Dénutrition Chez Les Patients Cancéreux À L’hôpital National De Niamey (Niger)

Introduction : La dénutrition est un problème fréquemment rencontré chez les patients suivis pour pathologie cancéreuse. Elle est d'origine multifactorielle et constitue un problème important compliquant la prise en charge de ces patients. Méthodologie : Il s’agissait d’une étude prospective et descriptive qui a été menée du 1 juillet au 30 Septembre auprès de patients cancéreux hospitalisés dans le service d’Oncohématologie de l’Hôpital National de Niamey. Le diagnostic de la dénutrition était posé sur la base de l’IMC, l’albuminémie et ou de la perte de poids. Résultats : La prévalence de la dénutrition était estimée à 66,70%. Tous avaient répondu aux critères de l’IMC, 54, 38% avaient une hypoalbuminémie et 82,40% avaient perdu du poids. Les tranches d’âge entre 0 et 15 ans et supérieure à 60 ans étaient les plus touchées avec respectivement 76,19% et 75%. Les cancers à haut risque de dénutrition étaient représentés par les tumeurs de la langue, de l’œsophage et les tumeurs pulmonaires. Cette dénutrition était d'origine multifactorielle, d'où l'importance de déterminer les différents facteurs de risque tels que : la nature de la tumeur, la durée d'hospitalisation, les facteurs cliniques (diarrhée, vomissement, anorexie, et douleur). Parmi les patients qui étaient dénutris sous chimiothérapie, 84,61% étaient dénutris après la troisième (3) cure. Seul l’âge était associé significativement avec la dénutrition (p<0,05). Sur la prise en charge nutritionnelle, six (6) patients seulement avaient bénéficié d’une alimentation entérale soit 5,9%. Aucun patient dénutri n’avait bénéficié d’une alimentation parentérale. Introduction: Undernutrition is a problem frequently encountered in patients followed for cancer pathology. It is of multifactorial origin and constitutes an important problem complicating the management of these patients. Methodology: This was a prospective and descriptive study which was conducted from July 1 to September 30 with cancer patients hospitalized in the Onco-Hematology department of Niamey National Hospital. The diagnosis of undernutrition was made on the basis of BMI, albuminemia and weight loss. Results: The prevalence of undernutrition was estimated at 66.70%. All had met the BMI criteria, 54, 38% had hypo albuminemia and 82.40% had lost weight. The age groups between 0 and 15 and over 60 were the most affected with 76.19% and 75% respectively. Cancers at high risk of undernutrition were represented by tumors of the tongue, esophagus and lung tumors. This undernutrition was of multifactorial origin, hence the importance of determining the various risk factors such as: the nature of the tumor, the duration of hospitalization, clinical factors (diarrhea, vomiting, anorexia, and pain). Of the patients who were malnourished under chemotherapy, 84.61% were malnourished after the third (3) course of treatment. Only age was significantly associated with undernutrition (p <0.05). In terms of nutritional management, only six (6) patients had benefited from enteral nutrition, ie 5.9%. No malnourished patient had received parenteral nutrition

Réactions et résilience des populations face à la crue de 2012 dans le cinquième arrondissement de Niamey

This study focuses on the way in which authorities and populations deal with flooding phenomena. The fifth municipality of Niamey city has been threatened since 2012.This situation impacts on economy of its population. The aim of this article is to understand the logics of each of these actors in implemented strategies at the time and following the event. Combining qualitative and quantitative approaches, the study made it possible to highlight several measures developed by authorities and individuals to deal with the events. In response to the 2012 phenomena and the dysfunctions observed in terms of warning and population evacuation, prevention and protection strategies including enhancement of protective dike along the river as well as the relocation of the most exposed populations and prohibition of construction in flood zones have been initiated by the authorities. These measures have been complemented by various individual self-protection strategies using local materials in water-resistant housing reconstruction

Relocalisation préventive suite à la crue de Niamey 2012 : vulnérabilités socio-économiques émergentes et retour en zone inondable

En 2012, une grande inondation par débordement fluvial a affecté le quotidien de 45464 personnes de la ville de Niamey. Suite à cet événement, les autorités ont décidé de relocaliser 4963 personnes hors zone inondable. Cependant, une grande partie des personnes déplacées sont revenues en zone à risque un mois plus tard et sont de nouveau inondées en 2013. Dans l’objectif de comprendre ce qui a motivé ce retour en zone inondable, il a été procédé à une enquête auprès des responsables de la ville et des résidents de sept quartiers du cinquième arrondissement communal. Elle a mis en évidence que les populations affectées se sont retrouvées quelques temps après leur relocalisation, dans des conditions de vie difficiles suite à une perte d’emploi et à un accès difficile à l’eau, au transport et au logement. Ces conditions ont révélé de nouvelles vulnérabilités et influencé le retour de certaines d’entre elles en zone inondable.In 2012, a large fluvial flood affected the daily life of 45464 people in the city of Niamey. Following this event, the authorities decided to relocate 4963 people outside the flooded zone. However, many people returned to the zone at risk a month later and were flooded again in 2013. In order to understand what motivated this return to the flooded zone, a survey was conducted among city officials and residents of seven neighborhoods in the fifth district. She pointed out that the affected populations found themselves some time after their relocation, in difficult living conditions as a result of job loss and difficult access to water, transport and housing. These conditions have revealed new vulnerabilities and influenced the return of some of them to flooded zone

How EU Pressure Hampers Circular Migration between Niger and Libya

On 26 May 2015, under pressure from its European partners, the Nigerien government issued Law 36-2015, which forbids Nigeriens from transporting international migrants north from Agadez towards Libya or Algeria. While this law supposedly targets only international migrants, a closer look reveals its extended impact on circular migration and the local population. The implementation of Law 36-2015 has negatively affected the local economy in the Agadez region, as people who had once made a living from migration in the wider sense have faced sudden unemployment. In reaction to the law's implementation, drivers and migrants have developed a diverse range of strategies to circumvent new restrictions. As a result, migration to Libya and Algeria has become more expensive and more dangerous, since drivers are forced to use unofficial routes that include higher bribe payments to local security officials. Because routes have become more clandestine, dangerous, and expensive, the official number of Nigeriens migrating to Libya or Algeria has declined, leading to unintended consequences for their local communities for whom income from different forms of migration is part of an important resilience strategy to counter unemployment, poverty, and droughts. Given the law's sole and explicit focus on international migrants, international NGOs working in the region of Agadez have started to concentrate mostly on non-Nigerien migrants. This has fuelled dissatisfaction among the local population, with the potential for future violence. The European Union should stop using humanitarian aid as a bargaining chip to implement European externalisation policies. Rather than pursuing migration policies in sub-Saharan Africa that have evinced negative consequences for traditional and local forms of migration, policymakers should design policies that incorporate the knowledge, perspectives, and needs of both local actors and the affected local population - migrants and non-migrants alike

Efficient management of health centres human resources in Zambia

This study uses Data Envelopment Analysis (DEA) to estimate the degree of technical, allocative and cost efficiency in individual public and private health centres in Zambia; and to identify the relative inefficiencies in the use of various inputs among individual health centers. About 83% of the 40 health centres were technically inefficient; and 88% of them were both allocatively and cost inefficient. The privately owned health centers were found to be more efficient than public facilities. © 2006 Springer Science+Business Media, Inc