βu.ɾǔː.ndi]; Swahili: Jamuhuri ya Burundi; French: République du Burundi, [buʁundi] or [byʁyndi]), is a landlocked country in the Great Rift Valley where the African Great Lakes region and East Africa converge. It is bordered by Rwanda to the north, Tanzania to the east and southeast, and the Democratic Republic of the Congo to the west; Lake Tanganyika lies along its southwestern border. The capital cities are Gitega and Bujumbura, the latter of which is the country's largest city.The Twa, Hutu and Tutsi peoples have lived in Burundi for at least 500 years. For more than 200 of those years, Burundi was an independent kingdom, until the beginning of the 20th century, when Germany ruled the region. After the First World War and Germany's defeat, the League of Nations "mandated" the territory to Belgium. After the Second World War, this transformed into a United Nations Trust Territory. Both Germans and Belgians ruled Burundi and Rwanda as a European colony known as Ruanda-Urundi. Burundi and Rwanda had never been under common rule until the time of European invasion of Africa.Burundi gained independence in 1962 and initially had a monarchy, but a series of assassinations, coups and a general climate of regional instability culminated in the establishment of a republic and a one-party state in 1966. Bouts of ethnic cleansing and ultimately two civil wars and genocides during the 1970s and again in the 1990s resulted in hundreds of thousands of deaths, leaving the economy undeveloped and the population as one of the world's poorest. The year 2015 witnessed large-scale political strife as President Pierre Nkurunziza opted to run for a third term in office, a coup attempt failed and the country's parliamentary and presidential elections were broadly criticised by members of the international community.The sovereign state of Burundi's political system is that of a presidential representative democratic republic based upon a multi-party state. The president of Burundi is the head of state and head of government. There are currently 21 registered parties in Burundi. On 13 March 1992, Tutsi coup leader Pierre Buyoya established a constitution, which provided for a multi-party political process and reflected multi-party competition. Six years later, on 6 June 1998, the constitution was changed, broadening the National Assembly's seats and making provisions for two vice-presidents. Because of the Arusha Accord, Burundi enacted a transitional government in 2000. In October 2016, Burundi informed the UN of its intention to withdraw from the International Criminal Court.Burundi remains primarily a rural society, with just 13.4% of the population living in urban areas in 2019. The population density of around 315 people per square kilometre (753 per sq mi) is the second highest in Sub-Saharan Africa. Roughly 85% of the population are of Hutu ethnic origin, 15% are Tutsi, and fewer than 1% are indigenous Twa. The official languages of Burundi are Kirundi, French, and English, Kirundi being recognised officially as the sole national language.One of the smallest countries in Africa, Burundi's land is used mostly for subsistence agriculture and grazing, which has led to deforestation, soil erosion and habitat loss. As of 2005[update], the country was almost completely deforested, with less than 6% of its land covered by trees and over half of that being commercial plantations.Burundi is the poorest country according to gross domestic product (nominal) per capita, with 272$ in 2022, and a least developed country facing poverty, corruption, instability, authoritarianism, illiteracy, and more.Burundi is densely populated, and many young people emigrate in search of opportunities elsewhere. The World Happiness Report 2018 ranked the country as the world's least happy with a rank of 156. Burundi is a member of the African Union, Common Market for Eastern and Southern Africa, United Nations and the Non-Aligned Movement. Burundi has the lowest GDP per capita as of 2022. The president of Burundi is the head of state and head of government. There are currently 21 registered parties in Burundi. On 13 March 1992, Tutsi coup leader Pierre Buyoya established a constitution, which provided for a multi-party political process and reflected multi-party competition. Because of the Arusha Accord, Burundi enacted a transitional government in 2000. The population density of around 315 people per square kilometre (753 per sq mi) is the second highest in Sub-Saharan Africa.
Background: Posterior cruciate ligament (PCL) injury is a relatively common musculoskeletal condition. However, there is currently a lack of consensus on decision-making, treatment and postoperative management for such injuries. Objectives: To use the modified Delphi method to reach expert consensus on the management of PCL injury. Methods: A literature search of PubMed, Cochrane Library, Embase, and Web of Science for articles up to 17 October 2024, to support the development of recommendation statements. An Expert Panel of 90 experienced clinicians from orthopaedics and sports medicine participated in a two-round Delphi process. Each statement was evaluated in two parts: the first part assessed content appropriateness (score of 7-9 indicating appropriateness and 4-6 indicating possible appropriateness), while the second part assessed agreement (score of 5-9 indicating agreement). Results: The panel members developed 11 statements using the Delphi process, addressing the following topics: (1) clinical decision-making, (2) treatment, and (3) postoperative management about PCL injuries. The final consensus was reached on 11 statements and we eventually translated these statements into a corresponding table of expert recommendations. Conclusion: Consensus was reached on 11 statements regarding three aspects of PCL injury management. These findings provide a foundation for developing evidence-based guidelines that can enhance clinical decision-making, improve treatment strategies, and optimize postoperative care for patients with PCL injuries.
Background: Integrated national programme for the control of neglected tropical diseases and blindness aims to achieve a paradigm shift from control of morbidity to interruption of transmission and ultimately elimination.Objective: The aim of this study was to understand onchocerciasis epidemiology and control strategies in the context of Burundi. Specifically, the study sought to understand the coverage of Ivermectin treatment in onchocerciasis endemic zones, to assess the impact of African Programme for Onchocerciasis Control (APOC) approach on treatment coverage and forecast the therapeutic coverage to 2030 horizon in Burundi.Methods: We used retrospective data collected from 2005 to 2019 in four onchocerciasis endemic provinces in Burundi. For mapping and ivermectin coverage rates comparison, we respectively used a spatial analysis and welch testing methods. After, we forecasted the therapeutic coverage using the Autoregressive Integrated Moving Average (ARIMA) model, a statistical analysis model which uses time series data to predict future trends. All analysis were done using Quantum Geographic Information System (QGIS) and the R 3.5.3 software.Results: During study period, a mean population of 1,536, 392 (95% CI: 1,114 ,870 -1,932 ,403) has been targeted by ivermectin treatment in all the four provinces. The ivermectin coverage rate was 77.8% (95% CI: 67.8% to 81.6%). Specifically, ivermectin coverage rates were 76.4%, 76.6% and 78.7% in Rutana, Bururi and Cibitoke - Bubanza respectively. After six years of massive drug administration under World Health Organization community guidelines launched in 2011, the coverage rates were, except the 2016 year, above 80%. Forecasts for 2030 showed that the coverage rate for treatment could increase.Conclusion: This study showed that the ivermectin coverage rate significantly increased during the community-directed treatment approach period. The coverage rate should remain over 80% until 2030 in endemic regions, a strategy which should contribute to decrease the onchocerciasis prevalence and lead to onchocerciasis elimination.
Health system contributing to health security constituting an approach that harmoniously brings together efforts to strengthen the resources and capacities necessary for the implementation of the International Health Regulations, the components of health systems and those of other sectors for effective management of health emergencies, while maintaining the continuity of essential health services. The countries that have a weak health system face many challenges related to health security. A descriptive study was used during this study to identify if Burundi health system is contributing to the health security. 5health zones have been selected and 350 individuals questioned if they have received health education related to diseases with epidemic potential and if they have suffered from them. A questionnaire which includes the diseases with epidemic potential was distributed to 350 respondents between 20 to 55 years old. The majority (58%) of the respondents were female compared to 42% male. Most (93.0 %) respondents have received health education related to prevention of diseases with epidemic potential. The result shows significant differences in location, gender, marital status, occupation, and several outbreaks (P<0.001). The future research should focus on the re-organization of health systems to respond effectively to different heath threats, especially these can spread locally and globally. Identification of all these issues that can spread to neighbors, and which can cause high morbidity and mortality. of the country, the gaps, and priorities and to know where to convey the efforts for universal health coverage. Keywords: Burundi, Epidemic potential, Health system, health security, prevention.
Background: Management of emergency hernias surgery should include certain complications most often up after 30 days of the operation.Aim: To analyze the factors contributing to morbidity and mortality after 30 days of emergency hernia surgery in children in the surgical departments of 8 Bujumbura hospitals.Patients and Methods: This is a prospective study over a period of one year which included all hernias operated on in emergency from January 1, 2022 to February 29, 2023.Results: During the period, 282 patients (children) were admitted to the operating theatre for abdominal parietal hernias, of which 46 were admitted for emergency hernia surgery.Males accounted for 86.96% (40), sex ratio 6.6.The average age was 3.4 years.The persistence of the peritoneo-vaginal canal represented 52.17% of cases.Inguino-scrotal hernia was prevalent (43.48%).The main complication was strangulation (80.43%).Morbidity accounted for 1.3% of complications (infection, residual pain, testicular atrophy, hernia recurrence).No deaths were found.Altemeier stage and gender were statistically related to morbi-mortality of emergency hernia surgery in adults at 30 days post-op (p = 0.0260 and p = 0.0212 respectively).Conclusion: Abdominal parietal hernias are common in children, dominated by groin hernias.The high frequency of strangulation calls for awareness of cold hernia repairs.
Selon l'enquête démographique et de santé de 2017 au Burundi, 250 personnes de 15 à 49 ans (soit 1 %) étaient atteintes d'insuffisance rénale chronique terminale (IRCT). Le seul traitement de suppléance pour ces patients reste l'hémodialyse dont l'accès reste un défi avec plus de 88 % des centres de dialyse situés dans une seule province (Bujumbura-Mairie) sur les 18 que compte le pays. Une étude menée en 2019 avait montré que 65 patients atteints d'IRCT avaient bénéficié de l'hémodialyse, de 2014 à 2017 et leur taux de mortalité à deux ans était de 95 %. Face à cette mortalité élevée, nous nous sommes intéressés à l'identification des facteurs associés à la mortalité des patients IRCT. Il s'agit d'une étude rétrospective à visée analytique a été réalisée dans trois hôpitaux sur un échantillon de 42 patients souffrant d'IRCT et sous hémodialyse. Les données utilisées ont été extraites du logiciel « OpenClinic » utilisé pour la gestion des dossiers cliniques des patients au Burundi, dont les trois hôpitaux de notre étude situés dans la province de Bujumbura-Mairie. Ces données ont été complétées par celles contenues dans les dossiers cliniques, au format papier, des patients. Les patients perdus de vue et les patients vivants à la fin de l'étude ont été censurés, et le décès par une autre cause que l'insuffisance rénale chronique a été considérée comme un événement compétitif. Les associations entre les variables de l'étude et le décès au cours du suivi ont été mesurées par le modèle de régression de Fine et Gray, à l'aide du logiciel R. L'infection sur cathéter a été la plus grande complication observée au cours de l'hémodialyse (58,2 %), tandis que l'hypertension artérielle (80,9 %) et le diabète (71,6 %) étaient les pathologies les plus observées au début du traitement des patients. En analyse multivariée, la créatininémie élevée (SHR : 1,001[IC à 95% : 1,001 ; 1], p<0,001), l'urémie élevée (SHR : 1,03[IC à 95% : 1,02 ; 1,05], p<0,001), la calcémie élevée (SHR : 0,17[IC à 95% : 0,09 ; 0,33], p<0,001) et la kaliémie élevée (SHR : 1,27[IC à 95% : 1,12 ; 1,44], p<0,001) étaient les facteurs associés à la survenue du décès dû à l'IRCT. Au vu de ces résultats, il s'avère nécessaire de mettre en œuvre i) des stratégies permettant de respecter le nombre de dialyses recommandé ii) des mesures de lutte contre les infections nosocomiales pour cette population. La mise en place d'un registre national des patients IRCT est d'une importance capitale pour suivre leur état de santé et mieux orienter les politiques de santé en leur faveur.
