Strengthening capacity-building in malaria and schistosomiasis control under China-Africa cooperation:Assessing a case study of Burkina Faso

Malaria and schistosomiasis are highly prevalent in Burkina Faso,whereas China has successfully eliminated malaria as well as schistosomiasis as a public health problem.To implement the China-Africa health cooperation initiative,a series of activities were launched since 2019 to enhance understanding and cooperation among malaria and schistosomiasis professionals in China and Burkina Faso.This study described the achievements of the First Virtual Symposium of China-Burkina Faso Cooperation on Schistosomiasis and Malaria Control.Pre-and post-test questionnaires were employed to study the knowledge changes of participants regarding malaria and schistosomiasis control and elimination,explore capacity-building priorities,and identify potential challenges.Chi-squared statistics were used to compare the differences between sub-groups,and p value<0.05 was considered statistically significant.Participants ranked their preferences for challenges and capacity-building priorities in future cooperation.The responses of participants from both China and Burkina Faso indicated effective improvement in their general knowledge about the diseases whereas the improvement in professional knowledge on malaria and schistosomiasis was limited.The total correct response rate increased from 54.08%to 66.78%.Chinese participants had better schistosomiasis knowledge than Burkina Faso participants did,but the same result was not found for malaria.Diseases control strategies,surveillance and response system,and diagnostics techniques were identified as the top three priorities for future capacity building.Participants from China and Burkina Faso shared almost the same views about challenges except with respect to pathogens,which the former saw as a major challenge and the latter did not.The study findings will help policymakers,health managers,and researchers to understand the future cooperation between Burkina Faso and China on malaria and schistosomiasis.

What Tool for Diagnosis of Latent Tuberculosis Infection in Developing Country with Tuberculosis High Burden: Interferon Gamma Release Assays versus Tuberculin Skin Test in Burkina Faso

Background: The diagnosis and treatment of active tuberculosis and the detection/management of latent tuberculosis infection (LTBI) cases are the two main strategies for the TB control, particularly in endemic countries. Tuberculin skin test (TST) and Interferon Gamma Release Assays (IGRAs) are tools for detection of LTBI. The objective of this study was to evaluate the performance of the TST and QuantiFERON-TB Gold Plus® (QTF-Plus) and to identify a threshold for TST in best agreement with QTF-Plus for LTBI detection in a high TB burden setting. Methods: In July 2020, a cross-sectional analytical study was performed for QFT-Plus using blood samples and TST in 101 individuals with a high risk of TB living in Bobo-Dioulasso, Burkina Faso. A crude comparison between both tests was done and receiver operating characteristic curve was generated to determine TST’s threshold. TST sensitivity, specificity, predictive values and accuracy were calculated. Adjusted agreement between TST and QFT-Plus was evaluated. Results: With the minimum threshold of positivity set at 5 mm for TST, the overall agreement between the latter and QFT-Plus was poor with a Kappa coefficient (κ) rated at 0.319 (95% CI: 0.131 - 0.508). This cut-off yielded a sensitivity of 94.12% (95% CI: 88.53 - 99.71), and very poor specificity of 36.4% (95% IC: 25.0 - 47.80). However, an adjusted cut-off set at 11 mm gave a better specificity of 72.73% (95% CI: 62.1 - 83.30) of TST and improved the PPV (86%). Moreover, concordance between both tests was improved with κ at 0.56 (95% CI: 0.385 - 0.728) and 80.20% of accuracy. Factors associated with discordance between TST (11 mm) and QFT-Plus results were BCG vaccination, OR = 7.53 (95% CI: 1.43 - 139.25), p = 0.05 and chronic cough, OR = 5.07 (95% CI: 1.27 - 20.43), p = 0.01. Conclusions: This study showed that using a minimal cut-off of 11mm for TST significantly improved the concordance between QTF-Plus (IGRA) and TST. Using the cut-off TST of 11 mm would be ideal in low-income countries with a high TB burden, taking into account factors that could contribute to the discrepancy of results.

Could China’s journey of malaria elimination extend to Africa?

World Health Organization (WHO) certified China malaria-free on June 30, 2021, which brightens the goal of global malaria elimination efforts. China contributed its unique innovations to the global community: Artemisinin, discovered by Tu Youyou, has saved millions of lives globally;the “1-3-7” norm developed in 2012, has been adapted in the local contexts of countries in the Southeast Asia and Africa. How to the targets of Global Technical Strategy for Malaria (GTS) 2016−2030. By looking into the malaria control phase, towards elimination phase from 1960 to 2011 in sub-Saharan Africa and China, we found that the gap in malaria burden will widen unless the interventions in Africa are enhanced. It is imperative to identify the key China–Africa cooperation areas on malaria control and elimination, so that synergized efforts could be pooled together to help African countries achieve the elimination goal. The practices from China malaria control and elimination efforts could be leveraged to fast-track malaria elimination efforts in Africa, which makes it possible that the China’s journey of malaria elimination extends to Africa.