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High prevalence of hepatitis B infections in Burkina Faso (1996-2017): a systematic review with meta-analysis of epidemiological studies
Get PDF博士(医学)Doctor of Philosophy in Medical Science広島大
High prevalence of hepatitis B infections in Burkina Faso (1996-2017): a systematic review with meta-analysis of epidemiological studies
No full textMaternal antenatal malaria and sexually transmitted infections treatment for the prevention of low birth weight in rural areas of Burkina Faso
No full textAbstract: Low birth weight (LBW, <2,500 g), caused by impaired fetal growth or preterm birth, is the biggest driver of neonatal mortality as it is associated with nearly 80% of all neonatal deaths in sub–Saharan Africa (SSA). In this region, maternal exposure during pregnancy to malaria and sexually transmitted infections (STIs) substantially contribute to LBW occurrence. While there is the WHO recommended sulfadoxine-pyrimethamine based intermittent preventive treatment of malaria in pregnancy (IPTp-SP) strategy to prevent malaria associated adverse birth outcomes, no chemoprevention exists for STIs. Current practices tend to associate an antibiotic efficacious on curable bacterial STIs to the routine IPTp-SP to prevent the combined effects of these infections. However, the hypothesis of whether this combination can reduce LBW is unclear.The context of this study, conducted in rural areas of Burkina Faso, is characterized by a poor socio-economic and security situation resulting in weak health indicators, difficult access to basic health services and a high prevalence of LBW and its contributing infectious factors. The overall aim of the thesis was to contribute to reducing the incidence of adverse birth outcomes in Burkina Faso by systematically adding an antibiotic efficacious on STIs to the WHO recommended IPTp-SP. Specifically, we aimed to i) determine the prevalence and factors associated with LBW; ii) determine the magnitude of pregnant women exposure to malaria and bacterial STIs (syphilis, chlamydiosis and gonorrhea); and iii) test the effects of adding two oral doses of azithromycin to the IPTp-SP strategy to reduce the risk of LBW.Our data showed that LBW prevalence remains high and represented 12% (35/291) of all live-newborns in a health facility-based study conducted in Nanoro heath district at the start of the new IPTp policy. Five years after the start of the new policy, although a reduction trend was observed, the prevalence remained high and 11% (66/600) of neonates assessed were low birth weight in a health facility-based case series study. The analyses showed that several modifiable factors can be targeted to reduce the risk of LBW. Indeed, malaria, which prevalence varied between 17 and 25% according to the diagnostic approach used, was associated with a two-time increase of the risk of LBW. Neonates born from mothers who did not uptake at least three doses of SP for malaria prophylaxis during their pregnancy were shown with a two-times increased risk of LBW. The non-use of insecticide treated nets was also significantly associated with LBW (2.5 times increase). Adolescent primigravid mothers were particularly exposed to LBW delivery, malaria, and sexually transmitted infections.The intervention study within which we included pregnant women at their early stage of pregnancy, showed that the adjunction of azithromycin to the three doses IPTp-SP could not significantly reduce the incidence of LBW across treatment arms beyond that of the three doses IPTp-SP alone (9.4% versus 8.7%). However, the reported rates were lower than that reported in our epidemiological studies, suggesting that an early and adequate initiation of the three-doses IPTp-SP still represents an effective prevention measure. We concluded that the prevalence of LBW in the context of Burkina Faso remains high and that ensuring a minimum of three doses of sulfadoxine pyrimethamine remains an effective prevention strategy. The adjunction of azithromycin to the IPTp-SP regimen did not yield any further benefits. Therefore, strengthening the three doses IPTp-SP strategy would be necessary. Additional interventions are needed to reduce the incidence of LBW so that the neonatal mortality reduction’s goal targeted by the United Nations sustainable development goals (SDGs) can be achievedRésumé: Le petit poids de naissance (PPN, <2 500 g), causé par un retard de croissance intra-utérin ou par une naissance prématurée, est le principal facteur de mortalité néonatale car il est associé à près de 80% des décès néonatals survenant en Afrique subsaharienne. Dans cette région, l'exposition maternelle pendant la grossesse au paludisme et aux infections sexuellement transmises (ISTs) est associée à la survenue de PPN. Pendant que la stratégie du traitement préventif intermittent du paludisme pendant la grossesse avec la sulfadoxine pyriméthamine (TPIg-SP) est recommandée par l’OMS pour prévenir les effets du paludisme, il n’existe aucun traitement préventif pour les ISTs. La pratique actuelle tend à associer un antibiotique efficace sur les ISTs bactériennes au TPIg-SP afin de prévenir leurs effets. Cependant, l’hypothèse que cette association réduirait le risque de PPN n'est pas encore élucidé.Le contexte de cette étude, menée en milieu rural du Burkina Faso, est caractérisé par un défi socio-économique et sécuritaire difficile résultant en de faibles indicateurs sanitaires et une prévalence élevée de PPN et de ses facteurs infectieux. Le but de cette thèse était de contribuer à la réduction de la survenue des issues défavorables de grossesse par l’adjonction systématique d’un antibiotique efficace sur les ISTs au TPIg-SP recommandé par l'OMS. Plus précisément, il s’est agi de i) déterminer la prévalence et les facteurs associés au PPN; ii) déterminer l'ampleur de l’exposition maternelle pendant la grossesse au paludisme et aux ISTs (syphilis, chlamydiose and gonorrhée); et iii) tester l’efficacité et la sécurité d’une stratégie de prévention du PPN associant deux doses d'azithromycine au TPIg-SP pour réduire le risque de PPN.Nos données montrent que la prévalence de l'insuffisance pondérale à la naissance reste élevée et qu'elle a représenté 12% (35/291) de l’ensemble des nouveau-nés vivants au cours d’une étude menée au sein des formations sanitaires du district de santé de Nanoro au début de la nouvelle politique de TPIg. Cinq ans après le début de la nouvelle politique, bien qu'une tendance à la réduction ait été observée, la prévalence est reste élevée et 11% (66/600) des nouveau-nés évalués présentaient une insuffisance pondérale à la naissance dans le cadre d'une série de cas collectés dans quatre formations sanitaires du district sanitaire de Yako.Les analyses ont montré que plusieurs facteurs modifiables peuvent être ciblés pour réduire le risque de PPN. En effet, le paludisme, dont la prévalence variait entre 17% et 25% selon l'approche diagnostique utilisée, était associé à une multiplication par deux du risque de PPN comparativement aux mères sans paludisme. Les nouveau-nés de mères n'ayant pas pris au moins trois doses de SP pour la prophylaxie du paludisme pendant la grossesse montraient également un risque de PPN multiplié par plus de deux. La non-utilisation de moustiquaires imprégnées d'insecticide était également significativement associée (2,5 fois plus) au PPN. Les adolescentes primigestes étaient particulièrement exposées à la fois au PPN, au paludisme et aux infections sexuellement transmises.L'étude d'intervention au cours de laquelle nous avons inclus des femmes enceintes à un stade précoce de leurs grossesses a montré que l'ajout d'azithromycine aux trois doses de TPIg-SP ne réduisait pas de façon significative le risque du PPN entre les bras de traitements (8.7% dans le bras intervention versus 9,4% dans le bras contrôle). Cependant, les taux rapportés étaient inférieurs à ceux de nos études épidémiologiques, suggérant ainsi qu'une initiation précoce et adéquate de la stratégie des trois doses de TPIg-SP reste une mesure de prévention efficace.Nous avons conclu que la prévalence du PPN dans le contexte du Burkina Faso reste élevée et que l'administration d'un minimum de trois doses de sulfadoxine pyriméthamine reste une stratégie de prévention efficace. L'ajout d'azithromycine au TPIg-SP n'a apporté aucun avantage supplémentaire significatif. Par conséquent, un renforcement de la stratégie du traitement préventif intermittent par la sulfadoxine-pyriméthamine (TPIg-SP) avec un minimum de trois doses est nécessaire. Des interventions supplémentaires restent néanmoins nécessaires pour réduire l’incidence du PPN afin que les objectifs de réduction de la mortalité néonatale fixés dans le cadre des objectifs du développement durables (ODD) puissent être réalisés.Doctorat en Santé Publiqueinfo:eu-repo/semantics/nonPublishe
Going Beyond Counting First Authors in Author Co-citation Analysis
Get PDFThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
Variations on the Author
Get PDF“Variations on the Author” discusses two of Eduardo Coutinho’s recent films (Um Dia na Vida, from 2010, and Últimas Conversas, posthumously released in 2015) and their contribution to the general question of documentary authorship. The director’s filmography is characterized by a consistent yet self-effacing form of authorial self-inscription: Coutinho often features as an interviewer that rather than express opinions propels discourses; an interviewer that is good at listening. This mode of self-inscription characterizes him as an author who is not expressive but who is nonetheless markedly present on the screen. In Um Dia na Vida, however, Coutinho is completely absent form the image, while Últimas Conversas, on the contrary, includes a confessional prologue that moves the director from the margins to the center of his films. This article examines the ways in which these works stand out in the filmography of a director who offers new insights into the notion of cinematic authorship
Appropriate Similarity Measures for Author Cocitation Analysis
Get PDFWe provide a number of new insights into the methodological discussion about author cocitation analysis. We first argue that the use of the Pearson correlation for measuring the similarity between authors’ cocitation profiles is not very satisfactory. We then discuss what kind of similarity measures may be used as an alternative to the Pearson correlation. We consider three similarity measures in particular. One is the well-known cosine. The other two similarity measures have not been used before in the bibliometric literature. Finally, we show by means of an example that our findings have a high practical relevance.information science;Pearson correlation;cosine;similarity measure;author cocitation analysis
Dispelling the Myths Behind First-author Citation Counts
Get PDFWe conducted a full-scale evaluative citation analysis study of scholars in the XML research field to explore just how different from each other author rankings resulting from different citation counting methods actually are, and to demonstrate the capability of emerging data and tools on the Web in supporting more realistic citation counting methods. Our results contest some common arguments for the continued
use of first-author citation counts in the evaluation of scholars, such as high correlations between author rankings by first-author citation counts and other citation
counting methods, and high costs of using more realistic citation counting methods that are not well-supported by the ISI databases. It is argued that increasingly available digital full text research papers make it possible for citation analysis studies to go beyond what the ISI databases have directly supported and to employ more
sophisticated methods
koamabayili/VECTRON-author-checklist: VECTRON author checklist
No full textWe have done our best to complete the author checklist relating to the use of animals in the hut study. Note that the objective for the hut study was to evaluate the IRS treatment applications for residual efficacy against Anopheles mosquitoes, including the local An. coluzzii mosquito population. Cows were only used to attract mosquitoes into the huts and no tests were carried out directly on the cows. The author checklist is intended for use with studies where experiments are carried out on animals, which is why we have had such difficulty in completing this for the hut study, as many of the questions do not relate to how the cows were used
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