The need to provide maternal comfort and facilitate rapid recovery during caesarean section requires pain management. The aim of our study of low-dose morphine spinal analgesia during caesarean section was to evaluate its effectiveness during and after the operation. Methodology: We conducted a prospective, descriptive, cross-sectional study lasting 6 months from 1 July to 31 December 2023. It involved 101 Caesarean women undergoing spinal analgesia, selected by random sampling at the reference health centre in Commune I of the Bamako district. Results: The mean age of the patients was 27 ±1.51 years, with ASA I classification in 63.4%. The combination of bupivacaine 10 mg and morphine 0.1 mg was used in 68.3% of cases. The mean duration of motor block release was 2.78 ± 0.7 hours. The manifestation of pain (VAS=0) was 100% at H1 (first hour), with peaks of VAS [1,3] in 42.57% and VAS [4,6] in 6.97% at H4 (fourth hour). Arterial hypotension was found in 57% of cases. From H12 onwards, all the women were very satisfied. Conclusion: The efficacy of morphine spinal analgesia during caesarean section has been proven in all our parturients from H12 (twelfth hour). However, pain management in the first few hours must be started with a well-adapted protocol.

Background: There are over 2000 genetically diverse ethnolinguistic groups in Africa that could help decipher human evolutionary history and the genetic basis of phenotypic variation. We have analysed 298 genomes from Niger Congo populations from six sub Saharan African countries (Uganda, Democratic Republic of Congo, Cameroon, Zambia, Ivory Coast, Guinea) and a Nilo Saharan population from Uganda. These samples were collected as part of the TrypanoGEN consortium project http://www.trypanogen.net. Results: The population genetic structure of the 298 individuals revealed four clusters which correlated with ethnolinguistic group and geographical latitude, that is, West African Niger-Congo A, Central African Niger Congo, East African Niger-Congo B and the NiloSaharan. We observed a spatial distribution of positive natural selection signatures in genes associated with AIDS, Tuberculosis, Malaria and Human African Trypanosomiasis among the TrypanoGEN samples. Having observed a marked difference between the NiloSaharan Lugbara and Niger Congo populations, we identified four genes [APOBEC3G, TOP2B, CAPN9, LANCL2, (iHS -log p > 3.0, Rsb -log p > 3.0, Fst > 0.1 Bonferroni p > 1.8x10e4)], which are highly differentiated between the two ethnic groups and under positive selection in the Lugbara population. Conclusion: The signatures that differentiate ethnically distinct populations provide information on the specific ecological adaptations with respect to disease history and susceptibility/ resistance; as demonstrated in this study where APOBEG3G is believed to be involved in the susceptibility of the Nilo Saharan Lugbara population to Hepatitis B virus infection.

A geographic information system is a helpful tool for the defi­nition of a control plan against tsetse. Its practical application in entomological data collection for the planning and future evaluation of tsetse control was carried out in Western Burkina Faso from December 2007 to November 2008. The sampling area was selected according to the main rivers basins and the limits of Glossina palpalis gambiensis and G. tachinoides dis­tributions. The study area was gridded in 100-kilometer-square cells. In each cell a maximum of 13 potential trapping sites were selected, then spotted in the field by using a global posi­tioning system. The entomological survey was carried out with biconical Challier-Laveissière traps collected 72 hours after their installation. The data analysis was performed with binomial mixed random and Poisson distribution models. Mapping was carried out with Arc GIS 9.3 to help to deter­mine the Northern limit (12° 45’ N) of tsetse distribution in the target area. The proportions of infested sites were 89.6 and 76.4% on the ascending and descending sections of Mou­houn River, respectively (the first flows northeastward from the spring, and the second southeastward, then southward from the confluence with Sourou River), and 16.7 and 10.3% on their tributaries, respectively. Between isohyets 700–800 and 800–900 m no significant differences were observed in tsetse apparent density per trap or in the infested sites. Both trapped species were however distributed unevenly depending on the sections of Mouhoun River. On the ascending branch G. p. gambiensis represented 79.5% of tsetse catches, and on the descending branch G. tachinoides represented 96.0% of them. Catches of mechanical vectors were relatively few. Their distri­butions were similar to that of tsetse but with higher densities on some tributaries.

Epidemiological Monitoring Network of Chemoresistance to Trypanocidal and Acaricides Drugs in West Africa (RESCAO). To better coordinate the efforts against trypanocidal and acaricides drugs resistance, the Institute of Tropical Medicine (ITM) of Antwerp and the "Centre International de Recherche-Développement sur l'Elevage en zone Subhumide (CIRDES)" of Bobo Dioulasso, established in April 2009 an epidemiological surveillance network of chemoresistance to trypanocidal and acaricides drugs in Western Africa, named RESCAO. Its main objective is to contribute to the improvement of the livestock health and of the productivity of agriculture in tropical Africa, through both an efficient strategic control of trypanosomosis and tick born diseases, including a rational use of the available therapeutic drugs. RESCAO is headed by a regional steering committee based at CIRDES. This committee meets on a yearly basis to overview the on-going activities and to identify new strategies for action. Moreover, molecular analyzes performed on samples from seven West African's countries, members of RESCAO, have shown that resistance to diminazeneaceturate was widespread in Trypanosoma congolense with percentages ranging from 67.85 (19/28) for Burkina Faso to 100% (9/9) for Ghana.

In view of gathering baseline information about the prevalence of animal trypanosomosis, the Pan African Tsetse and Trypanosomiasis Eradication Campaign (PATTEC) funded a cross sectional survey in the region of the Boucle du Mouhoun which constitutes the Northern limit of the tsetse distribution in Burkina. This cross sectional study was carried out in 53 villages located in the six provinces of the region. A total of 2002 cattle, 1466 small ruminants and 481 donkeys were sampled. This survey showed that about 25% of the cattle had been treated with trypanocidal drugs within 3 months before the survey compared to 3% and 0.42% for the small ruminants and donkeys, respectively. Parasitological prevalence in cattle was low: 0.77% (95% C.I. 0.30–1.95%). No goats and three donkeys were found infected with trypanosomes. Infections were mainly due to Trypanosoma vivax (75.0%) with cases of Trypanosoma congolense (25.0%). In cattle, the serological prevalence of trypanosomosis, for the entire region of the Boucle du Mouhoun, was 34.2% (95% C.I. 26.1–43.4%). For sheep, goats and donkeys, the prevalence were of 20.9% (95% C.I. 12.2–33.5%), 8.5% (95% C.I. 5.7–12.5%) and 5.8% (95% C.I. 3.9–8.6%), respectively. The age and distance to the river were the two main risk factors associated with seropositivity.

A longitudinal study assessed the chemoresistance to isometamidium chloride (ISM) and diminazene aceturate (DA) in the region of the Boucle du Mouhoun in Burkina Faso. A preliminary cross-sectional survey allowed the identification of the 10 villages with the highest parasitological prevalences (from 2.1% to 16.1%). In each of these 10 villages, two herds of approximately 50 bovines were selected, one being treated with ISM (1mg/kg b.w.) and the other remaining untreated as control group. All animals (treated and untreated herds) becoming infected were treated with DA (3.5mg/kg b.w.). In total, 978 head of cattle were followed up. Fortnightly controls of the parasitaemia and PCV were carried out during 8 weeks. The main trypanosome species was Trypanosoma vivax (83.6%) followed by Trypanosoma congolense (16.4%). In two villages, less than 25% of the control untreated cattle became positive indicating no need to use prophylactic treatment. These two villages were not further studied. Resistance to ISM was observed in 5 of the remaining 8 villages (Débé, Bendougou, Kangotenga, Mou and Laro) where the relative risk (control/treated hazard ratios) of becoming infected was lower than 2 i.e. between 0.89 (95% CI: 0.43–2.74) and 1.75 (95% CI: 0.57–5.37). In contrast, this study did not show evidence of resistance to DA in the surveyed villages with only 8.6% (n=93) of the cattle relapsing after treatment. Our results suggest that because of the low prevalence of multiple resistances in the area a meticulous use of the sanative pair system would constitute the best option to delay as much as possible the spread of chemoresistance till complete eradication of the disease by vector control operations.

The study allowed establishing values of certain biochemical parameters in 48 donkeys selected in seven villages of the agro-pastoral zone of Sideradougou, Burkina Faso. Values found in donkeys of this agro-pastoral zone were within the ranges of those found in donkeys elsewhere in the world, except that values of creatinine and aspartate aminotransferase (AST) were lower in Burkinabese donkeys. The values of these biochemical parameters varied with trypanosomosis infection in donkeys. Indeed, donkeys suffering from trypanosomosis got higher values alanine transaminase (p = 0.035) than the noninfected donkeys. The values of AST in the healthy donkeys was (p = 0.009). The values of total proteins were significantly higher in the infected donkeys (p = 0.003), while the albumin values did not vary significantly; the variation in proteins concentration was due to globulins levels. The gamma globulin level was increased in the trypanosomosis-infected donkeys (p = 0.003).

The objective of this paper was to describe recent data from Burkina Faso and Côte d'Ivoire on Human African Trypanosomosis medical monitoring in order to (i) update the disease situation in these two countries that have been sharing important migratory, economic and epidemiological links for more than a century and (ii) to define the future strategic plans to achieve the goal of a sustainable control/elimination process. Results of active and passive surveillance indicate that all sleeping sickness patients diagnosed these last years in Burkina Faso were imported cases from Côte d'Ivoire. Nevertheless the re-introduction of the parasite is effective and the risk of a resumption of transmission exists. In Côte d'Ivoire, few cases are still diagnosed in several historical foci and the fear exists that the disease could reemerge in these foci or spread to other areas. In order to achieve a sustainable elimination of sleeping sickness in these two countries, control entities have to adapt their strategy to the different epidemiological contexts. At the exception of specific cases, the current disease prevalence no longer justifies the use of expensive medical surveys by exhaustive screening of the population. New disease control strategies, based on the exchange of epidemiological information between the two countries and integrated to the regular national health systems are required to target priority intervention areas. Follow-up in time of both treated patients and serological suspects that are potential asymptomatic carriers of parasite is also important. In parallel, researchers need to better characterize the respective roles of the human and animal reservoir in the maintenance of transmission and evaluate the different control strategies taken by National Control Programs in term of cost/effectiveness to help optimize them.

L'objectif de cet article est de décrire les récentes données de surveillance médicale de la Trypanosomose Humaine Africaine (THA) au Burkina Faso et en Côte d'Ivoire afin (i) de dresser un bilan de la situation actuelle de la maladie dans ces deux pays qui entretiennent depuis plus d'un siècle des liens migratoires, économiques et épidémiologiques intimes et (ii) de définir les stratégies à mettre en place dans l'objectif d'une élimination durable. Les résultats de la surveillance active et passive ont montré que les trypanosomés dépistés au Burkina-Faso ces dernières années sont tous des cas importés provenant de Côte d'Ivoire. Cependant, la réintroduction du parasite est effective et le risque d'une reprise de la transmission existe. En Côte d'Ivoire, plusieurs foyers "historiques" toujours endémiques font craindre des phénomènes de réémergence et de propagation. Dans l'objectif d'une élimination durable de la THA dans ces deux pays, les acteurs de la lutte doivent adapter leur système de surveillance en fonction des différents contextes épidémiologiques. Les prévalences actuelles ne justifient plus, excepté des cas particuliers, l'usage systématique et très onéreux du dépistage actif par prospections médicales exhaustives. Elles tendent plutôt à privilégier des systèmes intégrés aux systèmes de santé nationaux et utiliser des méthodes permettant de cibler les zones prioritaires d'intervention à partir notamment d'un échange d'informations épidémiologiques entre les deux pays. Pour accompagner le processus d'élimination durable, les acteurs de la recherche doivent étudier le rôle respectif des réservoirs humain et animal dans le maintien de la transmission, participer au suivi sur le long terme des cas traités et des suspects sérologiques, et évaluer en termes de coût/efficacité les stratégies mises en place par les Programmes Nationaux afin de les optimiser.

African animal trypanosomosis is a parasitic blood disease transmitted by tsetse flies and is widespread in sub-Saharan Africa. West African taurine breeds have the ability, known as trypanotolerance, to limit parasitaemia and anaemia and remain productive in enzootic areas. Several quantitative trait loci (QTL) underlying traits related to trypanotolerance have been identified in an experimentally infected F(2) population resulting from a cross between taurine and zebu cattle. Although this information is highly valuable, the QTL remain to be confirmed in populations subjected to natural conditions of infection, and the corresponding regions need to be refined. In our study, 360 West African cattle were phenotyped for the packed cell volume control under natural conditions of infection in south-western Burkina Faso. Phenotypes were assessed by analysing data from previous cattle monitored over 2 years in an area enzootic for trypanosomosis. We further genotyped for 64 microsatellite markers mapping within four previously reported QTL on BTA02, BTA04, BTA07 and BTA13. These data enabled us to estimate the heritability of the phenotype using the kinship matrix between individuals computed from genotyping data. Thus, depending on the estimators considered and the method used, the heritability of anaemia control ranged from 0.09 to 0.22. Finally, an analysis of association identified an allele of the MNB42 marker on BTA04 as being strongly associated with anaemia control, and a candidate gene, INHBA, as being close to that marker.

Trypanocidal drugs are the most commonly purchased and used livestock input by resource-poor farmers in sub-Saharan Africa. The effective use of trypanocidal drugs by smallholder farmers is threatened by the development of widespread resistance. This is a particular concern for smallholder crop-livestock farmers in the cotton zone of West Africa. A recent project funded by the Germany Ministry for Economic Cooperation and Development (BMZ) confirmed significant resistance to trypanocidal drugs in villages with high trypanosomosis risk in Burkina Faso and Mali. Strategies for resistance prevention were investigated. Keeping trypanotolerant cattle was found to be an effective disease management strategy, but farmers' preference for trypano-susceptible breeds, for reasons unrelated to animal health, suggest that the intromission of zebu genotype will continue. Community vector control was found to be effective in managing trypanosomosis in the presence of resistance and the high-level participatory approach tested was found to be more sustainable than low-level approaches previously used in the region. This suggests that participatory vector control with appropriate external support is likely to be a viable option for implementing resistance 'clean-up'. Promoting rational drug use (RDU) emerged as a promising prevention strategy, with clear improvements in farmer knowledge, farmer practice and animal health outcomes. However, policy studies showed low understanding of the problem of resistance and the absence of an enabling environment for RDU. Engagement was initiated with actors involved in the problem of resistance and for its solution, including manufacturers, sellers and users of drugs, regulators and extension providers.

In the Mouhoun River basin, Burkina Faso, the main vectors of African animal trypanosomoses are Glossina palpalis gambiensis Vanderplank and Glossina tachinoides Westwood (Diptera: Glossinidae), both of which are riverine tsetse species. The aim of our study was to understand the impact of landscape anthropogenic changes on the seasonal dynamics of vectors and associated trypanosomosis risk. Three sites were selected on the basis of the level of disturbance of tsetse habitats and predominant tsetse species: disturbed (Boromo, for G. tachinoides) and half-disturbed (Douroula for G. tachinoides and Kadomba for G. p. gambiensis). At each of these sites, seasonal variations in the apparent densities of tsetse and mechanical vectors and tsetse infection rates were monitored over 17 months. Tsetse densities differed significantly between sites and seasons. Of 5613 captured tsetse, 1897 were dissected; 34 of these were found to be infected with trypanosomes. The most frequent infection was Trypanosoma vivax (1.4%), followed by Trypanosoma congolense (0.3%) and Trypanosoma brucei (0.05%). The mean physiological age of 703 tsetse females was investigated to better characterize the transmission risk. Despite the environmental changes, it appeared that tsetse lived long enough to transmit trypanosomes, especially in half-disturbed landscapes. A total of 3021 other biting flies from 15 species (mainly Tabanidae and Stomoxyinae) were also caught: their densities also differed significantly among sites and seasons. Their relative importance regarding trypanosome transmission is discussed; the trypanosomosis risk in cattle was similar at all sites despite very low tsetse densities (but high mechanical vector densities) in one of them.

Tsetse flies and animal trypanosomosis (T&T) are the main constraints to animal production in Burkina Faso. This paper gives an overview of the various activities in the field of tsetse and trypanosomosis research and control that have led to the successful implementation of control campaigns and their positive impact on livestock production. Over the years, much effort had been put in the development of control tools and their implementation in Burkina Faso. A situation is made with the different campaigns against the T&T implemented in Burkina Faso, mainly in the patoral zones of Sidéradougou and Yalé. The life-time and achievements of these campaigns are discussed. The present situation of T&T is also discussed, especially the epidemiology of animal trypanosomosis, the innovations in diagnosis, social and economical impact, trypanotolerance and chemioresistance against trypanocides, appeared during the 1980s in the province of Kénédougou. Furthermore, the use of remote sensing to identify high risk zones in the country and the tsetse population genetics are described. Finally, conclusions are drawn to improve future control strategies of the Pan-African Tsetse and Trypanosomosis Eradication Campaign (PATTEC) in Burkina Faso.

In Burkina Faso, the Mouhoun river basin (formerly "Black Volta") constitutes a historical focus of Human (HAT) and Animal (AAT) African Trypanosomoses, both transmitted by tsetse flies. Nowadays, HAT seems to have disappeared from this area, while AAT still causes severe economic losses. In order to explain these different epidemiological situations, we undertook a geographical study based on the analysis of aerial pictures between 1952 and 2007, and field surveys to collect medical, entomological, and veterinary data on trypanosomoses. Our results suggest that in this area, landscapes have been dramatically modified as a consequence of population growth, and in turn have had an impact on the number and distribution of tsetse flies. Combined with the historical medical action on HAT which probably led to the disappearance of T. b. gambiense, this environmental degradation and the development of hydrological structures provide explanations for the local disappearance of HAT, and for the maintenance of AAT. It appears necessary to extrapolate these studies to other areas in order to identify the factors explaining the presence/absence of trypanosomoses in the context of human population growth and climatic changes, in order to help to target priority areas for the control of these diseases.

In this study, we explore the potential of using select global geographic information system (GIS) datasets to map the distribution and densities of riverine tsetse fly at a local scale in the Mouhoun river basin (Burkina Faso). In particular, we analyse the correlation between low-resolution datasets that predict global and regional tsetse distribution and more than 800 trapping scores for Glossina palpalis gambiensis Vanderplank and G. tachinoides Westwood. The results show that these datasets with global or regional scope, including the Global Land Cover database for the year 2000 (GLC2000), are not suitable for use at a local scale (e.g. in designing baseline data collection protocols for vector control campaigns). On the other hand, higher resolution global datasets available in the public domain, namely the NASA Landsat Orthorectified Image Library (LOIL) and the HydroSHEDS drainage network, have great potential for mapping tsetse habitat when used in process-based models. (Resume d'auteur)

Au Burkina-Faso, la boucle du Mouhoun constitue un foyer historique des trypanosomoses humaines africaines (THA) et animales africaines (TAA), transmises par les glossines. Aujourd’hui, la THA semble avoir disparu de cette région après quelques soubresauts dans les années 1970, tandis que la TAA continue de sévir. Afin de mieux comprendre ces évolutions divergentes, nous avons mené une étude géographique basée sur l’analyse de photographies aériennes entre 1952 et 2007, ainsi que d’enquêtes de terrain sur les aspects médicaux, entomologiques et vétérinaires des trypanosomoses. Il apparaît que le paysage de cette région a connu en l’espace d’un siècle des modifications intenses, notamment du fait de l’augmentation des densités de population et des surfaces cultivées, qui n’ont pas été sans conséquences sur le nombre et la distribution des mouches tsé-tsé. Associée à la lutte médicale qui avait permis la stérilisation du réservoir humain de trypanosomes dans les années 1940, cette dégradation paysagère, accompagnée du développement des aménagements hydrauliques et d’évolutions des modalités de migration des hommes et des animaux, semble pouvoir expliquer ces disparités THA/TAA. La mise en évidence de ces facteurs, et leur prise en compte lors d’études ultérieures menées dans d’autres régions, devrait permettre de délimiter des zones d’intervention prioritaires contre les trypanosomoses et leurs vecteurs dans un contexte de lutte internationale contre ces pathologies.

Une série de trois enquêtes longitudinales sur des bovins a été conduite entre Août 2003 et Avril 2004 autour de Sikasso au Mali. Ces enquêtes avaient pour objectif de faire une étude épidémiologique saisonnière des trypanosomoses animales dans un contexte de chimiorésistance aux trypanocides. Du point de vue parasitologique, il existe une hétérogénéité dans l’évolution de la maladie. De fortes prévalences parasitologiques ont été enregistrées au mois d’Août correspondant à la saison pluvieuse,dans les sites de Diassadiè (34%) et de Wahibéra (28,89%). Ces deux villages ont été les seuls à présenter une variation saisonnière significative (p< 0,05) des valeurs de prévalences observées. Les infections étaient majoritairement dues à Trypanosoma congolense (64,81 à 67,12% des cas), suivi de Trypanosoma vivax (28,77 à 35,19%) et rarement de Trypanosoma brucei (1,37%). La valeur moyenne de l’hématocrite ensaison pluvieuse était la plus forte (26,49% + 0,43) avec une variation saisonnière significative. Sur le plan entomologique, deux espèces de glossines riveraines ont été identifiées en toute saison avec des densités apparentes par piège (DAP) allant de 3,45 à 5,29 pour l’espèce Glossina palpalis gambiensis et variant entre 0,98 et 2,80 pour Glossina tachinoides. Une corrélation significative (a=0,05) entre la densité apparente de Glossina palpalis gambiensis et le taux d’infection des bovins a été observée en saison pluvieuse. Des échecs de traitement (résistance) à l’acéturate de diminazène ont été suspectés dans plusieurs sites.

Demographic evolution, climatic change and economical development that happened in West Africa during the XXth century had a lot of consequences on human settlement and landscape. These changes have in turn an impact on the pathogenic system of human and animal trypanosomoses. Since last century, the northern tsetse distribution limit has shifted towards the south, probably due to a decrease in rainfall combined to the impact of human pressure. Sleeping sickness (SS) foci have also shifted from the savannah areas (where there is no more SS) to the forest and mangrove areas of West Africa, but animal trypanosomoses are still present in savannah. We show a decrease of tsetse of the morsitans group as a result of an increase of human densities. On the opposite, tsetse species like Glossina palpalis adapt to high human densities and are found in the biggest urban centres of West Africa. There is a need to promote multidisciplinary studies on this demographic-climatic-vector borne disease topic, especially in Africa to be able to define future areas of presence/absence of these diseases in order to help continental plans of control that have recently begun.

The epidemiology of tsetse-transmitted trypanosomiasis depends, among other factors, on the proportion of infected flies in a tsetse population. A wide range of intrinsic and extrinsic factors seem to determine the ability of a tsetse fly to become infected and to transmit the parasite. In this paper, we investigated the effect of nutritional stress of reproducing female Glossina morsitans morsitans on the susceptibility of their offspring to trypanosomal infections. Adult female flies that were nutritionally stressed by feeding only once a week, produced pupae with a significant lower weight and offspring with a significant lower fat content as well as a lower baseline immune peptide gene expression. Moreover, infection experiments showed that the emerging teneral flies were significantly more susceptible to a Trypanosoma congolense or Trypanosoma brucei brucei infection than flies emerging from non-starved adult females. These findings suggest that in the field, substantial nutritional stress of adult tsetse flies, as is often experienced during the hot dry season, can increase significantly the vectorial capacity of the emerging teneral flies and thus result in an increased infection rate of the tsetse population.

The West African trypanosomoses are mostly transmitted by riverine species of tsetse fly. In this study, we estimate the dispersal and population size of tsetse populations located along the Mouhoun river in Burkina Faso where tsetse habitats are experiencing increasing fragmentation caused by human encroachment. Dispersal estimated through direct (mark and recapture) and indirect (genetic isolation by distance) methods appeared consistent with one another. In these fragmented landscapes, tsetse flies displayed localized, small subpopulations with relatively short effective dispersal. We discuss how such information is crucial for designing optimal strategies for eliminating this threat. To estimate ecological parameters of wild animal populations, the genetic measures are both a cost- and time-effective alternative to mark-release-recapture. They can be applied to other vector-borne diseases of medical and/or economic importance.