organization; Bobo-Dioulasso, Burkina Faso
| | - Blami Dao
- Jhpiego, 1045 Boulevard Ratag-Rima, Gounghin Sud, Ouagadougou, Burkina Faso
| | | | | | - Fatim Tall
- World Health Organization, Africa Regional Office
| | | | - Kofi Busia
- West African Health Organization; Bobo-Dioulasso, Burkina Faso
| | - Nanlop Ogbureke
- West African Health Organization; Bobo-Dioulasso, Burkina Faso
| | - Marguerite Ndour
- Integrated FP / MNCH / Nutrition Project, IntraHealth International | Because Health Workers Save Lives Ouagadougou, Burkina Faso
| | - Isidore Y Sinkondo
- Integrated FP / MNCH / Nutrition Project, IntraHealth International | Because Health Workers Save Lives Ouagadougou, Burkina Faso
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9
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Ouedraogo L, Habonimana D, Nkurunziza T, Chilanga A, Hayfa E, Fatim T, Kidula N, Conombo G, Muriithi A, Onyiah P. Towards achieving the family planning targets in the African region: a rapid review of task sharing policies. Reprod Health 2021; 18:22. [PMID: 33485339 PMCID: PMC7825212 DOI: 10.1186/s12978-020-01038-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2020] [Accepted: 11/05/2020] [Indexed: 02/02/2023] Open
Abstract
Background Expanding access and use of effective contraception is important in achieving universal access to reproductive healthcare services, especially in low- and middle-income countries (LMICs), such as those in sub-Saharan Africa (SSA). Shortage of trained healthcare providers is an important contributor to increased unmet need for contraception in SSA. The World Health Organization (WHO) recommends task sharing as an important strategy to improve access to sexual and reproductive healthcare services by addressing shortage of healthcare providers. This study explores the status, successes, challenges and impacts of the implementation of task sharing for family planning in five SSA countries. This evidence is aimed at promoting the implementation and scale-up of task sharing programmes in SSA countries by WHO. Methodology and findings We employed a rapid programme review (RPR) methodology to generate evidence on task sharing for family planning programmes from five SSA countries namely, Burkina Faso, Cote d’Ivoire, Ethiopia, Ghana, and Nigeria. This involved a desk review of country task sharing policy documents, implementation plans and guidelines, annual sexual and reproductive health programme reports, WHO regional meeting reports on task sharing for family planning; and information from key informants on country background, intervention packages, impact, enablers, challenges and ways forward on task sharing for family planning. The findings indicate mainly the involvement of community health workers, midwives and nurses in the task sharing programmes with training in provision of contraceptive pills and long-acting reversible contraceptives (LARC). Results indicate an increase in family planning indicators during the task shifting implementation period. For instance, injectable contraceptive use increased more than threefold within six months in Burkina Faso; contraceptive prevalence rate doubled with declines in total fertility and unmet need for contraception in Ethiopia; and uptake of LARC increased in Ghana and Nigeria. Some barriers to successful implementation include poor retention of lower cadre providers, inadequate documentation, and poor data systems. Conclusions Task sharing plays a role in increasing contraceptive uptake and holds promise in promoting universal access to family planning in the SSA region. Evidence from this RPR is helpful in elaborating country policies and scale-up of task sharing for family planning programmes.
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Affiliation(s)
- Leopold Ouedraogo
- Reproductive, Maternal Health and Ageing Team, World Health Organization, Regional Office for Africa, Brazzaville, Republic of the Congo.
| | - Desire Habonimana
- Department of Community Medicine, Research and Innovation Unit, Faculty of Medicine, University of Burundi, Bujumbura, Burundi
| | - Triphonie Nkurunziza
- Reproductive, Maternal Health and Ageing Team, World Health Organization, Regional Office for Africa, Brazzaville, Republic of the Congo
| | - Asmani Chilanga
- Reproductive, Maternal Health and Ageing Team, Intercountry Support Team for West Africa, World Health Organization, Ouagadougou, Burkina Faso
| | - Elamin Hayfa
- Reproductive, Maternal Health and Ageing Team, Intercountry Support Team for East and Southern Africa, World Health Organization, Harare, Zimbabwe
| | - Tall Fatim
- Reproductive, Maternal Health and Ageing Team, Intercountry Support Team for West Africa, World Health Organization, Ouagadougou, Burkina Faso
| | - Nancy Kidula
- Reproductive, Maternal Health and Ageing Team, Intercountry Support Team for East and Southern Africa, World Health Organization, Harare, Zimbabwe
| | - Ghislaine Conombo
- Reproductive, Maternal Health and Ageing Team, Intercountry Support Team for Central Africa, World Health Organization, Libreville, Gabon
| | - Assumpta Muriithi
- Reproductive, Maternal Health and Ageing Team, World Health Organization, Regional Office for Africa, Brazzaville, Republic of the Congo
| | - Pamela Onyiah
- Reproductive, Maternal Health and Ageing Team, World Health Organization, Regional Office for Africa, Brazzaville, Republic of the Congo
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10
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Habonimana D, Ouedraogo L, Ndirahisha E, Misago N, Ciza R, Niyomwungere D, Niyongabo F, Irakoze JB, Nkurunziza JD, Manirakiza S. Understanding the influence of the COVID-19 pandemic on hospital-based mortality in Burundi: a cross-sectional study comparing two time periods. Epidemiol Infect 2020; 148:e280. [PMID: 33183401 PMCID: PMC7711354 DOI: 10.1017/s0950268820002770] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2020] [Revised: 11/02/2020] [Accepted: 11/05/2020] [Indexed: 01/15/2023] Open
Abstract
This study used hospital records from two time periods to understand the implication of COVID-19 on hospital-based deaths in Burundi. The place of COVID-19 symptoms was sought among deaths that occurred from January to May 2020 (during the pandemic) vs. January to May 2019 (before the pandemic). First, death proportions were tested to seize differences between mortality rates for each month in 2020 vs. 2019. In the second time, we compared mean time-to-death between the two periods using the Kaplan-Meier survival curve. Finally, a logistic regression was fitted to assess the likelihood of dying from COVID-19 symptoms between the two periods. We found statistical evidence of a higher death rate in May 2020 as compared to May 2019. Moreover, death occurred faster in 2020 (mean = 6.7 days, s.d. = 8.9) than in 2019 (mean = 7.8 days, s.d. = 10.9). Unlike in 2019, being a male was significantly associated with a much lower likelihood of dying with one or more COVID-19 symptom(s) in 2020 (odds ratio 0.35, 95% confidence interval 0.14-0.87). This study yielded some evidence for a possible COVID-19-related hospital-based mortality trend for May 2020. However, considering the time-constraint of the study, further similar studies over a longer period of time need to be conducted to trace a clearer picture on COVID-19 implication on hospital-based deaths in Burundi.
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Affiliation(s)
- D. Habonimana
- Research and Innovation Unit, Department of Community Medicine, Faculty of Medicine, University of Burundi, Bujumbura, Burundi
| | - L. Ouedraogo
- Regional Adviser for Sexual and Reproductive Health, World Health Organization Regional Office for Africa, Brazaville, Congo
| | - E. Ndirahisha
- Department of Internal Medicine, Faculty of Medicine, University of Burundi, Bujumbura, Burundi
| | - N. Misago
- Health Healing Network Burundi, Bujumbura, Burundi
| | - R. Ciza
- Health Healing Network Burundi, Bujumbura, Burundi
| | - D. Niyomwungere
- Research and Innovation Unit, Department of Community Medicine, Faculty of Medicine, University of Burundi, Bujumbura, Burundi
| | - F. Niyongabo
- National Health Institute, Ministry of Public Health and AIDS Control, Bujumbura, Burundi
| | - J. B. Irakoze
- Factulty of Medicine, University of Burundi, Bujumbura, Burundi
| | - J. D. Nkurunziza
- Department of Statistics, Higher Institute of Education, Bujumbura, Burundi
| | - S. Manirakiza
- Department of Radiology and Imaging, Faculty of Medicine, University of Burundi, Bujumbura, Burundi
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11
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Millogo T, Kouanda S, Tran NT, Kaboré B, Keita N, Ouedraogo L, Tall F, Kiarie J, Thatte N, Festin M, Cuzin-Kihl A. Task sharing for family planning services, Burkina Faso. Bull World Health Organ 2019; 97:783-788. [PMID: 31673194 PMCID: PMC6802696 DOI: 10.2471/blt.19.230276] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2019] [Revised: 06/26/2019] [Accepted: 06/27/2019] [Indexed: 11/27/2022] Open
Abstract
PROBLEM In Burkina Faso, the coverage of services for family planning is low due to shortage of qualified health staff and limited access to services. APPROACH Following the launch of the Ouagadougou Partnership, an alliance to catalyse the expansion of family planning services, the health ministry created a consortium of family planning stakeholders in 2011. The consortium adopted a collaborative framework to implement a pilot project for task sharing in family planning at community and primary health-care centre levels in two rural districts. Stakeholders were responsible for their areas of expertise. These areas included advocacy; monitoring and evaluation; and capacity development of community health workers (CHWs) to offer oral and injectable contraceptives to new users and of auxiliary nurses and auxiliary midwives to provide implants and intrauterine devices. The health ministry implemented supportive supervision cascades involving relevant planning and service levels. LOCAL SETTING In Burkina Faso, only 15% (2563/17 087) of married women used modern contraceptives in 2010. RELEVANT CHANGES Adoption of new policies and clinical care standards expanded task sharing roles in family planning. The consortium trained a total of 79 CHWs and 124 auxiliary nurses and midwives. Between January 2017 and December 2018, CHWs provided injectables to 3698 new users, and auxiliary nurses or midwives provided 726 intrauterine devices and 2574 implants to new users. No safety issues were reported. LESSONS LEARNT The pilot project was feasible and safe, however, financial constraints are hindering scale-up efforts. Supportive supervision cascades were critical in ensuring success.
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Affiliation(s)
- Tieba Millogo
- Institut de Recherche en Sciences de la Santé, Ouagadougou, Burkina Faso
| | - Séni Kouanda
- Institut de Recherche en Sciences de la Santé, Ouagadougou, Burkina Faso
| | - Nguyen Toan Tran
- Australian Centre for Public and Population Health Research, University of Technology Sydney, Sydney, Australia
| | | | - Namoudou Keita
- West African Health Organization, Bobo-Dioulasso, Burkina Faso
| | | | - Fatim Tall
- Reproductive and Women’s Health, Intercountry support team World Health Organization, Ouagadougou, Burkina Faso
| | - James Kiarie
- Department of Reproductive Health and Research, World Health Organization, Avenue Appia 20, 1211 Geneva 27, Switzerland
| | - Nandita Thatte
- Department of Reproductive Health and Research, World Health Organization, Avenue Appia 20, 1211 Geneva 27, Switzerland
| | - Mario Festin
- Department of Reproductive Health and Research, World Health Organization, Avenue Appia 20, 1211 Geneva 27, Switzerland
| | - Asa Cuzin-Kihl
- Department of Reproductive Health and Research, World Health Organization, Avenue Appia 20, 1211 Geneva 27, Switzerland
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12
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Ebener S, Stenberg K, Brun M, Monet JP, Ray N, Sobel HL, Roos N, Gault P, Morrissey Conlon C, Bailey P, Moran AC, Ouedraogo L, Kitong JF, Ko E, Sanon D, Jega FM, Azogu O, Ouedraogo B, Osakwe C, Chimwemwe Chanza H, Steffen M, Ben Hamadi I, Tib H, Haj Asaad A, Tan Torres T. Proposing standardised geographical indicators of physical access to emergency obstetric and newborn care in low-income and middle-income countries. BMJ Glob Health 2019; 4:e000778. [PMID: 31354979 PMCID: PMC6623986 DOI: 10.1136/bmjgh-2018-000778] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2018] [Revised: 08/30/2018] [Accepted: 08/31/2018] [Indexed: 12/30/2022] Open
Abstract
Emergency obstetric and newborn care (EmONC) can be life-saving in managing well-known complications during childbirth. However, suboptimal availability, accessibility, quality and utilisation of EmONC services hampered meeting Millennium Development Goal target 5A. Evaluation and modelling tools of health system performance and future potential can help countries to optimise their strategies towards reaching Sustainable Development Goal (SDG) 3: ensure healthy lives and promote well-being for all at all ages. The standard set of indicators for monitoring EmONC has been found useful for assessing quality and utilisation but does not account for travel time required to physically access health services. The increased use of geographical information systems, availability of free geographical modelling tools such as AccessMod and the quality of geographical data provide opportunities to complement the existing EmONC indicators by adding geographically explicit measurements. This paper proposes three additional EmONC indicators to the standard set for monitoring EmONC; two consider physical accessibility and a third addresses referral time from basic to comprehensive EmONC services. We provide examples to illustrate how the AccessMod tool can be used to measure these indicators, analyse service utilisation and propose options for the scaling-up of EmONC services. The additional indicators and analysis methods can supplement traditional EmONC assessments by informing approaches to improve timely access to achieve Universal Health Coverage and reach SDG 3.
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Affiliation(s)
| | - Karin Stenberg
- WHO Headquarters, Department of Health Systems Governance and Financing (HGF), Geneva, Switzerland
| | - Michel Brun
- UNFPA, Technical Division, New York City, New York, USA
| | | | - Nicolas Ray
- University of Geneva, Institute of Global Health& Institute for Environmental Sciences, GeoHealth group, Geneva, Switzerland
| | | | - Nathalie Roos
- WHO Headquarters, Department of Maternal, Newborn, Child and Adolescent Health (MCA), Geneva, Switzerland
| | | | | | | | | | | | | | | | | | | | | | - Boureima Ouedraogo
- Direction générale des études et des statistiques sectorielles, Ouagadougou, Burkina Faso
| | | | | | - Mona Steffen
- University of Geneva, Institute of Global Health& Institute for Environmental Sciences, GeoHealth group, Geneva, Switzerland
| | | | | | | | - Tessa Tan Torres
- WHO Headquarters, Department of Health Systems Governance and Financing (HGF), Geneva, Switzerland
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13
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Thompson J, Undie CC, Amin A, Johnson BR, Khosla R, Ouedraogo L, Nkurunziza T, Rich S, Westley E, Garcia M, Birungi H, Askew I. Correction to: Harmonizing national abortion and pregnancy prevention laws and policies for sexual violence survivors with the Maputo Protocol: proceedings of a 2016 regional technical meeting in sub-Saharan Africa. BMC Proc 2018; 12:7. [PMID: 29932170 PMCID: PMC5989408 DOI: 10.1186/s12919-018-0103-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
[This corrects the article DOI: 10.1186/s12919-018-0101-5.].
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Affiliation(s)
- Jill Thompson
- Public Counsel, 610 South Ardmore Avenue, Los Angeles, CA 90005 USA
| | - Chi-Chi Undie
- Population Council, P.O. Box 17643-00500, Nairobi, Kenya
| | - Avni Amin
- Department of Reproductive Health and Research, World Health Organization, Avenue Appia 20, 1211 27 Geneva, Switzerland
| | - Brooke Ronald Johnson
- Department of Reproductive Health and Research, World Health Organization, Avenue Appia 20, 1211 27 Geneva, Switzerland
| | - Rajat Khosla
- Department of Reproductive Health and Research, World Health Organization, Avenue Appia 20, 1211 27 Geneva, Switzerland
| | - Leopold Ouedraogo
- Regional Office for Africa, World Health Organization, BP 06 Brazzaville, Republic of Congo
| | - Triphonie Nkurunziza
- Regional Office for Africa, World Health Organization, BP 06 Brazzaville, Republic of Congo
| | - Sarah Rich
- Women’s Refugee Commission, 15 West 37th Street, 9th Floor, New York, NY 10018 USA
| | - Elizabeth Westley
- International Consortium for Emergency Contraception (hosted by Management Sciences for Health), 45 Broadway, Suite 320, New York, NY 10006 USA
| | - Melissa Garcia
- International Consortium for Emergency Contraception (hosted by Management Sciences for Health), 45 Broadway, Suite 320, New York, NY 10006 USA
| | | | - Ian Askew
- Department of Reproductive Health and Research, World Health Organization, Avenue Appia 20, 1211 27 Geneva, Switzerland
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14
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Nurse-Findlay S, Taylor MM, Savage M, Mello MB, Saliyou S, Lavayen M, Seghers F, Campbell ML, Birgirimana F, Ouedraogo L, Newman Owiredu M, Kidula N, Pyne-Mercier L. Shortages of benzathine penicillin for prevention of mother-to-child transmission of syphilis: An evaluation from multi-country surveys and stakeholder interviews. PLoS Med 2017; 14:e1002473. [PMID: 29281619 PMCID: PMC5744908 DOI: 10.1371/journal.pmed.1002473] [Citation(s) in RCA: 96] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2017] [Accepted: 11/16/2017] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Benzathine penicillin G (BPG) is the only recommended treatment to prevent mother-to-child transmission of syphilis. Due to recent reports of country-level shortages of BPG, an evaluation was undertaken to quantify countries that have experienced shortages in the past 2 years and to describe factors contributing to these shortages. METHODS AND FINDINGS Country-level data about BPG shortages were collected using 3 survey approaches. First, a survey designed by the WHO Department of Reproductive Health and Research was distributed to 41 countries and territories in the Americas and 41 more in Africa. Second, WHO conducted an email survey of 28 US Centers for Disease Control and Prevention country directors. An additional 13 countries were in contact with WHO for related congenital syphilis prevention activities and also reported on BPG shortages. Third, the Clinton Health Access Initiative (CHAI) collected data from 14 countries (where it has active operations) to understand the extent of stock-outs, in-country purchasing, usage behavior, and breadth of available purchasing options to identify stock-outs worldwide. CHAI also conducted in-person interviews in the same 14 countries to understand the extent of stock-outs, in-country purchasing and usage behavior, and available purchasing options. CHAI also completed a desk review of 10 additional high-income countries, which were also included. BPG shortages were attributable to shortfalls in supply, demand, and procurement in the countries assessed. This assessment should not be considered globally representative as countries not surveyed may also have experienced BPG shortages. Country contacts may not have been aware of BPG shortages when surveyed or may have underreported medication substitutions due to desirability bias. Funding for the purchase of BPG by countries was not evaluated. In all, 114 countries and territories were approached to provide information on BPG shortages occurring during 2014-2016. Of unique countries and territories, 95 (83%) responded or had information evaluable from public records. Of these 95 countries and territories, 39 (41%) reported a BPG shortage, and 56 (59%) reported no BPG shortage; 10 (12%) countries with and without BPG shortages reported use of antibiotic alternatives to BPG for treatment of maternal syphilis. Market exits, inflexible production cycles, and minimum order quantities affect BPG supply. On the demand side, inaccurate forecasts and sole sourcing lead to under-procurement. Clinicians may also incorrectly prescribe BPG substitutes due to misperceptions of quality or of the likelihood of adverse outcomes. CONCLUSIONS Targets for improvement include drug forecasting and procurement, and addressing provider reluctance to use BPG. Opportunities to improve global supply, demand, and use of BPG should be prioritized alongside congenital syphilis elimination efforts.
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Affiliation(s)
- Stephen Nurse-Findlay
- Department of Reproductive Health, World Health Organization, Geneva, Switzerland
- * E-mail:
| | - Melanie M. Taylor
- Department of Reproductive Health, World Health Organization, Geneva, Switzerland
- Division of STD Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Margaret Savage
- Clinton Health Access Initiative, Boston, Massachusetts, United States of America
| | - Maeve B. Mello
- Pan American Health Organization, Washington, District of Columbia, United States of America
| | - Sanni Saliyou
- African Regional Office, World Health Organization, Brazzaville, Congo
| | - Manuel Lavayen
- Pan American Health Organization, Washington, District of Columbia, United States of America
| | - Frederic Seghers
- Clinton Health Access Initiative, Boston, Massachusetts, United States of America
| | - Michael L. Campbell
- Clinton Health Access Initiative, Boston, Massachusetts, United States of America
| | | | - Leopold Ouedraogo
- African Regional Office, World Health Organization, Brazzaville, Congo
| | - Morkor Newman Owiredu
- Intercountry Support Team for East and Southern Africa, World Health Organization, Harare, Zimbabwe
| | - Nancy Kidula
- Intercountry Support Team for East and Southern Africa, World Health Organization, Harare, Zimbabwe
| | - Lee Pyne-Mercier
- Bill & Melinda Gates Foundation, Seattle, Washington, United States of America
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15
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Leduc A, Traoré YN, Boyer K, Magne M, Grygiel P, Juhasz CC, Boyer C, Guerin F, Wonni I, Ouedraogo L, Vernière C, Ravigné V, Pruvost O. Bridgehead invasion of a monomorphic plant pathogenic bacterium:Xanthomonas citripv. citri, an emerging citrus pathogen in Mali and Burkina Faso. Environ Microbiol 2015; 17:4429-42. [DOI: 10.1111/1462-2920.12876] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2014] [Accepted: 03/06/2015] [Indexed: 11/29/2022]
Affiliation(s)
- A. Leduc
- UMR PVBMT; CIRAD; 97410 Saint Pierre La Réunion France
| | | | - K. Boyer
- UMR PVBMT; CIRAD; 97410 Saint Pierre La Réunion France
| | - M. Magne
- UMR PVBMT; CIRAD; 97410 Saint Pierre La Réunion France
| | - P. Grygiel
- UMR PVBMT; CIRAD; 97410 Saint Pierre La Réunion France
| | - C. C. Juhasz
- UMR PVBMT; CIRAD; 97410 Saint Pierre La Réunion France
| | - C. Boyer
- UMR PVBMT; CIRAD; 97410 Saint Pierre La Réunion France
| | - F. Guerin
- UMR PVBMT; Université de la Réunion; 97410 Saint Pierre La Réunion France
| | - I. Wonni
- Institut de l'Environnement et de Recherches agricoles; 01 BP910 Bobo Dioulasso Burkina Faso
| | - L. Ouedraogo
- Institut de l'Environnement et de Recherches agricoles; 01 BP910 Bobo Dioulasso Burkina Faso
| | - C. Vernière
- UMR PVBMT; CIRAD; 97410 Saint Pierre La Réunion France
| | - V. Ravigné
- UMR BGPI; CIRAD; 34398 Montpellier France
| | - O. Pruvost
- UMR PVBMT; CIRAD; 97410 Saint Pierre La Réunion France
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16
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Wonni I, Cottyn B, Detemmerman L, Dao S, Ouedraogo L, Sarra S, Tekete C, Poussier S, Corral R, Triplett L, Koita O, Koebnik R, Leach J, Szurek B, Maes M, Verdier V. Analysis of Xanthomonas oryzae pv. oryzicola population in Mali and Burkina Faso reveals a high level of genetic and pathogenic diversity. Phytopathology 2014; 104:520-31. [PMID: 24199713 DOI: 10.1094/phyto-07-13-0213-r] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Abstract
Bacterial leaf streak (BLS) caused by Xanthomonas oryzae pv. oryzicola was first reported in Africa in the 1980s. Recently, a substantial reemergence of this disease was observed in West Africa. Samples were collected at various sites in five and three different rice-growing regions of Burkina Faso and Mali, respectively. Sixty-seven X. oryzae pv. oryzicola strains were isolated from cultivated and wild rice varieties and from weeds showing BLS symptoms. X. oryzae pv. oryzicola strains were evaluated for virulence on rice and showed high variation in lesion length on a susceptible cultivar. X. oryzae pv. oryzicola strains were further characterized by multilocus sequence analysis (MLSA) using six housekeeping genes. Inferred dendrograms clearly indicated different groups among X. oryzae pv. oryzicola strains. Restriction fragment length polymorphism analysis using the transcriptional activator like effector avrXa7 as probe resulted in the identification of 18 haplotypes. Polymerase chain reaction-based analyses of two conserved type III effector (T3E) genes (xopAJ and xopW) differentiated the strains into distinct groups, with xopAJ not detected in most African X. oryzae pv. oryzicola strains. XopAJ functionality was confirmed by leaf infiltration on 'Kitaake' rice Rxo1 lines. Sequence analysis of xopW revealed four groups among X. oryzae pv. oryzicola strains. Distribution of 43 T3E genes shows variation in a subset of X. oryzae pv. oryzicola strains. Together, our results show that African X. oryzae pv. oryzicola strains are diverse and rapidly evolving, with a group endemic to Africa and another one that may have evolved from an Asian strain.
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17
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Juhasz CC, Leduc A, Boyer C, Guérin F, Vernière C, Pruvost O, Wonni I, Ouedraogo L. First Report of Xanthomonas citri pv. citri Causing Asiatic Citrus Canker in Burkina Faso. Plant Dis 2013; 97:1653. [PMID: 30716843 DOI: 10.1094/pdis-06-13-0600-pdn] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
Citrus canker, caused by Xanthomonas citri pv. citri, is a bacterial disease of economic importance in tropical and sub-tropical citrus-producing areas (EPPO-PQR online database). X. citri pv. citri causes severe infection in a wide range of citrus species, and induces erumpent, callus-like lesions with water-soaked margins leading to premature fruit drop and twig dieback. It has consequently been subjected to eradication efforts and international regulations. It was first described on the African continent in South Africa at the beginning of the 20th century, from which it was eventually eradicated. Since 2006, several outbreaks caused by phylogenetically diverse strains of X. citri pv. citri have been reported from several African countries (Ethiopia, Mali, Senegal, and Somalia). In July 2011, citrus canker in Burkina Faso was suspected in the area adjacent to the Sikassso Province of Mali where X. citri pv. citri has been confirmed. In November and December 2012, leaves of clementine (Citrus clementina), lemon (C. limon), Volkamer lemon (C. volkameriana), sweet orange (C. sinensis), tangelo (C. paradisi× C. reticulata), and mandarin (C. reticulata) were collected from orchards with trees showing symptoms of citrus canker in the Comoé, Houet, and Kénédougou provinces of Burkina Faso. Isolations performed using KC semi-selective medium (4) recovered 45 Xanthomonas-like strains. All Xanthomonas-like strains were tentatively identified as X. citri pv. citri by PCR (4/7 primers) using IAPAR 306 and sterile distilled water as the positive and negative controls, respectively (3). Among these, two strains (LK4-4 and LK4-5) produced a 'fuscans'-like brown diffusible pigment, a phenotype never reported previously for X. citri pv. citri. MultiLocus Sequence Analysis targeting six housekeeping genes (atpD, dnaK, efp, gltA, gyrB, and lepA) (1,2) fully identified seven strains from Burkina Faso (LJ301-1, LJ303-1, LK1-1, LK2-6, LK4-3, LK4-4, and LK4-5) as X. citri pv. citri (and not to any other Xanthomonas pathovars pathogenic to citrus or host range-restricted pathotypes of pathovar citri), and more specifically as sequence type ST2 which is composed mostly of pathotype A strains of X. citri pv. citri (2). The same seven strains were inoculated to at least four leaves of each of grapefruit cv. Henderson, Mexican lime SRA 140 (C. aurantifolia), Tahiti lime SRA 58 (C. latifolia), and sweet orange cv. Washington Navel, using a detached leaf assay (2). All strains developed typical erumpent, callus-like tissue at wound sites on all citrus species inoculated. No lesions developed on the negative control (sterile 10 mM tris buffer). Koch's postulate was fulfilled after reisolation of Xanthomonas-like yellow colonies from symptoms on Mexican lime produced by the seven strains. Boiled bacterial suspensions were assayed by PCR with 4/7 primers (3) and produced the expected 468-bp amplicon in contrast with the PCR negative control. To our knowledge, this is the first report of X. citri pv. citri in Burkina Faso. Citrus canker-free nurseries and grove sanitation should be implemented for reducing the prevalence of Asiatic canker in Burkina Faso and a thorough survey of citrus nurseries and groves in the region should be conducted. References: (1) N. F. Almeida et al. Phytopathology 100:208, 2010. (2) L. Bui Thi Ngoc et al. Int. J. Syst. Evol. Microbiol. 60:515, 2010. (3) J. S. Hartung et al. Phytopathology 86:95, 1996. (4) O. Pruvost et al. J. Appl. Microbiol. 99:803, 2005.
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Affiliation(s)
- C C Juhasz
- CIRAD-Université de la Réunion, UMR PVBMT, Saint Pierre, La Réunion, F-97410 France
| | - A Leduc
- CIRAD-Université de la Réunion, UMR PVBMT, Saint Pierre, La Réunion, F-97410 France
| | - C Boyer
- CIRAD-Université de la Réunion, UMR PVBMT, Saint Pierre, La Réunion, F-97410 France
| | - F Guérin
- CIRAD-Université de la Réunion, UMR PVBMT, Saint Pierre, La Réunion, F-97410 France
| | - C Vernière
- CIRAD-Université de la Réunion, UMR PVBMT, Saint Pierre, La Réunion, F-97410 France
| | - O Pruvost
- CIRAD-Université de la Réunion, UMR PVBMT, Saint Pierre, La Réunion, F-97410 France
| | - I Wonni
- Institut de l'Environnement et Recherches Agricoles, Bobo Dioulasso, Burkina Faso
| | - L Ouedraogo
- Institut de l'Environnement et Recherches Agricoles, Bobo Dioulasso, Burkina Faso
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Zoungrana J, Traore A, Ouedraogo L. P256: Survey of prevalence of healthcare associated infection in Chuyo Ouagadougou (Burkina Faso). Antimicrob Resist Infect Control 2013. [PMCID: PMC3688075 DOI: 10.1186/2047-2994-2-s1-p256] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
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Goepfert P, Elizaga M, Montefiori D, Hural J, DeRosa S, Tomaras G, Seaton K, Sato A, Ouedraogo L, Donastorg Y, Cardinali M, Lama J, Baden L, Keefer M, McElrath J, Kalams S, Robinson H. Phase 2a safety and immunogenicity testing of DNA and recombinant modified vaccinia ankara virus vaccines expressing virus-like particles. Retrovirology 2012. [PMCID: PMC3441271 DOI: 10.1186/1742-4690-9-s2-o56] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Affiliation(s)
- P Goepfert
- University of Alabama at Birmignham, Birmingham, AL, USA
| | - M Elizaga
- Fred Hutchinson Cancer Research Institute, Seattle, WA, USA
| | | | - J Hural
- Fred Hutchinson Cancer Research Institute, Seattle, WA, USA
| | - S DeRosa
- Fred Hutchinson Cancer Research Institute, Seattle, WA, USA
| | | | - K Seaton
- Duke University, Durham, NC, USA
| | - A Sato
- Fred Hutchinson Cancer Research Institute, Seattle, WA, USA
| | - L Ouedraogo
- NIAID Vaccine Clinical Research Branch, Bethesda, MD, USA
| | - Y Donastorg
- Unidad de Vacunas IDCP-COIN-DIGECITSS, Santo Dominago, Dominican Republic
| | - M Cardinali
- NIAID Vaccine Clinical Research Branch, Bethesda, MD, USA
| | - J Lama
- Asociacion Civil IMPACTA Salud y Educacion, Barranco, Lima, Peru
| | - L Baden
- Brigham and Women's Hospital, Boston, MA, USA
| | - M Keefer
- University of Rochester, Rochester, NY, USA
| | - J McElrath
- Fred Hutchinson Cancer Research Instituted, Seattle, WA, USA
| | - S Kalams
- Vanderbilt University, Nashville, TN, USA
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Spearman P, Tomaras G, Montefiori D, Huang Y, Ahmed H, Elizaga M, Hural J, McElrath J, Ouedraogo L, Pensiero M, Butler C, Kalams S, Overton ET, Barnett S, Group N. Rapid development of cross-clade neutralizing antibody responses after clade B gp120/gp140 protein priming and clade c gp140 protein boosting. Retrovirology 2012. [PMCID: PMC3441648 DOI: 10.1186/1742-4690-9-s2-p137] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Wonni I, Ouedraogo L, Verdier V. First Report of Bacterial Leaf Streak Caused by Xanthomonas oryzae pv. oryzicola on Rice in Burkina Faso. Plant Dis 2011; 95:72. [PMID: 30743690 DOI: 10.1094/pdis-08-10-0566] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Bacterial leaf streak (BLS) caused by Xanthomonas oryzae pv. oryzicola is prevalent in Asia where it can decrease yield by as much as 30%. In Africa, BLS has been reported in Madagascar, Nigeria, Senegal, and recently in Mali (1). The pathogen is seed transmitted and rice seeds can be a source of primary inoculum (3). In October 2009, leaf streak symptoms were observed on 3-month-old field rice grown in three regions of Burkina Faso (Haut-Bassin, Cascades, and East Center). Disease was found on cultivated Oryza sativa (varieties TS2, FKR19, and FKR56N), wild rice species (O. longistaminata and O. barthii), and weeds. Symptoms consisted of water-soaked lesions that developed into translucent, yellow streaks with visible exudates at the leaf surface. Yellow-pigmented Xanthomonas-like colonies were isolated on PSA semiselective medium (peptone 10 g, sucrose 10 g, bacto agar 16 g, distilled water 1,000 ml, actidione 50 mg liter-1, cephalexin 40 mg liter-1, and kasugamycin 20 mg liter-1). A multiplex PCR developed for the identification of Xanthomonas oryzae pathovars (2) was used to check the identity of Xanthomonas-like isolates. X. oryzae pv. oryzicola strains BLS256 from the Philippines and CFBP 7331 from Mali were used as positive controls. Three expected DNA fragments (331, 691, and 945 bp) corresponding to X. oryzae pv. oryzicola were obtained from all isolates using the multiplex PCR. No fragment was observed for negative controls (distilled water as the template). Five X. oryzae pv. oryzicola isolates were further analyzed by sequence analysis using portions of the gyrB housekeeping gene together with reference strains. Two sequence types were identified among Burkinabe isolates differing by only one nucleotide. When compared with the nucleotide database with BLAST, three isolates (BAI6, BAI15, and BAI19) were 100% identical to the type culture strain X. oryzae pv. oryzicola BLS256 (gyrB sequence was obtained from GenBank AAQN01000001.1) while the other two (BAI5 and BAI20) demonstrated 99% sequence similarity. The nucleotide sequence of isolate BAI5 was submitted to GenBank (HQ112342). Pathogenicity tests were performed on greenhouse-grown 3-week-old rice plants cv. Nipponbare. Cultures were grown overnight in PSA medium and adjusted in sterile water to 1 × 108 CFU/ml and inoculated into rice leaves with the blunt end of a 1-ml syringe. Four infiltrations were done per isolate per leaf and two leaves were inoculated per plant. Control plants were inoculated with sterile water. After 15 days of incubation in the greenhouse at 27 ± 1°C with a 12-h photoperiod, inoculated leaves exhibited water-soaked lesions with yellow exudates that were identical to symptoms seen in the field. Control plants remained symptomless. Colonies with morphology typical of Xanthomonas were recovered from the symptomatic leaves and typed using multiplex PCR to fulfill Koch's postulates. Three isolates have been deposited in the Collection Française de Bactéries Phytopathogènes (CFBP) and identified as X. oryzae pv. oryzicola strains CFBP7341-43. To our knowledge, this is the first report of X. oryzae pv. oryzicola in Burkina Faso. Further surveys and strain collection will be necessary to evaluate the geographic distribution and prevalence of BLS in Burkina Faso and neighboring countries. References: (1) C. Gonzalez et al. Mol. Plant-Microbe Interact. 20:534, 2007. (2) J. Lang et al. Plant Dis. 94:311, 2010. (3) G. Xie and T. Mew. Plant Dis. 82:1007, 1998.
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Affiliation(s)
- I Wonni
- INERA Bobo-Dioulasso, Burkina Faso
| | | | - V Verdier
- UMR 5096 IRD-CNRS-U. Perpignan, Laboratoire Génome et Développement des Plantes, 911 Avenue Agropolis BP 64501, 34394 Montpellier Cedex 5, France
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Sombie I, Kambou T, Conombo SG, Sankara O, Ouedraogo L, Zoungrana T, Hounton S, Meda N. [Retrospective study of urogenital fistula in Burkina Faso from 2001 to 2003]. Med Trop (Mars) 2007; 67:48-52. [PMID: 17506273] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/15/2023]
Abstract
The purpose of this study was to analyze aspects of obstetric urogenital fistulae to provide a foundation for implementation of a national control program in Burkina Faso. A cross-sectional study with quantitative and qualitative components was carried out in 47 hospitals in January 2004. The quantitative component consisted of analyzing available data for 2001, 2002 and 2003. The qualitative component consisted of interviewing women with fistulae to evaluate the impact of the disease on the quality of life and persons in charge of the health reference centers to identify the difficulties and needs of the facility. In the 3-year study period, 1,500,000 deliveries were attended and 347 fistulae were identified in the health reference centers. The incidence rate of obstetric fistulae was 23.1 per 100 000 deliveries (CI 95% 20.8-25.7). Women with fistulae were young and usually without paid employment. Many had a history of dystocia during the labor. Most fistulae were recent, small or average in size and located at the level of the vesico-vaginal septum. The failure rate of surgical treatment was about 17.5%. Four of the 12 women interviewed reported social alienation and ostrasization. Only 4 of the 47 hospitals studied had a personnel qualified to manage women with urogenital fistula on a daily basis. One NGO assisted women in obtaining care. Proposals for improvement of the situation were considered at a national validation workshop. These findings support the need to implement a national program that should be evaluated to see lessons learned from this study.
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Affiliation(s)
- I Sombie
- Centre Muraz, 01 BP 390 Bobo-Dioulasso 01, Burkina Faso.
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Ouedraogo L, Magnon M, Sawadogo L, Tricoche R. Receptors involved in the positive inotropic action induced by dopamine on the ventricle of a 7-day-old chick embryo heart. Fundam Clin Pharmacol 1998; 12:133-42. [PMID: 9565766 DOI: 10.1111/j.1472-8206.1998.tb00933.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Earlier experiments only revealed involvement of sympathetic pre-synaptic dopaminergic receptors in dopamine induced inotropism in myocardium. We therefore used electrically stimulated (1 Hz) isolated 7-day-old chick embryo heart ventricles, thought to be devoid of functional sympathetic nerves, to re-investigate post-synaptic receptors involvement and particularly that of dopaminergic receptors in the positive inotropic effect of dopamine. The results showed that noradrenaline, isoprenaline and dopamine produced a positive inotropic effect with a similar efficacy and with an order of potency as follows: Isoprenaline = Noradrenaline > Dopamine. Tyramine induced no significant modification of the "initial tension" indicating that functional sympathetic innervation and/or releasable endogenous catecholamines were not demonstrable in the 7-day-old chick embryo heart ventricle. Propranolol (1 microM) competitively antagonized the positive inotropic response to isoprenaline, noradrenaline and dopamine, meanwhile phentolamine (3 microM) failed to significantly modify the effects of both noradrenaline and dopamine, indicating that these catecholamines induced their positive inotropic effects via stimulation of beta-adrenoceptors; involvement of alpha-adrenergic receptors stimulation was not demonstrable in these effects. Moreover, haloperidol (2 microM) antagonized the positive inotropic response to dopamine but had not any significant effect on the response to isoprenaline. The combined application of both propranolol and haloperidol antagonized the positive inotropic response to dopamine to a greater extent than when these two antagonists were given alone. Consequently, post-synaptic dopaminergic receptors were also involved in the positive inotropic effect of dopamine. Furthermore, in preparations in which sodium channels were inactivated by high potassium physiological salt solution, high concentrations of dopamine (0.1 mM to 1 mM) induced a slow developing electrical and positive inotropic responses which were also inhibited by propranolol and haloperidol, but not by phentolamine. These latter results indicated that like beta-adrenergic stimulation, the slow inward calcium current activated by stimulation of adenylate cyclase, was at least in part involved in the positive inotropic response to dopamine. In conclusion, dopamine induced its positive inotropism via stimulation of post-synaptic beta-adrenergic and dopaminergic receptors. The contribution of dopaminergic receptors in this positive inotropic effect might be of the DA-2 receptors since haloperidol used had been reported to be more DA-2 than DA-1 antagonist. These DA-2 receptors subtypes would mediate activation of adenylate cyclase.
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Affiliation(s)
- L Ouedraogo
- Département de Biologie et Physiologie Animales, Faculté des Sciences et Techniques (FAST) Université de Ouagadougou, Burkina Faso
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Abstract
Isolated ventricles of developing chick embryo heart, paced at 1 Hz, were used to assess the positive inotropic responses to isoprenaline and noradrenaline in order to characterize the adrenergic receptors involved in these effects. In 7 day-old-chick embryo heart ventricle, isoprenaline and noradrenaline exhibited similar potencies and efficacies. Moreover, propranolol (1 microM) inhibited the positive inotropic effect of isoprenaline and noradrenaline, while pentholamine (3 microM) failed to affect the latter response; in addition, phenylephrine (1 microM-1 mM) had no positive inotropic effect. It was therefore concluded that isoprenaline and noradrenaline induce their effect via stimulation of beta-adrenergic receptors. The efficacy of isoprenaline and noradrenaline and the potency of isoprenaline increased from the 7th to 10th day while the potency of noradrenaline decreased. The decrease in noradrenaline potency with age was attributed to its uptake, while the increase in isoprenaline potency was attributed to the increase in beta-adrenergic receptors. However, the increase in efficacy of both isoprenaline and noradrenaline with age might be due to the higher density and/or higher maturity of contractile proteins.
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Affiliation(s)
- L Ouedraogo
- Laboratoire de physiologie animale, faculté des sciences et techniques, université de Ouagadougou, Burkina Faso
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Baudon D, Galaup B, Ouedraogo L, Gazin P. [Malaria morbidity in a hospital environment in Burkina Faso (West Africa)]. Med Trop (Mars) 1988; 48:9-13. [PMID: 3285119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
We carried out a study on malaria morbidity from November 1982 to October 1983 in the Pediatric Department of the Hospital of Bobo Dioulasso (Burkina Faso, West Africa). Malaria fever attacks were present in 21.4% of all febrile cases. The highest rate was observed in the 2-4 age group (42%). We observed 97.4% of all malaria fever attacks during the rainy season and the beginning of the dry season (June to December).
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Affiliation(s)
- D Baudon
- Service de santé des Armées, I.M.T.S.S.A., Marseille Armées
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Ouedraogo L, Chalumeau-Le Foulgoc MT. [Influence of experimental metamorphosis on plasma and erythrocyte lactic dehydrogenase isoenzymes in Ambystoma mexicanum Shaw]. C R Acad Hebd Seances Acad Sci D 1973; 276:1749-52. [PMID: 4202592] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
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