[Family environment and dental health disparities among urban children in Burkina Faso]

BACKGROUND

Dental caries is the most common multifactorial disease in children and has substantial negative impact on daily life. In sub-Saharan Africa, few data are available on the relationship between dental caries and the social and family environment of children. The objectives of the present study were firstly to assess the level of prevalence and severity of dental caries of children in Ouagadougou, the capital city of Burkina Faso and secondly to determine whether or not individual factors, family and living conditions are linked with dental health disparities within the population.

METHODS

Interview and clinical data were obtained from a household-based cross-sectional survey. A two-stage stratified sampling technique was applied in four areas of Ouagadougou representing different stages of urbanization.

RESULTS

The final study population included 1606 children aged 6-12 years. For the overall group the total caries prevalence rate was 48.2%. Results showed that the dental health status of the mother, social integration of the householder and socioeconomic level of the household were associated with the dental health of children. Disparities in dental health were prominent; poor dental health was relatively frequent in children from households poorly integrated into social networks with rather acceptable standard in terms of material wealth.

CONCLUSION

Our study showed that individual factors as well as family-related and environmental factors had an influence on their caries experience. The rapidly changing lifestyle affects oral health and the burden of oral diseases is expected to increase initially in people of upper classes and later in disadvantaged people. Disease prevention focussing on common risk factors of chronic diseases should be enhanced. In addition, the accessibility of quality fluoride products (e.g. toothpaste, salt, water) should be facilitated as soon as possible.

Conversion rate at two-month follow-up of smear-positive tuberculosis patients in Burkina Faso

SETTING

Burkina Faso, West Africa.

OBJECTIVE

1) To determine the trend of sputum smear conversion rates at the 2-month follow-up of new smear-positive tuberculosis (TB) patients; and 2) to compare conversion rates in cured TB patients and treatment failures.

DESIGN

Retrospective cohort study based on TB registers from all 80 diagnostic and treatment centres from 1995 to 2003. The conversion rate was defined as the number of negative results divided by the number of smear-positive patients for whom the 2-month follow-up examination was completed.

RESULTS

The 2-month follow-up completion rate was 92.1%; it increased from 86.3% in 1996 to 94.3% in 2003. The conversion rate was 82.9%, increasing from 76.3% in 1995 to 87.9% in 1997 and falling to 80.3% in 2003. The cure rate was higher among patients who were smear-negative at the 2-month follow-up (77.3%)

CONCLUSION

The conversion rate was satisfying, but had declined since 1997, which may be a matter of concern. This could be due to patient characteristics such as associated conditions (human immunodeficiency virus, malnutrition) or to drug management (ineffective administration of drugs even under directly observed treatment, insufficient dosages, resistance). Thorough research is needed to elucidate this negative trend.

[Nutritional status on admission and hospital mortality of under-five year old children with infectious diseases in Ouagadougou, Burkina Faso]

BACKGROUND

It is known that malnutrition in childhood interacting with infectious diseases contributes to increase mortality. In Burkina Faso, infectious pathologies and malnutrition are public health problems. We examined the impact of malnutrition status, using the Weight-for-age (WA) index, on mortality of children hospitalized for infectious diseases.

METHODS

This retrospective study uses a systematic sample derived from the year 1999 hospital register. In total data of 1573 children from 0 to 59 months were analyzed. The association between mortality and dependent variables was measured by relative risks (RR) in univariate analysis. A logistic regression was realized and attributable risk percent (etiologic fraction among exposed) of death was calculated.

RESULTS

The total intra-hospital lethality amounted to 15.3%. Age, diagnosis, type of care recourse and malnutrition (low WA index) on admission were associated to mortality. The logistic regression model confirmed the high risks of deaths for young children (0-11m), children in malnutrition (low WA index) and those with severe malaria. The attributable risk percent of death indicates that, 87% of deaths are statically attributable to severe malnutrition (WA Z-score<=-3) and 64.3% of deaths are statically attributable to moderate malnutrition (WA Z-score]-3, -2]).

CONCLUSION

Nutritional status evaluation would allow to select children at risk and reduce mortality by including nutritional intervention in standard treatment of children hospitalized for infectious diseases.