Bobo Dioulasso

Acute respiratory failure (ARF) is a common and serious medical emergency that often requires intensive care and respiratory support. This research investigates the use of Boussignac-type continuous positive airway pressure (CPAP) to potentially reduce the need for invasive intubation in patients with acute hypoxemic respiratory failure, especially in settings where access to invasive ventilation is limited, such as in low-income countries like Burkina Faso. The study is an open-label, multicenter, national randomized clinical trial conducted in four adult university hospitals. Participants will be randomly assigned within 3 hours of meeting inclusion criteria to one of two groups. The standard group will receive oxygen therapy through nasal prongs or face masks to maintain oxygen saturation above 92%. The CPAP group will receive additional CPAP treatment using a Boussignac device connected to an oronasal mask, starting at a pressure of 7.5 cmH2O and adjusted based on patient response. CPAP will be administered continuously for the first 6 to 12 hours, then intermittently for at least 6 hours per day until intubation criteria are met, death occurs, or treatment is discontinued. During the study, oxygen levels, respiratory rates, and tolerance to treatment will be closely monitored. Researchers will assess the proportion of patients requiring intubation within 7 days, as well as secondary outcomes including 28-day mortality, oxygenation effectiveness, hospital stay length, and safety of CPAP. Additional studies will explore the role of ultrasound in managing ARF, causes and prognosis of ARF and ARDS, and the cost of ARF management. Patient care will follow physician discretion based on ARF causes, and treatment adherence will be recorded.

Researchers are studying the biological vulnerabilities in Small Vulnerable Newborns (SVNs) compared to healthy newborns in urban Burkina Faso. The study focuses on how gut bacteria, the immune system, and breastmilk components develop and interact during the first six months of life. By using advanced multi-omics methods, the research aims to uncover mechanisms that could help reduce illness and death in these high-risk newborns and improve pregnancy and infant health outcomes. The study observes SVNs and healthy community controls from birth, examining the natural colonization of gut bacteria influenced by vaginal delivery and breastfeeding. It tracks the assembly and maturation of the infant gut microbiota, immune system development, and breastmilk composition over time. Key periods include the critical first days and weeks after birth, with detailed comparisons between SVNs and healthy infants regarding these biological processes. Participants are monitored through assessments of gut bacteria at multiple time points (days 3, 7, 14, 30, 60, and 180). The study collects data on immune system development and breastmilk factors, aiming to understand their relationships with infant growth and health. Safety and health status are observed, with newborns excluded if they have severe infections or respiratory issues. The research ultimately seeks to identify targets for interventions that promote healthy development in vulnerable newborns.

Researchers are evaluating different immunization schedules for the R21/Matrix-M (R21/MM) malaria vaccine in infants to find the best timing that fits with other routine infant vaccines. This Phase 2b study focuses on infants in Sub-Saharan Africa where malaria transmission is moderate to high. The R21/MM vaccine targets the circumsporozoite protein of the malaria parasite and has been recommended by the World Health Organization to prevent clinical malaria in young children. The study aims to understand how the age at first dose and the intervals between doses affect the vaccine's immune response and protection against malaria. Infants aged 6 to 7 weeks will be randomly assigned to one of three vaccination schedules: a compressed schedule at 6, 10, and 14 weeks; a relaxed schedule at 2, 4, and 6 months; or a relaxed schedule at 3, 6, and 9 months. Within each schedule group, infants will be randomized to receive four doses of either the R21/MM vaccine or a placebo, with the fourth dose given at 15 months. Alongside the malaria vaccine or placebo, infants will also receive routine Expanded Programme on Immunization (EPI) vaccines such as hexavalent, pneumococcal, rotavirus, measles and rubella, meningococcal A, yellow fever, and typhoid conjugate vaccines. After the study, all placebo recipients will be offered the three-dose compressed R21/MM schedule. Parents or guardians will be asked to bring their infants for scheduled visits and report any illnesses or travel during the study. The study will monitor immune responses by measuring antibody levels before vaccination and 28 days after the third dose. Safety is closely followed by tracking side effects for 7 days after each vaccination and any adverse events for up to 27 months of age. Researchers will also observe serious adverse events and events of special interest throughout the study duration, which lasts until the infant reaches 27 months old.

Environmental Enteric Dysfunction (EED) is a condition affecting the gut, leading to malnutrition, poor neurological development, stunting, oral vaccine failure, and infections. It is thought to cause 40% of childhood stunting and often begins during pregnancy due to maternal gut health issues. This trial explores whether improving gut microbiota with a probiotic can reduce harmful bacteria and inflammation in pregnant women, potentially improving nutrient availability and fetal growth. Pregnant women in Bangladesh, Burkina Faso, Pakistan, and Zambia will be enrolled in their first or early second trimester and randomized into three groups: one receiving oral vancomycin followed by the probiotic VE818, one receiving oral vancomycin followed by placebo, and one observation-only group. All participants will take multiple micronutrient supplements throughout pregnancy. Vancomycin is given three times daily for five days, followed by 14 days of either VE818 or placebo. The observation group receives no intervention. Participants will be monitored through biological samples including blood, saliva, urine, stool, vaginal swabs, and gastrointestinal samples collected by a capsule device. The main outcome is the change in counts of 11 specific fecal bacterial pathogens from baseline to two weeks after completing treatment. Follow-up includes tracking pregnancy and birth outcomes, with mother-infant health assessed up to one month after childbirth. Safety and clinical outcomes will be closely observed throughout.

Researchers are evaluating the TRI-MOM program, which aims to implement and assess a simplified, integrated, and coordinated strategy to eliminate mother-to-child transmission of HIV, syphilis, and hepatitis B virus (HBV) in selected maternal and child health services in Burkina Faso and The Gambia. This program focuses on improving antenatal screening and prevention through rapid diagnostic tests and coordinated care among healthcare workers. The TRI-MOM strategy involves four key activities: training healthcare professionals responsible for maternal health, conducting triple screening for HIV, syphilis, and HBV using rapid tests, assessing and treating women who test positive for any of these infections, and raising awareness among pregnant women about mother-to-child transmission while empowering infected women. The program is implemented in nine selected maternity clinics, with five in Burkina Faso and four in The Gambia. Participants will be women attending postnatal visits at the selected maternities. The study will assess the coverage of the TRI-MOM strategy before and after implementation through questionnaires administered to women at baseline and at 12 months. The evaluation includes a cross-sectional study, a cohort study of infected pregnant women, and analyses of cost and cost-effectiveness. The impact on prevention services, reduction of HBV transmission, and women's empowerment will be measured throughout the study period.

Researchers are evaluating the retinol isotope dilution (RID) technique to assess vitamin A status in schoolchildren aged 7 to 12 years in Burkina Faso. The study aims to validate and simplify this method for use in large population surveys, helping to better understand vitamin A deficiency and excess. Two cross-sectional studies will be conducted during different seasons to capture variations related to vitamin A intake, particularly during and after the mango season, a key vitamin A source in the region. The study involves 158 schoolchildren recruited from a primary school in Orodara. Sixty children will undergo the RID test to measure total body vitamin A stores, while the remaining 98 children will be divided into male and female groups to receive the modified relative dose response (MRDR) test. This test investigates absorption of 3,4-didehydroretinyl acetate administered in oil or capsule form. Blood samples will be collected at multiple time points to analyze vitamin A absorption and status. Participants will have baseline health and nutritional assessments, including weight, height, hemoglobin, malaria testing, and stool samples for parasites. Blood samples will be analyzed using advanced laboratory techniques to measure vitamin A compounds and inflammation markers. The study includes community awareness efforts and will last throughout the school year, with samples processed and analyzed to refine vitamin A status assessment methods for use in public health programs.