BackgroundAlthough the advantages of introducing point of care testing for syphilis in antenatal care (ANC) are well documented, there is little evidence on how to address structural issues within health systems. A better understanding of how these interventions work in a range of settings and contexts is needed in order to overcome bottlenecks at health system level. To better understand the relationships between implementation and context we developed and implemented an intervention focused on integrating a rapid screening test for syphilis in ANC services in rural primary health care facilities in Burkina Faso. This manuscript describes the intervention and reports on feasibility and acceptability of the intervention, the facilitators and barriers to the implementation of this intervention and the likelihood that point of care test for syphilis will become routinely incorporated in practice.MethodsIn Kaya Health and Demographic Surveillance System (Kaya HDSS), all 7 primary healthcare facilities were selected for intervention in 2013. A participatory approach was used to design and implement an antenatal syphilis screening intervention. The Normalization Process Model (NPM) proposed by May et al. was adapted in order to identify barriers and facilitators and to explore the likelihood to become routinely incorporated in practice. Registers, Observations (n = 14 ANC 1) of interactions between patients and health workers during ANC and interviews with health workers (n = 14) were our data sources.ResultsAn intervention that included onsite training, provision of supplies and medicines, quality control and supervision was implemented in 7 health facilities in 2013. Rapid syphilis test and treatment were delivered during ANC within the examination room with no specific additional mechanism regarding staff organization. The perceived barriers were lack of training of all staff, workload, stock-outs of consumables and lack of motivation of staff. Key facilitators included political environment, ease of use of test and acceptability to pregnant women.ConclusionsOnsite testing for antenatal syphilis is a feasible and acceptable intervention in ANC at primary health facility in Burkina Faso. The point-of care test for syphilis is more likely to be acceptable by health workers as routine service and incorporated as a normal practice.Trial registrationThe study was retrospectively registered on ClinicalTrials.gov under the Trial Registration Number NCT03156751.

Background and objective: Little information is available on the rapid diagnostic testing for syphilis in Burkina Faso. The objectives of the study were (i) to assess the sensitivity and specificity of four on site rapid tests in comparison with Treponema pallidum haemagglutination assay (TPHA) as a gold standard and (ii) to evaluate the operational characteristics of those tests among health workers in a maternity unit. Methods: Four rapid syphilis tests commercially available in Burkina Faso were evaluated using archived serum samples and Treponema pallidum hemagglutination assay (TPHA) as the gold standard. Blood samples were collected between November 2011 and June 2012 from blood donors at the Regional Blood Transfusion Center of Ouagadougou. The sensitivity and specificity of the tests were calculated. Evaluation of operational characteristics such as clarity of pamphlet, complexity of technique, duration, was conducted in a first-level healthcare center with health workers in maternity unit. Results: Alere DetermineTM Syphilis was the most sensitive of the four rapid syphilis tests evaluated. It was followed by SD Bioline Syphilis 3.0, Cypress Diagnostics Syphilis Quick test and Accu-Tell ® Rapid Anti-TP, which was the least sensitive. The four tests demonstrated a good diagnostic specificity for syphilis (95-98%), and healthcare workers found them easy to use. Conclusions:The study allowed confirming the good performance of three of four rapid syphilis tests in Burkina Faso. More research will be conducted to assess the feasibility of introducing selected rapid tests for syphilis in antenatal care services.

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Biscuits are ready-to-eat foods that are traditionally prepared mainly with wheat flour, fat, and sugar. Recently, biscuits’ technologies have been rapidly developed to improve their nutritional properties. This study aimed to determine the strategies of improving the nutritional quality of biscuits and the potential health benefits associated with them. A systematic review and meta-analysis were conducted, including articles on biscuits improved by technological processes and raw materials variation. Studies were searched from Google Scholar, PubMed, Scopus, and Web of Science published between 1997 and 2020, in English and French. The meta-analysis was performed using RStudio software, version 4.0.4 to classify the biscuits. One hundred and seven eligible articles were identified. Rice, pea, potato, sorghum, buckwheat, and flaxseed flours were respectively the most found substitutes to wheat flour. But the meta-analysis shown that the copra and foxtail millet biscuit fortified with amaranth, the wheat biscuits fortified with okra, and rice biscuits fortified with soybeans had a high protein content. These biscuits therefore have a potential to be used as complementary foods. The substitution of sugar and fat by several substitutes lead to a decrease in carbohydrates, fat, and energy value. It has also brought about an increase in other nutrients such as dietary fiber, proteins/amino acids, fatty acids, and phenolic compounds. Among the sugar and fat substitutes, stevia and inulin were respectively the most used. Regarding the use of biscuits in clinical trials, they were mainly used for addressing micronutrient deficiency and for weight loss.

REMERCIEMENTS Ces travaux ont été financés par le septième programme cadre de l'Union Européenne [Fp7/2007- 2013] à travers le projet INSTAPA (Novel staple food-based strategies to improve micronutrient status for better health and development in sub-saharan Africa) sous l'agrément N°211484. RESUMELes biscuits peuvent contribuer à améliorer le statut nutritionnel des jeunes enfants. L'effet de l'incorporation du moringa, de la spiruline, de la patate douce à chair orange (PDCO) et d'un complexe minéral et vitaminique (CMV) sur la qualité nutritionnelle des biscuits de sorgho est étudié. Pour ces ingrédients nutritionnels, trois niveaux d'incorporation sont étudiés à travers douze formulations de biscuit et leurs caractéristiques nutritionnelles et sensorielles analysées par des méthodes standard et comparées au biscuit témoin non enrichi. Les résultats obtenus montrent que les teneurs varient entre 1,8±0,6% et 7,9±1,1% pour l'humidité, entre 5,6±1,4% et 11,7±0,7% pour les protéines, entre 19,5±4,6% et 23,5±1,6% pour les lipides, entre 2±0,0% et 4,1±0,1% pour les cendres et entre 53,2±2,2% et 68,5±0,5% pour les glucides. L'augmentation des teneurs en protéines est significative avec l'addition du moringa et de la spiruline. La valeur énergétique est comparable pour l'ensemble des formulations avec cependant des profils nutritionnels différents. Les teneurs en fer, contrairement au zinc sont significativement plus élevées (p<0,05) dans les biscuits de sorgho enrichis. En conclusion, les formulations de biscuits de sorgho les plus acceptables au plan nutritionnel et sensoriel sont celles enrichies à 4% de spiruline, 10% de moringa et 18% de PDCO. © 2016 International Formulae Group. All rights reserved.Mots clés : Biscuit de sorgho, moringa, spiruline, patate douce à chair orange, caractéristiques nutritionnelles.Use of the moringa, spirulina, orange-fleshed sweet potato and a multivitamin complex in the manufacture of enriched sorghum biscuits for young children ABSTRACT Cookies can help to improve the nutritional status of young children. The effect of moringa, spirulina, orange fleshed sweet potato (PDCO) and multivitamin complex (CMV) incorporation on the quality of sorghum cookies was studied. For these nutritional ingredients, three rates of incorporation were studied through 12 cookies formulations and the nutritional and sensory characteristics analyzed using standard L. T. SONGRE-OUATTARA et al / Int. J. Biol. Chem. Sci. 10(4): 1651-1665, 2016 1652 methods and compared with control cookies without incorporation. Results showed that the contents varied between 1.8±0.6% and 7.9±1.1% for humidity, 5.6±1.4% and 11.7±0.7% for protein, 19.5±4.6% and 23.5±1.6% for fat, 2.0±0.0% and 4.1±0.1% for the ashes and between 53.2±2.2% and 68.5±0.5% for carbohydrate The increase in protein levels was significant with moringa leaves powder and spirulina addition. The energy densities were similar for all formulations although the nutrient profiles were different. Fe contents, in the opposite of zinc were significantly highe...