Time Zone: 0 hours. No daylight saving time in 2008
Tel. Country Code: 226
USADirect Tel.: 0
Electrical Standards: Electrical current is 220/50 (volts/hz). European Style Adaptor Plugs. Grounding Adaptor Plug D.
TRAVEL ADVISORY - BURKINA FASO
Sub-Saharan Africa has the highest incidence of insect-transmitted diseases, such as malaria, and all travelers need products to prevent mosquito and tick bites. I recommend all travelers use a combination of DEET or Picaridin repellent on their skin and Permethrin fabric insecticide on their clothing for greater than 99% protection against mosquito and tick bites.
- U.S. Embassy
Avenue Raoul Follereau
Tel:  50-30-67-23
Consular fax:  50-30-77-75
- Canadian Embassy
Tel:  31-18-94
Fax:  31-19-00
Internet: Website: http://www.dfait-maeci.gc.ca/world/embassies/menu-en.asp
- There is no British Embassy in Burkina Faso. In case of an emergency you should contact the British Embassy in Accra, Ghana. Our Honorary Consul, Mr Patrick de Leland, can only offer limited consular assistance in an emergency. His contact details are:
- Honorary Consulate of the UK in Burkina Faso
Mr Patrick de Lelande
Tel:  50 30 88 60
Fax:  50 31 25 43
- British High Commission
Tel:  (21) 221665
HIV Test: Not required.
Required Vaccinations: Yellow fever vaccination is required for all travelers >1 year of age arriving from all countries.
Passport/Visa: Burkina Faso, previously known as Upper Volta, is a landlocked, developing country in the Sahel region of West Africa. Its capital is Ouagadougou. Burkina Faso is a former French colony; the official language is French. It is one of the world•s poorest countries, and tourism infrastructure is limited.
ENTRY/EXIT REQUIREMENTS: A valid passport, visa, evidence of yellow-fever vaccination are required for entry into the country. Visas valid for seven days are available at land borders and for 21 days at the airport; however, both can be converted into visas of up to five years validity at the Direction du Controle des Migrations, a government office in central Ouagadougou. U.S. travelers should obtain longer-validity visas from the Embassy of Burkina Faso, 2340 Massachusetts Avenue NW, Washington, DC 20008, telephone (202) 332-5577. Overseas inquiries should be made at the nearest Burkinabe embassy or consulate.
Visit the Embassy of Burkina Faso website at http://www.burkinaembassy-usa.org/ for the most current visa information.
VACCINATIONS: RECOMMENDED AND ROUTINE
Hepatitis A: Recommended for all travelers >1 year of age.
Hepatitis B: Recommended for all non-immune travelers at potential risk for acquiring this infection. Hepatitis B is transmitted via infected blood or bodily fluids. Travelers may be exposed by needle sharing and unprotected sex; from acupuncture, tattooing or body piercing; when receiving non-sterile medical or dental injections, or unscreened blood transfusions; by direct contact with open skin sores on an infected person. Recommended for long-term travelers, expatriates, and any traveler requesting protection against hepatitis B infection.
Influenza: Recommended for all travelers over 6 months of age who have not had a flu shot in the previous 12 months.
Meningococcal (Meningitis): This disease is active. Vaccination with a quadrivalent meningitis vaccine (Menactra or Menomune) is recommended for all travelers, especially those anticipating close contact with the indigenous population.
Polio: A one-time dose of IPV vaccine is recommended for any traveler >age 18 who completed the primary childhood series but never received received an additional dose of polio vaccine as an adult. Available data do not indicate the need for more than a single lifetime booster dose with IPV (Inactivated Polio Vaccine).
Rabies: Rabies vaccine is recommended for: persons anticipating an extended stay; for those whose work or activities may bring them into contact with animals; for people going to rural or remote locations where medical care is not readily available; for travelers desiring extra protection.
Routine Immunizations: Immunizations against tetanus-diphtheria, measles, mumps, rubella (MMR vaccine) and varicella (chickenpox) should be updated, if necessary, before departure. MMR protection is especially important for any female of childbearing age who may become pregnant.
- In addition to tetanus, all travelers, including adults, should be fully immunized against diphtheria. A booster dose of a diphtheria-containing vaccine (Td or Tdap vaccine) should be given to those who have not received a dose within the previous 10 years.
Note: ADACEL is a new tetanus-diphtheria-pertussis (Tdap) vaccine that not only boosts immunity against diphtheria and tetanus, but has the advantage of also protecting against pertussis (whooping cough), a serious disease in adults as well as children. The Tdap vaccine can be administered in place of the Td vaccine when a booster is indicated.
A measles outbreak was reported from Burkina Faso in February 2009, chiefly occurring in four health districts: Fada (east), Bogodogo (center), Sindou (west), and Batie (southwest). As of June 30, 2009, the United Nations Office for the Coordination of Humanitarian Affairs (UNOCHA) has reported over 51,000 cases and 300 deaths of measles in Burkina Faso so far this year. This is the largest measles outbreak in Burkina Faso in 10 years.
Because of the risk of measles in both developed and developing countries, all international travelers should be up to date on immunizations, regardless of the travel destination. In addition, expatriates should make sure they are vaccinated against measles, especially in areas where outbreaks are occurring.
Typhoid: Recommended for all travelers.
Yellow Fever: Yellow fever vaccination is required for all travelers >1 year of age arriving from all countries. Recommended for all travelers >9 months of age.
HOSPITALS / DOCTORS
Medical care in Burkina Faso is well below Western Standards. Medical facilities and emergency hospital care are limited, particularly in areas outside the capital, Ouagadougou.
All travelers should be up-to-date on their immunizations and are advised to carry a medical kit as well as antibiotics to treat travelers diarrhea or other infections; they should bring drugs for malaria prophylaxis, if needed according to their itinerary. Travelers who are taking regular medications should carry them properly labeled and in sufficient quantity to last for the duration of their trip; they should not expect to obtain prescription or over-the-counter drugs in local stores or pharmacies in this country - the equivalent drugs may not be available; may be counterfeit; or of unreliable quality.
- Travelers are advised to obtain comprehensive travel insurance with specific overseas coverage, including air ambulance medevac. In the event of a serious illness or injury that can't be treated locally, every effort should be made to arrange medical evacuation to Western Europe.
Travelers should contact the U.S. or Canadian Embassies for medical referrals. The U.S Embassy maintains a listing of clinics and physicians at: http://ouagadougou.usembassy.gov/medical_information.html
- Polyclinique Notre Dame de la Paix
(behind Hotel Silmande)
Tel:  35 61 55
- Polyclinique du Centre
(downtown, south of the Grand Marche)
Tel:  31 37 78
Both Polyclinics Notre Dame de la Paix (behind the Hotel Silmande) and Polyclinique du Centre (behind ENAREF) are mostly locations where many private physicians keep office hours, but they do have doctors on site 24 hours/day; these are usually doctors who are still in training and with limited experience, but they can contact other physicians and specialists who are associated with the clinics.
DESTINATION HEALTH INFO FOR TRAVELERS
A Country Profile: Burkina Faso (formerly known as Upper Volta) is a landlocked nation of 12 million people located in West Africa. It has few natural resources, and hundreds of thousands of Burkinabe earn a living as migrant workers in the Ivory Coast and Ghana, providing opportunities for the spread of disease.
- Burkina Faso has high disease burdens for HIV, malaria and tuberculosis. A poor surveillance network makes it difficult to judge the extent of the HIV/AIDS epidemic in Burkina Faso. The United Nations Development Program estimates that the HIV-positive rate among adults is as high as 10 percent. More conservatively, at the Barcelona conference in 2002 UNAIDS estimated a 6.5 percent infection rate for Burkina Faso.
- Malaria accounts for 35 percent of hospitalizations and 25 percent of deaths in the country. WHO estimates that TB prevalence rate in Burkina Faso at 261 per 100,000 population and the TB death rate at 63 per 100,000.
- Doctors Without Borders/Medecins Sans Frontieres (MSF) has been working in Burkina Faso since 1995:
AIDS/HIV: Heterosexual contact is the predominate mode of transmission of HIV in sub-Saharan Africa. People in sub-Saharan Africa do not have many more lifetime partners than people in other parts of the world. However, researchers have found that in some areas it is not uncommon for people to have two or more regular sex partners at the same time. Someone is most likely to transmit HIV during the period shortly after they are infected, when they have very high levels of virus in their body. Therefore someone who has two or more concurrent partners is more likely to transfer HIV between their partners than someone who has a series of monogamous relationships. This too may help to explain why HIV is more widespread in Africa.
Both HIV prevalence rates and the numbers of people dying from AIDS vary greatly between African countries. In Somalia and Senegal the HIV prevalence is under 1% of the adult population, whereas in South Africa and Zambia around 15-20% of adults are infected with HIV. In four southern African countries, the national adult HIV prevalence rate has risen higher than was thought possible and now exceeds 20%. These countries are Botswana (24.1%), Lesotho (23.2%), Swaziland (33.4%) and Zimbabwe (20.1%).
West Africa has been less affected by AIDS, but the HIV prevalence rates in some countries are creeping up. HIV prevalence is estimated to exceed 5% in Cameroon (5.4%), Cote dIvoire (7.1%) and Gabon (7.9%). Until recently the national HIV prevalence rate has remained relatively low in Nigeria, the most populous country in sub-Saharan Africa. The rate has grown slowly from below 2% in 1993 to 3.9% in 2005. But some states in Nigeria are already experiencing HIV infection rates as high as those now found in Cameroon. Already around 2.9 million Nigerians are estimated to be living with HIV. (Source: www.Avert.org)
- Adult HIV prevalence in Burkina Faso is relatively low compared to other countries. The adult (15-49) prevalence rate is 2.0%.
More statistics are available at: http://www.avert.org/subaadults.htm
- Transmission of HIV can be prevented by avoiding: sexual contact with a high-risk partner; injecting drug use with shared needles; non-sterile medical injections; unscreened blood transfusions.
- The threat of HIV/AIDS should not be a primary concern for the traveler. However, there may be a concern for a subset of travelers who may be exposed to HIV, the virus that causes AIDS, through contact with the body fluids of another person or their blood. Although travel has contributed in a general way to the global spread of AIDS, fear of traveling because of this disease is not warranted.
Accidents & Medical Insurance:
Accidents and injuries are the leading cause of death among travelers under the age of 55 and are most often caused by motor vehicle and motorcycle crashes; drownings, aircraft crashes, homicides, and burns are lesser causes. Important safety rules to follow are 1) Do not drive at night, 2) Do not rent a motorcycle, moped, bicycle, or motorbike, even if you are experienced, and 3) Don't swim alone, at night, or if intoxicated.
- Heart attacks cause most fatalities in older travelers.
- Infections cause only 1% of fatalities in overseas travelers, but, overall, infections are the most common cause of travel-related illness.
- MEDICAL INSURANCE: Travelers are advised to obtain, prior to departure, supplemental travel health insurance with specific overseas coverage. The policy should provide for direct payment to the overseas hospital and/or physician at the time of service and include a medical evacuation benefit. The policy should also provide 24-hour hotline access to a multilingual assistance center that can help arrange and monitor delivery of medical care and determine if medevac or air ambulance services are required.
African Sleeping Sickness (Trypanosomiasis): Disease activity apparently has been reported in the vicinities of Banfora and Bobo Diolasso in the southwest, and the Koudougou vicinity west of Ouagadougou. Travelers at most risk are those on safari and game-viewing holiday. Travelers to urban areas are at very low risk. The tsetse fly comes out in the early morning and the late afternoon. Insect repellent applied to the skin does not prevent tsetse fly bites, so travelers should wear protective clothing and sleep under a bed net.
- Initial symptoms: The bite of tsetse fly can be painful and may develop into a raised red sore, called a chancre. The initial sore may subside or develop into an expanding red, tender, swollen area, followed by a generalized illness with fever, myalgia, abdominal discomfort, diarrhea, vomiting, headache, rigors, and sweats.
Read more: http://www.phac-aspc.gc.ca/tmp-pmv/info/af_trypan-eng.php
Avian Influenza A (Bird Flu): The World Animal Health Organization (OIE) has confirmed that there has been an outbreak of Avian Influenza (Bird Flu) in poultry at a farm near Ouagadougou. No human infections or deaths have been reported.
- Avian influenza A (H5N1) is predominantly a disease of birds. The virus does not pass easily from birds to people and does not to pass from person to person (except in very rare cases of close contact with an infected blood relative).
- The risk to humans from avian influenza is believed to be very low and no travel restrictions are advised, except travelers should avoid visiting animal markets, poultry farms and other places where they may come into close contact with live or dead poultry, or domestic, caged or wild birds and their excretions. In addition, travelers are advised to:
1. Cook poultry and egg dishes thoroughly. (Well-cooked poultry is safe to eat.)
2. Wash hands frequently with soap and water if around poultry.
- The World Health Organization (WHO) does not recommend travel restrictions to countries experiencing outbreaks of influenza A (H5N1) in birds, including those countries which have reported associated cases of human infection.
To date, no cases of avian influenza A (H5N1) illness have been identified among short-term travelers visiting countries affected by outbreaks among poultry or wild birds.
The usual vaccines against influenza are not protective against “bird flu.” Oseltamivir (Tamiflu) is somewhat effective in the treatment of avian influenza A (H5N1). It seems to be effective in some cases, but may fail in others. Recently, resistant strains have been reported. In addition, the dosage and duration of treatment appear to be different in severe cases.
Cholera: There has been a cholera outbreak in Ouagadougou and its outlying areas, including as far as Koudougou, sixty miles West of the capital. The authorities reported over 200 cases including six deaths. The district of Pissy, at the southern periphery of the capital, has been particularly badly hit.
Although this disease is reported active in this country, the threat to tourists is low. Cholera is an uncommon disease in travelers from developed countries. Cholera vaccine is recommended only for people, such as relief workers or health care personnel, who are working in a high-risk endemic area under less than adequate sanitary conditions, or travelers who work or live in remote, endemic or epidemic areas and who don’t have ready access to medical care. Canada, Australia, and countries in the European Union license an oral cholera vaccine. The cholera vaccine is not available in the United States.
- The main symptom of more severe cholera is copious watery diarrhea.
- Antibiotic therapy is a useful adjunct to fluid replacement in the treatment of cholera by substantially reducing the duration and volume of diarrhea and thereby lessening fluid requirements and shortening the duration of hospitalization.
- A single 1-gm oral dose of azithromycin is effective treatment for severe cholera in adults. This drug is also effective for treating cholera in children. (NEJM:http://content.nejm.org/cgi/content/short/354/23/2452
Filariasis: Bancroftian filariasis is reported in this country. Travelers should take measures to prevent mosquito bites.
Hepatitis: All travelers not previously immunized against hepatitis A should be vaccinated against this disease. Hepatitis A is transmitted through contaminated food and water. Travelers who will have access to safe food and water are at lower risk. Those at higher risk include travelers visiting friends and relatives, long-term travelers, and those visiting areas of poor sanitation. Hepatitis E may be endemic, but levels are unclear. Transmission of HEV occurs primarily through contaminated drinking water. In developing countries, prevention of HEV relies primarily on the provision of clean water supplies and overall improved sanitation and hygiene. There is no vaccine.
- The overall hepatitis B (HBsAg) carrier rate in the general population is estimated at >10%. Hepatitis B is transmitted via infected blood or bodily fluids. Travelers may be exposed by needle sharing and unprotected sex; from non-sterile medical or dental injections, and acupuncture; from unscreened blood transfusions; by direct contact with open skin lesions of an infected person. The average traveler is at low risk for acquiring this infection. Vaccination against hepatitis B is recommended for: persons having casual/unprotected sex with new partners; sexual tourists; injecting drug users; long-term visitors; expatriates, and anybody wanting increased protection against the hepatitis B virus.
- Hepatitis C is endemic at moderate levels in the general population. Most hepatitis C virus (HCV) is spread either through intravenous drug use or, in lesser-developed countries, through blood contamination during medical procedures. Over 200 million people around the world are infected with hepatitis C — an overall incidence of around 3.3% of the population of the world. Statistically, as many people are infected with HCV as are with HIV, the virus that causes AIDS.
Influenza: Influenza is transmitted year-round in the tropics. The flu vaccine is recommended for all travelers over age 6 months who have not received a flu shot in the previous 12 months.
Insects: All travelers should take measures to prevent both daytime and nighttime insect bites. Insect-bite prevention measures include a DEET-containing repellent applied to exposed skin, permethrin spray or solution applied to clothing and gear, and use of a permthrin-treated bednet at night while sleeping.
Leishmaniasis: Low apparent risk. Cutaneous leishmaniasis has been reported in the western and eastern areas, and a focus was identified near Arabinda (northeastern province of Soum). Travelers should take precautions against insect (sandfly) bites.
Malaria: High risk throughout this country year-round, including urban areas. Risk is elevated during and immediately following the rainy season, June through October. Falciparum malaria accounts for 85%–95% of cases, followed by P. ovale. Multidrug resistant falciparum malaria is common.
- Prophylaxis with atovaquone/proguanil (Malarone), mefloquine (Lariam), doxycycline, or primaquine is recommended.
A malaria map is located on the Fit for Travel website (www.fitfortravel.nhs.uk), which is compiled and maintained by experts from the Travel Health division at Health Protection Scotland (HPS). Go to www.fitfortravel.nhs.uk and select Malaria Map from the Burkina Faso page on the Destinations menu or A-Z Index.
Malaria is transmitted via the bite of an infected female Anopheles mosquito. Anopheles mosquitoes feed predominantly during the hours from dusk to dawn. All travelers should take measures to prevent evening and nighttime mosquito bites. Insect-bite prevention measures include applying a DEET-containing repellent to exposed skin, applying permethrin spray or solution to clothing and gear, and sleeping under a permethrin-treated bednet. DEET-based repellents have been the gold standard of protection under circumstances in which it is crucial to be protected against insect bites that may transmit disease. Nearly 100% protection can be achieved when DEET repellents are used in combination with permethrin-treated clothing.
NOTE: Picardin repellents (20% formulation, such as Sawyer GoReady or Natrapel 8-hour) are now recommended by the CDC and the World Health Organization as acceptable non-DEET alternatives to protect against malaria-transmitting mosquito bites. Picaridin is also effective and ticks and biting flies.
- You should consider the diagnosis of malaria if you develop an unexplained fever during or after being in this country.
- Long-term travelers who may not have access to medical care should bring along medications for emergency self-treatment should they develop symptoms suggestive of malaria, such as fever, chills, headaches, and muscle aches, and cannot obtain medical care within 24 hours.
Meningitis: Burkina Faso is the most heavily affected meningitis belt country in sub-Saharan Africa with a total of over 1500 cases, and over 200 deaths, reported through February 2008. Serogroup A meningitis is the causative organism in almost all cases.
- Quadrivalent meningitis vaccine (Menactra or Menomune) is recommended for all travelers to this country, especially if they will be having close contact with the indigenous population.
- Areas in sub-Saharan Africa with frequent epidemics of meningococcal meningitis are found at:
Onchocerciasis: Also called river blindness. Highest transmission occurs near fast-flowing rivers. Incidence is declining, due to blackfly control programs. Travelers should take measures to prevent insect (blackfly) bites.
Other Diseases/Hazards: African tick typhus (also called boutonneuse fever)
- African tick-bite fever
- Brucellosis (from consumption of unpasteurized dairy products or infected meat fom cattle)
- Dengue (low apparent risk; travelers should take measures to prevent daytime mosquito bites)
- Dracunculiasis (risk is countrywide)
- Lassa fever (rare, sporadic cases; transmitted from infected rodents via dried urine/feces, usually in dust in rural dwellings)
- Tick-borne relapsing feverintestinal worms (common), and typhoid fever are reported.
Rabies: Sporadic cases of human rabies are reported countrywide. Although rabies is rare among tourists—there is risk. No one should pet or pick up any stray animals. All children should be warned to avoid contact with any animal.
Pre-exposure rabies vaccine is recommended for travel longer than 3 months, for shorter stays in rural when travelers plan to venture off the usual tourist routes and where they may be more exposed to the stray dog population; when travelers desire extra protection; or when they will not be able to get immediate medical care.
- All animal bite wounds, especially from a dog, should be thoroughly cleansed with soap and water and then medically evaluated for possible post-exposure treatment, regardless of your vaccination status. Pre-exposure vaccination eliminates the need for rabies immune globulin, but does not eliminate the need for two additional booster doses of vaccine. Even if rabies vaccine was administered before travel, a 2-dose booster series of vaccine is needed after the bite of a rabid animal.
Schistosomiasis: Urinary schistosomiasis is widely distributed, especially in the eastern one-third of this country. Intestinal schistosomiasis is widely distributed in the southwest, with scattered foci in other areas, especially near Banfora in western Burkina Faso.
- Schistosomiasis is a parasitic flatworm infection of the intestinal or urinary system caused by one of several species of Schistosoma. Schistosomiasis is transmitted through exposure to contaminated water while wading, swimming, and bathing. Schistosoma larvae, released from infected freshwater snails, penetrate intact skin to establish infection. All travelers should avoid swimming, wading, or bathing in freshwater lakes, ponds, or streams. There is no risk in chlorinated swimming pools or in seawater.
Tick-Borne Diseases: Tick-borne illness is common in Africa. African tick typhus, also called Mediterranean spotted fever, is transmitted by dog ticks. The etiologic agent for this infection is Rickettsia conorii. African tick-bite fever (ATBF), a recently rediscovered rickettsiosis of the spotted fever group, is very similar to African tick typhus, and is caused by Rickettsia africae; it is transmitted by cattle ticks. ATBF is also highly prevalent in Africa. The symptoms of tick typhus of both types include fever, severe headache, myalgia, and inoculation eschars (which appear as black crusts surrounded by a red halo at the site of the tick bite).
- All tick-transmitted disease of the spotted fever type respond well to treatment with doxycycline or tetracycline.
Travelers' Diarrhea: High risk. All surface water sources should be considered potentially contaminated. Water from deep wells is usually free of bacterial contamination, but may contain high levels of minerals and sediment. Outside of hotels and resorts, we recommend that you boil, filter or purify all drinking water or drink only bottled water or other bottled beverages and do not use ice cubes. Avoid unpasteurized milk and dairy products. Do not eat raw or undercooked food (especially meat, fish, raw vegetables—these may transmit intestinal parasites, as well as bacteria). Peel all fruits.
- Good hand hygiene reduces the incidence of travelers’ diarrhea by 30%.
- A quinolone antibiotic, or azithromycin, combined with loperamide (Imodium), is recommended for the treatment of diarrhea. Diarrhea not responding to antibiotic treatment may be due to a parasitic disease such as giardiasis, amebiasis, or cryptosporidiosis.
- Seek qualified medical care if you have bloody diarrhea and fever, severe abdominal pain, uncontrolled vomiting, or dehydration.
Tuberculosis: Tuberculosis is highly endemic in Burkina Faso with an annual occurrence was greater than or equal to 40 cases per 100,000 population. Tuberculosis (TB) is transmitted following inhalation of infectious respiratory droplets. Most travelers are at low risk. Travelers at higher risk include those who are visiting friends and relatives (particularly young children), long-term travelers, and those who have close contact, prolonged contact with the local population. There is no prophylactic drug to prevent TB. Travelers with significant exposure should have PPD skin testing done to evaluate their risk of infection.
Typhoid Fever: Typhoid fever is the most serious of the Salmonella infections. Typhoid vaccine is recommended by the CDC for all unvaccinated people traveling to or working in sub-Saharan Africa, especially if visiting smaller cities, villages, or rural areas and staying with friends or relatives where exposure might occur through food or water. Current vaccines against Salmonella typhi are only 50-80% protective and do not protect against Salmonella paratyphi, the cause of paratyphoid fever. (Paratyphoid fever bears similarities with typhoid fever, but the course is generally more benign.) Travelers should continue to practice strict food, water and personal hygiene precautions, even if vaccinated.
Yellow Fever: In October 2008, The Ministry of Health reported 2 laboratory confirmed cases of yellow fever in the health district of Ouahigouya [Yatenga province], in the north of the country, near the border with Mali.
The last outbreaks occurred in September 2005 from the Batie, Gaoua and Banfora districts in the southeastern part of the country, near the border with Cote d’Ivoire.
- Yellow fever vaccination is required for all travelers over 1 year of age arriving from all countries. Vaccination is recommended for all travelers >9 months of age.