Dataset Information

Clinical and epidemiologic characteristics associated with dengue during and outside the 2016 outbreak identified in health facility-based surveillance in Ouagadougou, Burkina Faso.

ABSTRACT: BACKGROUND:In Africa, the magnitude of dengue virus (DENV) transmission is largely unknown. In Burkina Faso, several outbreaks have been reported and data are often based on findings from outbreak investigations. METHODS:To better understand dengue epidemiology and clinical characteristics in Burkina Faso, a fever surveillance study was conducted among patients aged 1-55 years, who presented with non-malarial febrile illness at five primary healthcare facilities in Ouagadougou, Burkina Faso from December 2014 to February 2017, encompassing a 3-month dengue outbreak in September-November 2016. Acute and convalescent blood samples were collected within an interval of 10-21 days between visits. Acute samples were tested with dengue rapid diagnostic tests (RDT) and a selected subset with RT-PCR, and all acute/convalescent samples with IgM/IgG ELISA. RESULTS:Among 2929 non-malarial febrile patients, 740 (25%) were dengue-positive based on RT-PCR and/or IgM/IgG ELISA; 428 out of 777 patients (55%) and 312 out of 2152 (14%) were dengue-positive during outbreak and non-outbreak periods, respectively. There were 11% (316/2929) and 4% (129/2929) patients showing positive for NS1 and IgM, on the RDT, respectively. DENV 2 predominated during the outbreak, whereas DENV 3 predominated before the outbreak. Only 25% of dengue-positive cases were clinically diagnosed with suspected dengue. The odds of requiring observation for ?3 days (versus routine outpatient care) were 11 times higher among dengue-positive cases than non-dengue cases. In adjusted analyses, dengue-positivity was associated with rash and retro-orbital pain (OR = 2.6 and 7.4, respectively) during the outbreak and with rash and nausea/vomiting (OR = 1.5 and 1.4, respectively) during the non-outbreak period. CONCLUSION:Dengue virus is an important pathogen in Burkina Faso, accounting for a substantial proportion of non-malarial fevers both during and outside outbreak, but is only infrequently suspected by clinicians. Additional longitudinal data would help to further define characteristics of dengue for improved case detection and surveillance.

SUBMITTER: Lim JK

PROVIDER: S-EPMC6897397 | biostudies-literature | 2019 Dec

REPOSITORIES: biostudies-literature

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Clinical and epidemiologic characteristics associated with dengue during and outside the 2016 outbreak identified in health facility-based surveillance in Ouagadougou, Burkina Faso.

Lim Jacqueline K JK Seydou Yaro Y Carabali Mabel M Barro Ahmed A Dahourou Desire Lucien DL Lee Kang Sung KS Nikiema Teguewende T Namkung Suk S Lee Jung-Seok JS Shin Mee Young MY Bonnet Emmanuel E Kagone Therese T Kaba Losseni L Edwards Tansy T Somé Paul-André PA Yang Jae Seung JS Alexander Neal N Yoon In-Kyu IK Ridde Valéry V

PLoS neglected tropical diseases 20191206 12

<h4>Background</h4>In Africa, the magnitude of dengue virus (DENV) transmission is largely unknown. In Burkina Faso, several outbreaks have been reported and data are often based on findings from outbreak investigations.<h4>Methods</h4>To better understand dengue epidemiology and clinical characteristics in Burkina Faso, a fever surveillance study was conducted among patients aged 1-55 years, who presented with non-malarial febrile illness at five primary healthcare facilities in Ouagadougou, Bu ...[more]

PMID: 31809504

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Project description:BackgroundDengue's emergence in West Africa was typified by the Burkina Faso outbreaks in 2016 and 2017, the nation's largest to date. In both years, we undertook three-month surveys of Aedes populations in or near the capital city Ouagadougou, where the outbreaks were centered.MethodologyIn 1200LG (urban), Tabtenga (peri-urban) and Goundry (rural) localities, we collected indoor and outdoor resting mosquito adults, characterized larval habitats and containers producing pupae and reared immature stages to adulthood in the laboratory for identification. All mosquito adults were identified morphologically. Host species (from which bloodmeals were taken) were identified by PCR. Generalized mixed models were used to investigate relationships between adult or larval densities and multiple explanatory variables.ResultsFrom samples in 1,780 houses, adult Ae. aegypti were significantly more abundant in the two urban localities (Tabtenga and 1200 LG) in both years than in the rural site (Goundry), where Anopheles spp. were far more common. Results from adult collections indicated a highly exophilic and anthropophilic (>90% bloodmeals of human origin) vector population, but with a relatively high proportion of bloodfed females caught inside houses. Habitats producing most pupae were waste tires (37% of total pupae), animal troughs (44%) and large water barrels (30%). While Stegomyia indices were not reliable indicators of adult mosquito abundance, shared influences on adult and immature stage densities included rainfall and container water level, collection month and container type/purpose. Spatial analysis showed autocorrelation of densities, with a partial overlap in adult and immature stage hotspots.ConclusionResults provide an evidence base for the selection of appropriate vector control methods to minimize the risk, frequency and magnitude of future outbreaks in Ouagadougou. An integrated strategy combining community-driven practices, waste disposal and insecticide-based interventions is proposed. The prospects for developing a regional approach to arbovirus control in West Africa or across Africa are discussed.

Project description:BACKGROUND:Given the scarcity of resources in developing countries, malaria treatment requires new strategies that target specific populations, time periods and geographical areas. While the spatial pattern of malaria transmission is known to vary depending on local conditions, its temporal evolution has yet to be evaluated. The aim of this study was to determine the spatio-temporal dynamic of malaria in the central region of Burkina Faso, taking into account meteorological factors. METHODS:Drawing on national databases, 101 health areas were studied from 2011 to 2015, together with weekly meteorological data (temperature, number of rain events, rainfall, humidity, wind speed). Meteorological factors were investigated using a principal component analysis (PCA) to reduce dimensions and avoid collinearities. The Box-Jenkins ARIMA model was used to test the stationarity of the time series. The impact of meteorological factors on malaria incidence was measured with a general additive model. A change-point analysis was performed to detect malaria transmission periods. For each transmission period, malaria incidence was mapped and hotspots were identified using spatial cluster detection. RESULTS:Malaria incidence never went below 13.7 cases/10,000 person-weeks. The first and second PCA components (constituted by rain/humidity and temperatures, respectively) were correlated with malaria incidence with a lag of 2 weeks. The impact of temperature was significantly non-linear: malaria incidence increased with temperature but declined sharply with high temperature. A significant positive linear trend was found for the entire time period. Three transmission periods were detected: low (16.8-29.9 cases/10,000 person-weeks), high (51.7-84.8 cases/10,000 person-weeks), and intermediate (26.7-32.2 cases/10,000 person-weeks). The location of clusters identified as high risk varied little across transmission periods. CONCLUSION:This study highlighted the spatial variability and relative temporal stability of malaria incidence around the capital Ouagadougou, in the central region of Burkina Faso. Despite increasing efforts in fighting the disease, malaria incidence remained high and increased over the period of study. Hotspots, particularly those detected for low transmission periods, should be investigated further to uncover the local environmental and behavioural factors of transmission, and hence to allow for the development of better targeted control strategies.

Project description:BackgroundAlthough the relationship between self-rated health (SRH) and physical and mental health is well documented in developed countries, very few studies have analyzed this association in the developing world, particularly in Africa. In this study, we examine the associations of SRH with measures of physical and mental health (chronic diseases, functional limitations, and depression) among adults in Ouagadougou, Burkina Faso, and how these associations vary by sex, age, and education level.MethodsThis study was based on 2195 individuals aged 15 years or older who participated in a cross-sectional interviewer-administered health survey conducted in 2010 in areas of the Ouagadougou Health and Demographic Surveillance System. Logistic regression models were used to analyze the associations of poor SRH with chronic diseases, functional limitations, and depression, first in the whole sample and then stratified by sex, age, and education level.ResultsPoor SRH was strongly correlated with chronic diseases and functional limitations, but not with depression, suggesting that in this context, physical health probably makes up most of people's perceptions of their health status. The effect of functional limitations on poor SRH increased with age, probably because the ability to circumvent or compensate for a disability diminishes with age. The effect of functional limitations was also stronger among the least educated, probably because physical integrity is more important for people who depend on it for their livelihood. In contrast, the effect of chronic diseases appeared to decrease with age. No variation by sex was observed in the associations of SRH with chronic diseases, functional limitations, or depression.ConclusionsOur findings suggest that different subpopulations delineated by age and education level weight the components of health differently in their self-rated health in Ouagadougou, Burkina Faso. In-depth studies are needed to understand why and how these groups do so.

Project description:BackgroundDespite low endemicity, malaria remains a major health problem in urban areas where a high proportion of fevers are presumptively treated using anti-malarial drugs. Low acquired malaria immunity, behaviour of city-dwellers, access to health care and preventive interventions, and heterogenic suitability of urban ecosystems for malaria transmission contribute to the complexity of the malaria epidemiology in urban areas.MethodsThe study was designed to identify the determinants of malaria transmission estimated by the prevalence of anti-circumsporozoite (CSP) antibodies, the prevalence and density of Plasmodium falciparum infection, and the prevalence of malarial disease in areas of Ouagadougou, Burkina-Faso. Thick blood smears, dried blood spots and clinical status have been collected from 3,354 randomly chosen children aged 6 months to 12 years using two cross-sectional surveys (during the dry and rainy seasons) in eight areas from four ecological strata defined according to building density and land tenure (regular versus irregular). Demographic characteristics, socio-economic information, and sanitary and environmental data concerning the children or their households were simultaneously collected. Dependent variables were analysed using mixed multivariable models with random effects, taking into account the clustering of participants within compounds and areas.ResultsOverall prevalences of CSP-antibodies and P. falciparum infections were 7.7% and 16.6% during the dry season, and 12.4% and 26.1% during the rainy season, respectively, with significant differences according to ecological strata. Malaria risk was significantly higher among children who i) lived in households with lower economic or education levels, iii) near the hydrographic network, iv) in sparsely built-up areas, v) in irregularly built areas, vi) who did not use a bed net, vii) were sampled during the rainy season or ii) had traveled outside of Ouagadougou.ConclusionMalaria control should be focused in areas which are irregularly or sparsely built-up or near the hydrographic network. Furthermore, urban children would benefit from preventive interventions (e.g. anti-vectorial devices or chemoprophylaxis) aimed at reducing malaria risk during and after travel in rural areas.

Dataset Information

Clinical and epidemiologic characteristics associated with dengue during and outside the 2016 outbreak identified in health facility-based surveillance in Ouagadougou, Burkina Faso.

Publications

Clinical and epidemiologic characteristics associated with dengue during and outside the 2016 outbreak identified in health facility-based surveillance in Ouagadougou, Burkina Faso.

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