Evaluation De La Denutrition Chez Les Enfants Ages De 2 A 60 Mois Hospitalises Aux Services De Pediatrie Des Hopitaux De Ziguinchor (Senegal)

Introduction: Malnutrition is a public health problem in developing countries. The prevalence of malnutrition at the national level hardly reflects the reality in hospitals. It is in this context that we assessed the nutritional status of children from 2 months to 5 years hospitalized in the pediatric ward of the regional hospital and the Ziguinchor Peace Hospital. Materials and methods: This was a prospective study from June 1 to October 30, 2016. Children aged 2 to 60 months, hospitalized in one of the two services, were included. Children with esdato-ascetic syndrome were not included. Epidemiological, anthropometric data, and associated diagnosis were studied. Results: We included 114 children (70 boys and 44 girls). The average age was 21.9 months [4-59]. Forty-two point one percent (42.1%) of infants <6 months were breastfed exclusively with breast milk. The weaning of children was done early in 55.3%. The mean age of mothers was 26.6 years [17-38]. The socioeconomic level was low in 62.3% of cases. The prevalence of malnutrition averaged 35.5% for underweight; 32.9% for wasting and 32.0% for stunting. Acute respiratory infections (ARI) and acute gastroenteritis were the most common associated conditions. Mean hospital stay was 8 days ± 009 [3-28]. About two thirds of the patients (n = 72) had a hospital stay of more than 7 days. Malnutrition was significantly associated with multiparity, low socioeconomic status, hospital stay of more than 7 days and infectious diseases. Conclusion: Infections and a hospital stay longer than a week are factors favoring malnutrition in children from 2 months to 5 years

Factors Affecting the Statural Growth Retardation in Children using Steroids in Idiopathic Nephrotic Syndrome

Background and Aim: Idiopathic nephrotic syndrome or nephrosis causes massive protein leakage in the urine. Its treatment requires steroids (prednisone, methylprednisolone), often for a prolonged period, notably in case of steroid-dependence or steroid-resistance. In children, long-term use of steroids can lead to several side effects such as statural growth retardation/ stunting. This study evaluated the frequency of stunting in idiopathic nephrotic syndrome in children on steroids and identified the associated factors.     
 Material and Methods: This was a retrospective, descriptive cohort study carried out in children aged 0 to 16 years treated at the paediatric nephrology unit of Aristide Le Dantec Hospital in Dakar, between 1 December 2017 and 31 May 2020. All records of nephrotic children treated in outpatient or inpatient setting were included. These children had to be on corticosteroid therapy for at least 30 months and have a height taken regularly during follow-up consultations.
 Results: Of 259 children followed for idiopathic nephrotic syndrome, 93 were included in the study. The median age was 96.5 months and the sex ratio was 1.9. The mean height of the children at the beginning of the follow-up was -0.26 DS, at the end it was -0.88 DS. At the beginning of the follow-up, 8 children had already stunting. At 12 months follow-up, 72 children (77.4%) had a decrease in z-score; and at 30 months, there were 7 more children (84.9%) who had a decrease in z-score. Methylprednisolone boluses were given to 17 children (18.3%). Calcium supplementation was done in 91 children (97.8%). Vitamin D supplementation was given to 91 children (97.8%). The mean number of relapses was 1.8. Factors associated with stunting were number of relapses ≤3 (p=0.03), duration of corticosteroid therapy >6 months (p<0.0001) and cumulative doses of prednisone >100 mg/kg (p=0.04).
 Conclusion: In prolonged nephrotic syndrome in children, corticosteroids can cause stunting

Study of variations in the broncho-arterial pedicles of the upper right lung lobe

Bronchial distribution and functional arterial vascularization of the upper lobe of the right lung are subject to many anatomical variations. The control of  these variations is essential for endoscopic and agiographic examinations. It also offers a better guarantee for safe and controlled surgery. In this  preliminary work, the exploitation of 15 heart-lung blocks treated by the injection corrosion method allowed us to study the general arrangement of the  broncho-arteries of the right upper lung lobe and their anatomical variations in the Senegalese population. Our results were as follows: the right upper  lobar bronchus was born on average at 1.25 cm from the tracheal bifurcation, with an average length of 1.13 cm. It ended with trifurcation into apical  (B1), dorsal (B2) and ventral (B3) segmental bronchi in 10 cases (66.66%); in 3 cases (20%), it ended with bifurcation into the dorsal segmental bronchus  and the apico-ventral trunk (B1+B3) (1 case), the apico-dorsal trunk (B1+B2) and the ventral segmental bronchus (B3), finally, in ventral and dorsal  segmentary bronchi giving each one an apical branch (1 case); in a last case, it ended by quadrifurcation, giving an external parabronche. The right upper  lobe was vascularized by 1 to 4 arteries, with eight modes of vascularization. It received more frequently two arteries. The anterior mediastinal  artery was the most common (100%). These results allowed us to discuss anatomical variations in the bronchial tree of the right upper lung lobe and the  pulmonary arterial distribution in that lobe. These variations must be taken into account during endoscopic examinations of imaging and surgery of  pulmonary excision, under penalty of accidents.&nbsp

Senegal: Presidential elections 2019 - The shining example of democratic transition immersed in muddy power-politics

Whereas Senegal has long been sold as a showcase of democracy in Africa, including peaceful political alternance, things apparently changed fundamentally with the Senegalese presidentials of 2019 that brought new configurations. One of the major issues was political transhumance that has been elevated to the rank of religion in defiance of morality. It threatened political stability and peace. In response, social networks of predominantly young activists, created in 2011 in the aftermath of the Arab Spring focused on grass-roots advocacy with the electorate on good governance and democracy. They proposed a break with a political system that they consider as neo-colonialist. Moreover, Senegal’s justice is frequently accused to be biased, and the servility of the Constitutional Council which is in the first place an electoral court has often been denounced

The evolving SARS-CoV-2 epidemic in Africa: Insights from rapidly expanding genomic surveillance

INTRODUCTION Investment in Africa over the past year with regard to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) sequencing has led to a massive increase in the number of sequences, which, to date, exceeds 100,000 sequences generated to track the pandemic on the continent. These sequences have profoundly affected how public health officials in Africa have navigated the COVID-19 pandemic. RATIONALE We demonstrate how the first 100,000 SARS-CoV-2 sequences from Africa have helped monitor the epidemic on the continent, how genomic surveillance expanded over the course of the pandemic, and how we adapted our sequencing methods to deal with an evolving virus. Finally, we also examine how viral lineages have spread across the continent in a phylogeographic framework to gain insights into the underlying temporal and spatial transmission dynamics for several variants of concern (VOCs). RESULTS Our results indicate that the number of countries in Africa that can sequence the virus within their own borders is growing and that this is coupled with a shorter turnaround time from the time of sampling to sequence submission. Ongoing evolution necessitated the continual updating of primer sets, and, as a result, eight primer sets were designed in tandem with viral evolution and used to ensure effective sequencing of the virus. The pandemic unfolded through multiple waves of infection that were each driven by distinct genetic lineages, with B.1-like ancestral strains associated with the first pandemic wave of infections in 2020. Successive waves on the continent were fueled by different VOCs, with Alpha and Beta cocirculating in distinct spatial patterns during the second wave and Delta and Omicron affecting the whole continent during the third and fourth waves, respectively. Phylogeographic reconstruction points toward distinct differences in viral importation and exportation patterns associated with the Alpha, Beta, Delta, and Omicron variants and subvariants, when considering both Africa versus the rest of the world and viral dissemination within the continent. Our epidemiological and phylogenetic inferences therefore underscore the heterogeneous nature of the pandemic on the continent and highlight key insights and challenges, for instance, recognizing the limitations of low testing proportions. We also highlight the early warning capacity that genomic surveillance in Africa has had for the rest of the world with the detection of new lineages and variants, the most recent being the characterization of various Omicron subvariants. CONCLUSION Sustained investment for diagnostics and genomic surveillance in Africa is needed as the virus continues to evolve. This is important not only to help combat SARS-CoV-2 on the continent but also because it can be used as a platform to help address the many emerging and reemerging infectious disease threats in Africa. In particular, capacity building for local sequencing within countries or within the continent should be prioritized because this is generally associated with shorter turnaround times, providing the most benefit to local public health authorities tasked with pandemic response and mitigation and allowing for the fastest reaction to localized outbreaks. These investments are crucial for pandemic preparedness and response and will serve the health of the continent well into the 21st century

L'étude des conditions thermodynamiques et cinétiques du procédé de captage de CO₂ par formation d'hydrates de gaz : Application au mélange CO₂-CH₄

210 pagesThe CO2 capture using gas hydrate crystallisation is a rupture technology to recover CO2 from gas emitted by industry. The goal is to find cheaper energy solutions to sequester CO2 than conventional processes (amine absorption and TSA / PSA processes). The objective is to study the thermodynamic and kinetic conditions of a process to capture CO2 by the formation of gas hydrates. Gas hydrates have properties of selectivity and a large storage capacity for a separation of gas.The thermodynamic aspects were to determine the phase diagrams to see the feasibility of this technique. We showed that the operating pressures may be important in cases where the liquid phase is only made up of water. To reduce compression costs, we used the TBAB (TetraButylAmmoniumBromide) as an additive. The use of this additive can reduce considerably the operating pressures by 16. However, this pressure gain is accompanied by a loss of storage capacity. We also showed that the model of Van der Waals and Platteeuw is able to describe the phase diagrams obtained. The effect of TBAB on the gas solubility is also determined with different behaviours depending of the gas. For the kinetic part, we showed experimentally a preferential consumption of CO2 in the first moments of the crystallization. A kinetic model based on material and population balances adapted for gas mixtures is proposed. The model describes well the evolution of total gas consumption and the phenomenon of preferential consumption of CO2 at the beginning of the crystallization. This model with good kinetic parameters is able to monitor the size of crystals which is an important feature for transportation aspects of gas hydrates.Le travail de thèse réalisé rentre dans le cadre de la lutte contre les émissions de gaz à effet de serre en trouvant des solutions de piégeage du CO2 moins coûteuses en énergie que les procédés conventionnels (absorption aux amines et les procédés TSA/PSA). L'objectif est d'étudier les conditions thermodynamiques et cinétiques d'un procédé de captage de CO2 par formation d'hydrates de gaz. Les hydrates de gaz présentent des propriétés de sélectivité et une capacité de stockage importantes pour une séparation de gaz.L'étude des aspects thermodynamiques a consisté à la détermination des diagrammes de phase permettent de juger la faisabilité de la technique. Nous avons montré que les pressions opératoires peuvent être importantes dans le cas où la phase liquide est uniquement constituée d'eau. Pour limiter les coûts de compression, nous avons utilisé le TBAB (TetraButylAmmoniumBromide) comme additif. L'utilisation de cet additif permet de réduire considérablement les pressions opératoires avec un gain pouvant aller jusqu'à un facteur 16. Cependant ce gain de pression s'accompagne d'une perte de capacité de stockage. Nous avons également montré que le modèle de van der Waals et Platteeuw permet de décrire les diagrammes de phase obtenus. L'effet du TBAB sur la solubilité des gaz est également déterminé avec des comportements différents selon les gaz. Pour la partie cinétique, nous avons montré expérimentalement une consommation préférentielle du CO2 dans les premiers instants de la cristallisation. Un modèle cinétique reposant sur un couplage des bilans matière et bilans de population adapté pour les mélanges de gaz est proposé. Le modèle décrit parfaitement l'évolution de la consommation totale de gaz et le phénomène de consommation préférentielle du CO2 au début de la cristallisation. Ce modèle avec les paramètres cinétiques adéquats permet de suivre la granulométrie qui est une caractéristique importante pour les aspects de transport des hydrates de gaz

Etude des conditions thermodynamiques et cinétiques du procédé de captage de CO2 par formation d'hydrates de gaz (application au mélange CO2-CH4)

Le travail de thèse réalisé rentre dans le cadre de la lutte contre les émissions de gaz à effet de serre en trouvant des solutions de piégeage du CO2 moins coûteuses en énergie que les procédés conventionnels (absorption aux amines et les procédés TSA/PSA). L objectif est d étudier les conditions thermodynamiques et cinétiques d un procédé de captage de CO2 par formation d hydrates de gaz. Les hydrates de gaz présentent des propriétés de sélectivité et une capacité de stockage importantes pour une séparation de gaz. L étude des aspects thermodynamiques a consisté à la détermination des diagrammes de phase permettent de juger la faisabilité de la technique. Nous avons montré que les pressions opératoires peuvent être importantes dans le cas où la phase liquide est uniquement constituée d eau. Pour limiter les coûts de compression, nous avons utilisé le TBAB (TetraButylAmmoniumBromide) comme additif. L utilisation de cet additif permet de réduire considérablement les pressions opératoires avec un gain pouvant aller jusqu à un facteur 16. Cependant ce gain de pression s accompagne d une perte de capacité de stockage. Nous avons également montré que le modèle de van der Waals et Platteeuw permet de décrire les diagrammes de phase obtenus. L effet du TBAB sur la solubilité des gaz est également déterminé avec des comportements différents selon les gaz. Pour la partie cinétique, nous avons montré expérimentalement une consommation préférentielle du CO2 dans les premiers instants de la cristallisation. Un modèle cinétique reposant sur un couplage des bilans matière et bilans de population adapté pour les mélanges de gaz est proposé. Le modèle décrit parfaitement l évolution de la consommation totale de gaz et le phénomène de consommation préférentielle du CO2 au début de la cristallisation. Ce modèle avec les paramètres cinétiques adéquats permet de suivre la granulométrie qui est une caractéristique importante pour les aspects de transport des hydrates de gaz.The CO2 capture using gas hydrate crystallisation is a rupture technology to recover CO2 from gas emitted by industry. The goal is to find cheaper energy solutions to sequester CO2 than conventional processes (amine absorption and TSA / PSA processes). The objective is to study the thermodynamic and kinetic conditions of a process to capture CO2 by the formation of gas hydrates. Gas hydrates have properties of selectivity and a large storage capacity for a separation of gas. The thermodynamic aspects were to determine the phase diagrams to see the feasibility of this technique. We showed that the operating pressures may be important in cases where the liquid phase is only made up of water. To reduce compression costs, we used the TBAB (TetraButylAmmoniumBromide) as an additive. The use of this additive can reduce considerably the operating pressures by 16. However, this pressure gain is accompanied by a loss of storage capacity. We also showed that the model of Van der Waals and Platteeuw is able to describe the phase diagrams obtained. The effect of TBAB on the gas solubility is also determined with different behaviours depending of the gas. For the kinetic part, we showed experimentally a preferential consumption of CO2 in the first moments of the crystallization. A kinetic model based on material and population balances adapted for gas mixtures is proposed. The model describes well the evolution of total gas consumption and the phenomenon of preferential consumption of CO2 at the beginning of the crystallization. This model with good kinetic parameters is able to monitor the size of crystals which is an important feature for transportation aspects of gas hydratesST ETIENNE-ENS des Mines (422182304) / SudocSudocFranceF

Captage du CO₂ par formation d'hydrates de gaz : aspects thermodynamiques et cinétiques

National audienceLe captage du CO2 par la formation d'hydrates de gaz est envisagé dans la lutte contre les émissions de gaz à effet de serre. L'étude des équilibres tri phasiques Gaz, Liquide et Hydrate du mélange CO2- CH4 a montré la faisabilité d'une telle technique avec une phase hydrate majoritairement composée de CO2. Les résultats thermodynamiques ont été confrontés au modèle hermodynamique de Van der Waals et Platteeuw et nous observons une bonne concordance. L'aspect cinétique de la séparation de ces deux gaz a été aussi étudié afin de déterminer les vitesses relatives de capture des gaz. Nous remarquons une consommation très importante de CO2 dans les premiers instants de la cristallisation. Ce résultat a été interprété grâce au modèle cinétique élaboré. Ce modèle cinétique montre des comportements différents des deux gaz. Concernant le CH4, la consommation de gaz est limitée par le transfert gaz/liquide comme l'avaient prédit Skovborg et Rasmussen. Pour le CO2, la consommation de gaz est limitée par la diffusion de gaz à travers la couche limitante entourant les particules d'hydrates et la réaction d'incorporation

Profils épidemiologiques, cliniques et hématologiques de la drépanocytose homozygote SS en phase inter critique chez l’enfant à Ziguinchor, Sénégal

La drépanocytose pose un problème de santé publique au Sénégal. Elle concerne principalement les enfants et les adolescents. L'objectif de notre travail était de déterminer les profils épidémiologiques, cliniques et hématologiques de la drépanocytose homozygote SS dans une cohorte d'enfants suivis à l'hôpital de la paix de Ziguinchor. Il s'agit d'une étude rétrospective portant sur des dossiers d'enfants drépanocytaires. Etaient inclus, les drépanocytaires SS âgés entre 2mois et 21ans, reçus en phase inter critique durant la période d'étude allant du 1er Janvier 2015 au 31 Août 2017. N'étaient pas inclus dans l'étude les hétérozygotes composites (SC, S béta thalassémie). Nous avons colligé 46 dossiers de drépanocytaires SS (20 filles et 26 garçons). L'âge moyen des enfants était de 8,0ans [11mois-21ans]. Environ 1/3 des enfants (39,1%) avaient un âge inférieur ou égal à 5 ans. Il y avait une diversité ethnique avec une prédominance de diola (30,2%) suivi de mandingue (27,9%) et de poular (25,6%). L'âge moyen des enfants à la 1ére crise était de 35,5mois [7-192 mois]. Plus de 1/3 des enfants (41,3%) avaient fait une 1ére crise avant le deuxième anniversaire. Le type de la 1ére crise, qu'avait présenté l'enfant, était dominé par la crise vaso-occlusive (32,6%) suivi du syndrome pied-main (30,4%). Les signes cliniques en phase inter critique étaient la pâleur 95,6%); l'ictère (36,9%) et la splénomégalie (21,7%). A l'hémogramme, le nombre de globules blancs moyen était de 12465 leucocytes/mm3 [5340-26900]. L'hyperleucocytose, supérieure à 10 000 leucocytes/mm3 était retrouvée chez 34 malades (73,9%). La totalité des malades présentait une anémie avec une moyenne 08,6 g/dl [05,7-11,8]. Le taux d'hémoglobine S variait entre 54,6 et 98,4%. Le diagnostic et la prise en charge médicale de la drépanocytose SS sont tardifs à Ziguinchor. Le dépistage néonatal pourrait favoriser une prise en charge précoce dans la région.Mots clés: Drépanocytose SS, phase inter critique, enfantEnglish Title: Epidemiological, clinical and hematological profiles of homozygous sickle cell disease during the intercritical period among children in Ziguinchor, SenegalEnglish AbstractSickle cell disease poses a public health problem in Senegal. It mainly affects children and adolescents. This study aimed to determine the epidemiological, clinical and hematological profiles of homozygous (SS) sickle cell disease in a cohort of children followed-up at the Peace Hospital in Ziguinchor. We conducted a retrospective study of the medical records from children with sickle cell disease. All patients aged between 2 months and 21 years with sickle cell disease SS during the intercritical period, hospitalized during the study period from 1st January 2015 to 31 August 2017 were included in our study. Compound heterozygous patients (SC, S Beta Thalassemia) were not included. We collected 46 medical records of patients with sickle cell disease SS (20 girls and 26 boys). The average age of children was 8,0 years [11 months-21 years]. Approximately 1/3 of children (39.1%) had an age less than or equal to 5 years. There was an ethnic diversity showing a predominance of the Diola (30.2%) followed by the Mandinga (27.9%) and the Poular (25.6%). The average age of children with first crisis was 35,5 months [7-192 months]. More than 1/3 of children (41.3%) had had first crisis before their second anniversary. In the child, first crisis was dominated by vaso-occlusive crisis (32.6%) followed by hand-foot syndrome (30.4%). Clinical signs during the intercritical period were pallor 95.6%), jaundice (36.9%) and splenomegaly (21.7%). Mean white blood cell count was 12465 leucocytes/mm3 [5340-26900]. Hyperleukocytosis greater than 10 000 leucocytes/mm3 was found in 34 patients (73.9%). All patients had anemia with an average hemoglobin of 08,6 g/dl [05,7-11,8]. Hemoglobin S rate ranged between 54.6 and 98.4%. Diagnosis and medical management of sickle cell disease SS are delayed in Ziguinchor. Neonatal screening may lead to improve early management of patients in the region.Keywords: Sickle cell diasease SS, intercritical period, chil