La gigantomastie juvénile: à propos d’un cas à l’institut Joliotcurie de Dakar et revue de la literature

La gigantomastie juvénile ou hypertrophie mammaire virginale est une augmentation pathologique supérieure à 1500 cm3 du volume des deux seins chez l'adolescente. Elle entraine des répercussions psychologiques et physiques importantes. Les traitements médicaux sont décevants laissant la place à la chirurgie qui peut compromettre l'avenir fonctionnel des glandes mammaires. Nous rapportons le cas d'une jeune fille porteuse d'une gigantomastie juvénile. Il s'agissait d'une jeune fille de 15 ans porteuse d'une gigantomastie invalidante dont la prise en charge, essentiellement chirurgicale par une mammoplastie de réduction a été effectuée à l'Institut Joliot Curie de Dakar. La gigantomastie juvénile est rare. Elle est invalidante chez une patiente en pleine croissance avec des répercussions psychologiques et physiques. Le traitement est médical et chirurgical. Les grossesses sont possibles et les récidives ne sont pas rares.Pan African Medical Journal 2015; 2

Chorologie, Ecologie et Usages des espèces sauvages apparentées aux légumes feuilles cultivées du genre Solanum L. au Sénégal : Cas de la zone des Niayes

Le genre Solanum est l'un des plus importants de la flore du Sénégal tant par sa richesse spécifique que par sa valeur socio-économique. Cependant, si les espèces cultivées font l’objet d’étude sous diverses formes, les sauvages sont fréquemment éliminées. L’étude vise à renseigner sur la chorologie, l’écologie et les usages des espèces sauvages apparentées de légumes feuilles cultivées. Des enquêtes ont été menées auprès des populations et les résultats obtenus ont été complétés par la recherche bibliographique et les informations mentionnées dans les parts d’herbier. L’étude révèle que ces espèces occupent des milieux divers. Au Sénégal, elles sont présentes dans toutes les zones agroécologiques avec une grande diversité dans la zone des Niayes. Elles se rencontrent aussi bien en milieux arides où la végétation est de type steppe qu’en milieux humides composées principalement de savanes et affectionnent mieux les sols ferrugineux tropicaux. L’étude ethnobotanique réalisée a révélé cinq types d’utilisation : médicinale (47,87%), alimentaire (27,66 %), culturelle (14,89%), fourragère 8,51% et artisanale 1,06%. Les organes affectés à ces utilisations sont la feuille (43,36%) suivie de la racine (30,97%), du fruit (24,78%) et de la tige (0,88%). La connaissance des espèces favorise une meilleure valorisation de celles qui vivent dans des écosystèmes en proie à une forte urbanisation.   The genus Solanum is one of the most important of the flora of Senegal both for its specific richness and its socio-economic value. However, while cultivated species are studied in various forms, wild species are frequently eliminated. The study aims to provide information on the chorology, ecology and uses of wild relatives of cultivated leafy vegetables. Population surveys were conducted and the results obtained were supplemented by literature search and information mentioned in the herbarium parts. The study revealed that these species occupy diverse environments. In Senegal, they are present in all agro-ecological zones with a great diversity in the Niayes zone. They are found in arid environments where the vegetation is steppe type as well as in humid environments composed mainly of savannah and are more fond of tropical ferruginous soils. The ethnobotanical study carried out revealed five types of use: medicinal (47.87%), food (27.66%), cultural (14.89%), fodder (8.51%) and artisanal (1.06%). The organs assigned to these uses are the leaf (43.36%) followed by the root (30.97%), the fruit (24.78%) and the stem (0.88%). The knowledge of the species favors a better valorization of those living in ecosystems in prey to a strong urbanization

Training of Trainers (ToT) on the dissemination of CSA practices and CIS toward increasing the productivity of target crops

Sustainable environmentally, economically viable, and socially acceptable ways are important factors in increasing food production and achieving food security. To achieve increasing food production, the capacity development of key stakeholders especially extension agents and youth farmers is of great necessity, toward increasing the adoption of climate-smart agricultural practices. The training of trainers (ToT) was organized to equip the lead beneficiary with relevant knowledge and skills on the dissemination of CSA practices and CIS towards increasing the productivity of target crops in order to increase the farmers’ adoption across the intervention villages. Specifically to; (1) review and share the experience of the 2022 on-farm participatory demonstration; (2) educate them on the importance and objectives of trials and demonstrations; (3) ensure the field technicians (ANCAR, CERAAS, identified local) in charge of setting up and supervising trials as well as demonstrations fully understand the designed protocol and monitor them to achieve good results; (4) train them on techniques of quality seed production and (5) benefit of climate-based advisories through ISAT platform for Increase productivity

Parasitoses Intestinales Et Statut Nutritionnel Chez L’enfant À Guédiawaye Au Sénégal

Introduction : Les parasitoses intestinales constituent un problème majeur de santé dans le monde particulièrement dans les pays en voie de développement. Afin de réduire l’ampleur de ces affections, le Ministère de la Santé du Sénégal a introduit en 2005 le déparasitage de masse systématique des enfants conformément aux recommandations de l’Organisation Mondiale pour la Santé (OMS). L’objectif de ce travail était de déterminer la prévalence des parasitoses intestinales et leur impact sur l’anémie et la nutrition quelques années après l’instauration de la chimiothérapie préventive. Matériels et méthodes : Etude transversale du 1er septembre 2017 au 28 février 2018 au niveau du service de pédiatrie du Centre Hospitalier Roi Baudouin de Guédiawaye. Un effectif de 375 enfants avait participé à l’étude, avec un âge moyen 44 mois et une prédominance masculine (54,1%). Pour chaque enfant reçu, un examen direct de selles et après une concentration par technique de Ritchie étaient effectués. L’état nutritionnel a été appréciés et les paramètres hématologiques évalués. Résultats : Au total, 103 enfants étaient porteurs de parasites soit une prévalence globale de 27,5%. Les helminthes étaient beaucoup plus représentatifs que les protozoaires et les espèces parasitaires les plus fréquentes étaient Ascaris lumbricoides (18,14%), Trichocéphales (3,74%), et Entamoeba coli (2,67%). L’état nutritionnel était normal chez 265 enfants tandis que 18,9% et 10,5% avaient respectivement une malnutrition aigüe modérée (MAM) et une malnutrition aigüe sévère (MAS). Nous avons noté une association significative entre la parasitose intestinale et la malnutrition (p=0,035 et OR=1,66). L’anémie était sévère chez 4,8% des enfants et modérée chez 68,6%. Une corrélation entre les parasitoses intestinales et la survenue d’une anémie a été démontrée (p=0,001 et OR=2,6). Conclusion : La prévalence des parasitoses intestinales reste élevée en banlieue dakaroise malgré le déparasitage de masse. L’amélioration des conditions de vie et l’élargissement du déparasitage aux enfants de plus de 5 ans pourraient rendre plus efficiente cette stratégie. Introduction: Intestinal parasitosis is a major health problem in the world, particularly in developing countries. In order to reduce the scale of these diseases, the Ministry of Health of Senegal introduced, in 2005, the systematic mass deworming of children in accordance with the recommendations of the World Health Organisation (WHO). This paper focuses on determining the prevalence of intestinal parasites and their impact on anemia and nutrition a few years after the initiation of preventive chemotherapy. Materials and methods: A cross-sectional study was conducted from 1st September 2017 to 28th February 2018 at the pediatric ward of the hospital center Roi Baudouin in Guédiawaye, Senegal. A total of 375 children participated in the study, with a mean age of 44 months and a male predominance (54.1%). Each child received a direct stool examination after a concentration using Ritchie techniques was obtained. The nutritional status was assessed and the hematological parameters evaluated. Results: A total of 103 children had parasites, with an overall prevalence of 27.5%. Helminths were much more representative than the protozoa, and the most common parasitic species were Ascaris lumbricoides (18.14%), whipworms (3.74%), and Entamoeba coli (2.67%). Nutritional status was normal in 265 children, while 18.9% and 10.5% respectively had moderate acute malnutrition (MAM) and severe acute malnutrition (SAM). A significant association between intestinal parasitosis and malnutrition was found (p = 0.035 and OR = 1.66). Anemia was severe in 4.8% of children and moderate in 68.6%. There was a link between intestinal parasitosis and the occurrence of anemia (p = 0.001 and OR = 2.6). Conclusion: The prevalence of intestinal parasitosis remains high in the suburbs of Dakar despite mass deworming. Improving living conditions and expanding deworming to children over 5 years of age could make this strategy more efficient

Cancers du sein bilatéraux synchrones et grossesse a l’institut Joliot Curie de Dakar (Sénégal)

Décrire notre stratégie diagnostique et thérapeutique dans les cancers du sein bilatéraux synchrones pendant la grossesse. L'âge gestationnel au moment du diagnostic du cancer était respectivement de 7; 21 et 25 semaines. Il s'agissait de stade IV et IIIA respectivement dans deux et un cas. Elles ont toutes bénéficié d'une chimiothérapie dans deux cas pendant la grossesse (6TEC et 3AC) et dans un cas après l'accouchement. Une mastectomie bilatérale a été réalisée dans un cas. Une patiente est décédée. Les autres étaient vivantes mais toutes métastatiques. Une hypotrophie foetale a été notée dans un cas. Le diagnostic du cancer est tardif dans cette association. La chirurgie est faisable et le type de chirurgie serait seulement fonction du stade du cancer. La chimiothérapie est possible avec moins de complications foetales aux deux derniers trimestres.Pan African Medical Journal 2016; 2

Dietary Intakes and Nutritional Status of Mother-Child (6-23 Months Old) Pair Targeted through the "Organic Residual Products for Biofortified Foods for Africa Project" in Rural Area in Senegal

Background: Despite micronutrient supplementation and food fortification strategies carried out for decades, micronutrient deficiencies remain prevalent among children under 5 years old in rural area in Senegal. The OR4FOOD project was implemented as a preventive and long-term approach to reduce malnutrition through biofortification. Objective: We aimed to assess the baseline dietary intakes and nutritional status of the mother-child (6-23 months old) pair in a rural community in Senegal. Methods: Dietary intakes were assessed using dietary recall questionnaires and weight food records. All foods and beverages consumed from waking to bedtime were quantified, and nutrient intakes were calculated. The nutritional status was measured by anthropometry. Results: Results showed that 77.2% of children had low dietary diversity score. Only 18% of them received an appropriate complementary feeding according to the minimum acceptable diet. Cereals and legumes were among the most consumed food groups, whereas orange-fleshed sweet potato (OFSP) and animal food products were rarely consumed. Median dietary intakes of iron, zinc, and vitamin A were lower than the recommended dietary allowances. Acute malnutrition and stunting affected 14.6% and 16.9% of children, respectively. Overall, 20.8% of mothers were underweighted, and overweight/obesity affected 23.1% of them. Conclusion: Malnutrition remains prevalent in rural areas of Senegal and affects both mothers and children. Furthermore, their nutrient requirements were not covered by the diet. Millet and cowpea being widely consumed, optimizing their iron and zinc content through biofortification and the introduction of OFSP might improve micronutrient intakes and would be promising strategies to prevent child malnutrition

Feasibility and safety of integrating mass drug administration for helminth control with seasonal malaria chemoprevention among Senegalese children: a randomized controlled, observer-blind trial

BACKGROUND: The overlap in the epidemiology of malaria and helminths has been identified as a potential area to exploit for the development of an integrated control strategy that may help to achieve elimination of malaria and helminths. A randomized, controlled, observer-blind trial was conducted to assess the feasibility and safety of combining mass drug administration (MDA) for schistosomiasis and soil transmitted helminths (STH) with seasonal malaria chemoprevention (SMC) among children living in Senegal. METHODS: Female and male children aged 1-14 years were randomized 1:1:1, to receive Vitamin A and Zinc on Day 0, followed by SMC drugs (sulfadoxine-pyrimethamine and amodiaquine) on Days 1-3 (control group); or praziquantel and Vitamin A on Day 0, followed by SMC drugs on Days 1-3 (treatment group 1); or albendazole and praziquantel on Day 0, followed by SMC drugs on Days 1-3 (treatment group 2). Safety assessment was performed by collecting adverse events from all children for six subsequent days following administration of the study drugs. Pre- and post-intervention, blood samples were collected for determination of haemoglobin concentration, malaria microscopy, and PCR assays. Stool samples were analyzed using Kato-Katz, Merthiolate-iodine-formalin and PCR methods. Urine filtration, PCR and circulating cathodic antigen tests were also performed. RESULTS: From 9 to 22 June 2022, 627 children aged 1-14 years were randomized into the three groups described above. Mild, transient vomiting was observed in 12.6% (26/206) of children in treatment group 2, in 10.6% (22/207) in group 1, and in 4.2% (9/214) in the control group (p = 0.005). Pre-intervention, the geometric mean value of Plasmodium falciparum parasite density was highest among children who received albendazole, praziquantel with SMC drugs. Post-intervention, the parasite density was highest among children who received SMC drugs only. Children who received praziquantel and SMC drugs had a lower risk of developing severe anaemia than their counterparts who received SMC drugs alone (OR = 0.81, 95% CI 0.13-5.00, p = 0.63). CONCLUSIONS: Integration of MDA for helminths with SMC drugs was safe and feasible among Senegalese children. These findings support further evaluation of the integrated control model. TRIAL REGISTRATION: The study is registered at Clinical Trial.gov NCT05354258

Enhancing Understanding of the Impact of Climate Change on Malaria in West Africa Using the Vector-Borne Disease Community Model of the International Center for Theoretical Physics (VECTRI) and the Bias-Corrected Phase 6 Coupled Model Intercomparison Project Data (CMIP6)

International audienceIn sub-Saharan Africa, temperatures are generally conducive to malaria transmission, and rainfall provides mosquitoes with optimal breeding conditions. The objective of this study is to assess the impact of future climate change on malaria transmission in West Africa using community-based vector-borne disease models, TRIeste (VECTRI). This VECTRI model, based on bias-corrected data from the Phase 6 Coupled Model Intercomparison Project (CMIP6), was used to simulate malaria parameters, such as the entomological inoculation rate (EIR). Due to the lack of data on confirmed malaria cases throughout West Africa, we first validated the forced VECTRI model with CMIP6 data in Senegal. This comparative study between observed malaria data from the National Malaria Control Program in Senegal (Programme National de Lutte contre le Paludisme, PNLP, PNLP) and malaria simulation data with the VECTRI (EIR) model has shown the ability of the biological model to simulate malaria transmission in Senegal. We then used the VECTRI model to reproduce the historical characteristics of malaria in West Africa and quantify the projected changes with two Shared Socio-economic Pathways (SSPs). The method adopted consists of first studying the climate in West Africa for a historical period (1950–2014), then evaluating the performance of VECTRI to simulate malaria over the same period (1950–2014), and finally studying the impact of projected climate change on malaria in a future period (2015–2100) according to the ssp245 ssp585 scenario. The results showed that low-latitude (southern) regions with abundant rainfall are the areas most affected by malaria transmission. Two transmission peaks are observed in June and October, with a period of high transmission extending from May to November. In contrast to regions with high latitudes in the north, semi-arid zones experience a relatively brief transmission period that occurs between August, September, and October, with the peak observed in September. Regarding projections based on the ssp585 scenario, the results indicate that, in general, malaria prevalence will gradually decrease in West Africa in the distant future. But the period of high transmission will tend to expand in the future. In addition, the shift of malaria prevalence from already affected areas to more suitable areas due to climate change is observed. Similar results were also observed with the ssp245 scenario regarding the projection of malaria prevalence. In contrast, the ssp245 scenario predicts an increase in malaria prevalence in the distant future, while the ssp585 scenario predicts a decrease. These findings are valuable for decision makers in developing public health initiatives in West Africa to mitigate the impact of this disease in the region in the context of climate change

Bias-Corrected CMIP5 Projections for Climate Change and Assessments of Impact on Malaria in Senegal under the VECTRI Model

On the climate-health issue, studies have already attempted to understand the influence of climate change on the transmission of malaria. Extreme weather events such as floods, droughts, or heat waves can alter the course and distribution of malaria. This study aims to understand the impact of future climate change on malaria transmission using, for the first time in Senegal, the ICTP’s community-based vector-borne disease model, TRIeste (VECTRI). This biological model is a dynamic mathematical model for the study of malaria transmission that considers the impact of climate and population variability. A new approach for VECTRI input parameters was also used. A bias correction technique, the cumulative distribution function transform (CDF-t) method, was applied to climate simulations to remove systematic biases in the Coupled Model Intercomparison Project Phase 5 (CMIP5) global climate models (GCMs) that could alter impact predictions. Beforehand, we use reference data for validation such as CPC global unified gauge-based analysis of daily precipitation (CPC for Climate Prediction Center), ERA5-land reanalysis, Climate Hazards InfraRed Precipitation with Station data (CHIRPS), and African Rainfall Climatology 2.0 (ARC2). The results were analyzed for two CMIP5 scenarios for the different time periods: assessment: 1983–2005; near future: 2006–2028; medium term: 2030–2052; and far future: 2077–2099). The validation results show that the models reproduce the annual cycle well. Except for the IPSL-CM5B model, which gives a peak in August, all the other models (ACCESS1–3, CanESM2, CSIRO, CMCC-CM, CMCC-CMS, CNRM-CM5, GFDL-CM3, GFDL-ESM2G, GFDL-ESM2M, inmcm4, and IPSL-CM5B) agree with the validation data on a maximum peak in September with a period of strong transmission in August–October. With spatial variation, the CMIP5 model simulations show more of a difference in the number of malaria cases between the south and the north. Malaria transmission is much higher in the south than in the north. However, the results predicted by the models on the occurrence of malaria by 2100 show differences between the RCP8.5 scenario, considered a high emission scenario, and the RCP4.5 scenario, considered an intermediate mitigation scenario. The CanESM2, CMCC-CM, CMCC-CMS, inmcm4, and IPSL-CM5B models predict decreases with the RCP4.5 scenario. However, ACCESS1–3, CSIRO, NRCM-CM5, GFDL-CM3, GFDL-ESM2G, and GFDL-ESM2M predict increases in malaria under all scenarios (RCP4.5 and RCP8.5). The projected decrease in malaria in the future with these models is much more visible in the RCP8.5 scenario. The results of this study are of paramount importance in the climate-health field. These results will assist in decision-making and will allow for the establishment of preventive surveillance systems for local climate-sensitive diseases, including malaria, in the targeted regions of Senegal