West African Health Organisation

To present our experience in the management of penile cancer (PC) in the context of a country with limited resources. This was a cross-sectional study with retrospective data collection and descriptive aim. It was conducted over a 20-year period from 1 January 2005 to 31 December 2024. The frequency was 1.05 cases per year. The mean age of the patients was 60.23±13.10 years. A proportion of 76.19% (n=16) of patients were uncircumcised. One patient was HIV positive. Ulceration of the penis was the main reason for consultation (88.23%). The average time to consultation was 11.7±11.37 months. Phimosis was observed in 2 patients. The histological type found was squamous cell carcinoma in all cases. Stage cT3 was the most common (71.42%), followed by stage cT4 in 28.58%. Twelve patients underwent surgical treatment. Total penectomy was performed in 5 patients, partial penectomy in 6 patients and emasculation in one patient. Node dissection was performed in 3 patients. The one-year survival rate was 83.33%. Penile cancer is rare and consultations are made at advanced stages. Awareness of the population on risk factors remains essential for early diagnosis and prevention.

Existing tools to evaluate surgical care and trauma systems in low-resource settings contain a large number of variables that may limit feasibility of their use in low-resource conflict settings (LRCS). Further, such tools do not emphasize damage control capabilities, which are particularly relevant for explosive ordnance casualties. To address these needs, we developed a revised version of the existing International Assessment of Capacity for Trauma (INTACT) tool, INTACT-Blast (INTACT-B). We then piloted this tool at regional health facilities in an LRCS in the Sahel. INTACT-B was developed by synthesizing expert opinion with a narrative review of existing LMIC trauma and surgical capacity assessment tools as well as U.S. Department of Defense Joint Trauma System Clinical Practice Guidelines. This instrument was then piloted across regional and district hospitals in Burkina Faso with functional surgical services. Thirty-six regional and district health facilities in Burkina Faso were included in the INTACT-B pilot, with required less than 15min for data entry. Both material (e.g., equipment and infrastructure) and training needs were identified. Only 30.6% of facilities reported the ability to perform damage control laparotomy, with differences between regional and district facilities (70.0% vs. 15.4%, respectively). Although 75.0% had blood banks, only 44.4% had access to tranexamic acid and 33.3% to tourniquets and hemostatic dressings. Imaging equipment was limited (38.5% of district facilities had a functioning X-ray machine). Fewer than half of facilities were capable of performing essential war surgery interventions, such as chest tube placement and amputation (both 47.2%) or fasciotomy (33.3%), with the most significant gaps at district facilities. No facilities either at the regional or district level reporting vascular repair capabilities including intravascular shunt. The INTACT-B tool provides a feasible instrument for evaluating trauma care capacity and capability in LRCS. Significant needs both with respect to material resources, infrastructure, and training were identified in the study setting. Information generated through use of the INTACT-B tool may help guide efforts to strengthen regional and district health facilities closer to point-of-injury, which holds potential to reduce preventable death among local casualties in LRCS.

Introduction: Ureteroscopy (URS) is a minimally invasive procedure that has become a common practice in endourology over the last two decades. Our study was initiated to evaluate the preliminary results of this technique in two university hospitals in Burkina Faso. Materials and methods: this was a retrospective descriptive study conducted over a 10-month period from January 1 to October 31, 2023. It included patients who underwent semi-rigid ureteroscopy for the treatment of upper urinary tract calculi. Results: we recruited 26 patients. The mean patient age was 39.65 years, with a range of 23 to 70 years. The calculus was right-sided in 61.54% (n=16) of cases and left-sided in 38.46% (n=10). The stone location was pelvic in 69.23% (n=18) and lumbar in 30.77% (n=8). The mean stone size was 13.73 mm, with a range of 7 to 22 mm. The mean stone density was 964.57 Hounsfield Units (HU), with a range of 457 to 1522. The mean fragmentation time was 97 minutes, with a range of 55 to 145 minutes. The mean hospital stay was 2 days, and the stone-free rate was 100% Conclusion: Semi-rigid ureteroscopy is new practice in Burkina Faso. It represents a valuable alternative for the management of upper urinary tract stones.

<i>Background: </i>Scrotal trauma represents a rare but serious urological emergency with potential consequences on fertility, endocrine function, and overall quality of life. Atypical cases such as self-mutilation, human bites, animal horn injuries, or war-related wounds pose significant diagnostic and therapeutic challenges. <i>Methods: </i>We report four unusual cases of scrotal trauma managed in a university teaching hospital. Clinical, surgical, therapeutic, and follow-up data were retrospectively analyzed. A targeted literature review was conducted to support the discussion on multidisciplinary management strategies. <i>Results: </i>The first case involved bilateral testicular self-amputation in a patient with paranoid schizophrenia, treated with surgical debridement, hemostatic ligation, testosterone replacement therapy, and psychiatric follow-up. The second case described a bull horn injury in a teenage cattle breeder, presenting with grade III left scrotal trauma (AAST), managed surgically. The third case involved bilateral scrotal human bite injuries sustained during a school altercation, treated with wound closure, antibiotic prophylaxis, serological monitoring, and medico-legal documentation. The fourth case concerned a soldier injured by an improvised explosive device (IED), presenting with extensive penoscrotal tissue loss and left testicular destruction, managed by damage control surgery and followed by andrological, orthopedic, and psychological care. <i>Conclusion: </i>Atypical scrotal trauma requires prompt, individualized, and multidisciplinary diagnostic and therapeutic approaches. Early surgical exploration, tailored psychological support, and specific risk prevention measures are essential to optimize both functional and psychosexual outcomes in these patients.

Introduction: Lassa fever remains a significant public health threat in West Africa. While vaccine candidates are advancing through the pipeline, efforts in planning timely and sufficient supply have been constrained by limited understanding of demand. This challenge is compounded by the shifting global financing landscape and unclear country-level investment capacity in the vaccine product and the implementation activities required to achieve appropriate coverage. Methods: A demand forecast model for a Lassa fever vaccine was developed. The model includes five implementation scenarios across endemic and non-endemic at-risk countries, accounting for diverse use cases such as integration into routine immunization, targeted geographic campaigns, occupational group campaigns, and reactive use through stockpiles. Key inputs included vaccine characteristics, coverage rates, market entry timing, and policy timelines. Assumptions were developed through literature review and will be refined via workshops and consultations with global, regional, and country experts. Results: Forecasts present a heterogenous vaccine demand picture between 2031 and 2036, driven primarily by differences in countries’ ability to invest. In more conservative scenarios, vaccine demand is initially limited to high-burden regions with gradual scale-up over time, focusing on high-risk groups. Demand is further influenced by product characteristics, such as well as ultra-cold chain capacity. Conclusion: The initial analysis reveals that demand is not solely a function of disease burden but is highly sensitive to country-level prioritization, funding availability, the strategic choices countries make around vaccine introduction. Understanding and anticipating Lassa fever vaccine demand is critical for guiding investment in manufacturing for product developers, in delivery systems for countries, and in policy advocacy for community groups. Demand forecasts must remain flexible, incorporating real-time inputs from country stakeholders and evolving financing landscapes. The ability and prioritisation of countries to invest in both vaccine procurement and implementation strategies will be the primary determinant of demand.

Introduction Zoonotic diseases represent a substantial growing threat in Nigeria, exacerbated by rapid urbanization, population pressure, and complex interactions at the human animal environment interface. Nigeria, implemented the Surveillance and Information Sharing Operational Tool (SIS-OT), developed by the Tripartite organizations FAO, WHO, and WOAH, in response to these risks. This initiative aimed to evaluate, prioritize, and strengthen coordinated surveillance capacities within the National One Health (OH) framework across sectors and administrative levels. Methods A participatory national workshop was conducted from September 28 to October 1, 2024, convening over 60 experts across the human-animal-environment health sectors and key technical partners. Utilizing the SIS-OT Excel based workbook, participants assessed 32 core activities critical to functional multisectoral surveillance systems. Evaluation covered five thematic domains: pre-planning, assessment, planning, implementation, and monitoring & evaluation. Four priority zoonotic diseases: Lassa fever, Mpox, Bovine tuberculosis and Rabies guided discussions. Capacity levels were scored, and targeted activities selected to develop a five-year roadmap for implementation. Results Assessment revealed critical systemic gaps. Of the 32 activities evaluated, 56.3% were at the lowest capacity level (level 1), with only 6.3% reaching full completion. Key weaknesses were observed in legal frameworks, workforce planning, infrastructure mapping, and data interoperability. The presence of a national OH secretariat, growing political momentum, multisectoral participation and willingness to institutionalize OH coordination at sub-national levels were highlighted as enablers. The developed roadmap outlined progressive actions; stakeholder mapping, training on data systems, legal harmonization workshops, simulation exercises, and establishment of data sharing agreements. Conclusion The SIS-OT process revealed key gaps and fostered cross sector dialogue, producing a clear roadmap to enhance OH surveillance and laboratory networks. Addressing workforce development, digital systems, legal frameworks, and coordination is vital. This approach provides a scalable model for ECOWAS countries.