Fractures of the proximal femur in the elderly in a sub-Saharan country

Background: The aim of this study was to describe the epidemiological, radiographic and therapeutic profile of the fractures of the proximal femur in the elderly in a sub-Saharan country.Methods: A retrospective longitudinal study was carried out at the orthopedic trauma department of Idrissa Pouye Hospital in Senegal. Sixty-six patients recruited were aged at least 90 years; and treated for proximal femur fracture between 2008 and 2017.Results: The median age of the patients was 91 years (90-107). Females represented 54.5%. The fracture was located in the right 65.2%. Femoral neck fractures were 53% predominant with 94.3% type IV according to Garden’s classification. Concerning the 31 patients with a pertrochanteric fractures, 61.3% were stable and 38.7% unstable. The time taken for seeking hospital care was an average of 5.8±9.7 days. All patients had a preoperative anesthesic score less than 4 according to the American society of anesthesiologists (ASA). The therapeutic indication was functional in 15.1% of cases, surgical by internal fixation in 39.2% and by arthroplasty in 45.7% of cases. Pertrochanteric fractures were managed by a dynamic hip screw (DHS) in 68.2% and by gamma nail in 18.2%. Femoral neck fractures were managed by Moore's arthroplasty in 93.3% and by bipolar hip prothesis (BHP) in 6.7%.Conclusions: Fractures of the proximal femur represent a growing problem in sub-Saharan Africa. For patients above 90 years, the management remains essentially surgical by internal fixation in pertrochanteric fractures or by arthroplasty in cervical fractures

Acute complications of preeclampsia: prognosis and management at Pikine National Hospital in Dakar (Senegal)

ABSTRACTBackground: The objective of this study was to evaluate the prevalence of acute complications of preeclampsia in order to describe the epidemiological profile of the disease, to assess its prognosis and management.Methods: This was a retrospective study of patients admitted to the Pikine National Hospital from 1 January 2010 to 31 December 2013 (48 months) with severe complicated pre-eclampsia. Included in this study were patients admitted or diagnosed with severe complicated pre-eclampsia and having given birth in the structure or not.Results: The incidence of severe preeclampsia in childbirth varied from 9.7% to 11.5% during the four years of our study. Patients were largely paucigest (55.7% of cases) and paucipares (58.5% of cases). The mean age was 28.14 years with extremes of 14 and 47 years. More than half of the patients (57.7%) were between 21 and 34 years of age. They were mostly married (90.7%). Three-quarters of the patients (76.8%) had proteinuria with ≥ 3 cross-bands. Thrombocytopenia was found in 9.7% of patients, hepatic cytolysis in 12.1%, and elevation of serum creatinine in 13.8%. The level of transaminases was found to be greater than 2 in the normal range in 12.1%. Complicated forms were the most represented in our study. These were acute complications, with 715 cases, or 57.3% of the patients. They were either isolated (52.8%) or associated (4.5%). These included eclampsia (24.9%), followed by retroplacental hematoma (24.6%), fetal death in utero (23.7%), HELLP syndrome (3.4%). , Acute edema of the lungs (1.5%), and acute renal failure (1.4%). The lethality was 2.4%. The causes of maternal death were dominated by eclampsia (14 cases), DIC (3 cases) and OAP (2 cases). We counted 77.7% of live births and a stillbirth of 254.5 ‰.Conclusions: Pre-eclampsia is a serious complication of pregnancy. Its frequency is still high in sub-Saharan Africa. In the presence of signs of severity, maternal (vital and functional) and neonatal prognosis are inevitably involved. If management is based on fetal extraction, resuscitation measures are a guarantee of maternal survival

Rodents as natural hosts of zoonotic Schistosoma species and hybrids: an epidemiological and evolutionary perspective from West Africa

The complex multi-host disease dynamics of schistosomiasis and Schistosoma spp., including the emergence of zoonotic parasite hybrids, remain largely unexplored in West Africa. We elucidated the role of wild small mammals as reservoir for zoonotic Schistosoma species and hybrids in endemic areas of Senegal. We identified Schistosoma mansoni, Schistosoma bovis, and a Schistosoma haematobium/S. bovis hybrid, with local prevalence in wild rodents ranging from 1.9% to 28.6%. Our findings indicate that rodents may be an important local reservoir for zoonotic schistosomiasis in endemic areas of West Africa, amplifying transmission to humans and acting as natural definitive hosts of schistosome hybrids

Étude de la variabilité agromorphologique de la collection nationale de mils locaux du Sénégal

Objectif : Le mil est la première culture vivrière au Sénégal. Il joue un rôle capital dans la vie des populations rurales qui en dépendent pour leur survie (STAT/FAO/SENEGAL, 2010). Il est cultivé sur plus 60% des terres arables. Les variétés locales étaient les plus utilisées mais depuis quelques années leur survie est menacée par l'introduction des variétés améliorées.Methodology et application des résultats : Pour éviter l'érosion génétique, des missions de collecte ont été organisées en 1994 et 2006 dans les principales zones de culture du mil. Le matériel collecté est caractérisé pour faciliter leur utilisation dans les programmes de création variétale. L'objectif du présent travail est caractériser le germoplasme national mil du Sénégal pour les rendre utilisables par les sélectionneurs pour la création de nouvelles variétés hautement productives pour l'augmentation de la production céréalière et l'atteinte de la sécurité alimentaire. Pour caractériser les accessions, 12 variables sélectionnées à partir du Descripteur du mil IPGRI/ICRISAT, 1993 ont été utilisées. Un dispositif expérimental en blocs complets randomisés avec 3 répétitions a été choisi et les sites d'essais étaient Bambey, Nioro et Darou pendant les hivernages 2011 et 2012. Les analyses descriptives ou qualitatives ; statistiques simples (ANOVA) ; de la diversité (phénologique ; génétique avec la méthode de la classification ascendante (CAH), avec les composantes principales (ACP) et l'analyse factorielle discriminante (AFD)) ont été réalisées avec les logiciels Genstat Discovery4 et R. Les analyses descriptives ont montré l'existence d'une grande variabilité entre les accessions pour les caractères qualitatifs comme l'architecture de l'épi et la couleur des grains. Les analyses statistiques simples (ANOVA) ont montré qu'il existe une différence hautement significative entre les entrées et les sites. Cependant, les interactions étaient non significatives à l'exception de la floraison, de l'indice de récolte et des rendements en grains et en matière sèche. Les analyses de la diversité phénologique a permis de classer les variétés en trois groupes selon le cycle végétatif (G1 des variétés extra-précoces, G2 des cycles courts et G3 des cycles longs). La classification ascendante hiérarchique (CAH) suivant la méthode de Ward a permis d'identifier la valeur des axes et les compositions des 3 groupes y découlant (le groupe G1 compte 106 accessions, le G2 compte 129 accessions et le G3 compte 8 accessions) et de tracer le dendrogramme de filiations. L'analyse de la diversité génétique par les composantes principales (ACP) a permis de déterminer la position des accessions par rapport aux axes expliquant les variabilités inter-accessions. L'analyse de la diversité génétique par la méthode factorielle discriminante a permis de déterminer la structuration de la diversité agromorphologique et la représentation graphique des accessions suivant un plan factoriel. Les groupes ainsi formés seront convertis en des entités hétérotiques constituées de pools de gènes différents où les sélectionneurs et autres scientifiques vont puiser pour créer des variétés hautement productives et résistantes aux stress bio et abiotiques afin de nourrir les populations et de lutter contre la faim et la malnutrition

Mapping the number of female sex workers in countries across sub- Saharan Africa

Female sex workers (FSW) are affected by individual, network, and structural risks, making them vulnerable to poor health and well-being. HIV prevention strategies and local community-based programs can rely on estimates of the number of FSW to plan and implement differentiated HIV prevention and treatment services. However, there are limited systematic assessments of the number of FSW in countries across sub-Saharan Africa to facilitate the identification of prevention and treatment gaps. Here we provide estimated population sizes of FSW and the corresponding uncertainties for almost all sub-national areas in sub-Saharan Africa. We first performed a literature review of FSW size estimates and then developed a Bayesian hierarchical model to synthesize these size estimates, resolving competing size estimates in the same area and producing estimates in areas without any data. We estimated that there are 2.5 million (95% uncertainty interval 1.9 to 3.1) FSW aged 15 to 49 in sub-Saharan Africa. This represents a proportion as percent of all women of childbearing age of 1.1% (95% uncertainty interval 0.8 to 1.3%). The analyses further revealed substantial differences between the proportions of FSW among adult females at the sub-national level and studied the relationship between these heterogeneities and many predictors. Ultimately, achieving the vision of no new HIV infections by 2030 necessitates dramatic improvements in our delivery of evidence-based services for sex workers across sub-Saharan Africa

Mini-FLOTAC as an alternative, non-invasive diagnostic tool for Schistosoma mansoni and other trematode infections in wildlife reservoirs

Schistosomiasis and food-borne trematodiases are not only of major public health concern, but can also have profound implications for livestock production and wildlife conservation. The zoonotic, multi-host nature of many digenean trematodes is a significant challenge for disease control programmes in endemic areas. However, our understanding of the epidemiological role that animal reservoirs, particularly wild hosts, may play in the transmission of zoonotic trematodiases suffers a dearth of information, with few, if any, standardised, reliable diagnostic tests available. We combined qualitative and quantitative data derived from post-mortem examinations, coprological analyses using the Mini-FLOTAC technique, and molecular tools to assess parasite community composition and the validity of non-invasive methods to detect trematode infections in 89 wild Hubert’s multimammate mice (Mastomys huberti) from northern Senegal

Plagiorchis sp. in small mammals of Senegal and the potential emergence of a zoonotic trematodiasis

Trematodes of the genus Plagiorchis have a wide geographical distribution and can exploit a variety of hosts. The occurrence and zoonotic potential of Plagiorchis spp. have been characterised across several countries in Asia; in contrast, information on Plagiorchis parasites in Africa remains anecdotal. We isolated a previously undescribed Plagiorchis species from the biliary tract and small intestine of 201 out of 427 small mammals collected in the region of Lake Guiers, Senegal, with local prevalence ranging from 38.6% to 77.0%. Conversely, Plagiorchis isolates were not observed in the 244 small mammals sampled in and around the town of Richard Toll, Senegal. Molecular phylogenetics of the internal transcribed spacer region, nuclear ribosomal DNA, and of the cytochrome c oxidase subunit 1 gene, mitochondrial DNA, supported the monophyly and multi-host spectrum of this newly discovered West African Plagiorchis species. Sequencing of individual cercariae shed by Radix natalensis (Gastropoda: Lymnaeidae) suggested that these freshwater snails may act as suitable first intermediate hosts. Phylogenetic analysis yielded a highly resolved topology indicating two different clades, one composed by Plagiorchis spp. infecting rodents, insectivores, and birds, while the other included parasites of bats. Our findings showed the low host specificity and high prevalence of the isolated Plagiorchis sp. in the Lake Guiers region, with Hubert's multimammate mice (Mastomys huberti) appearing to play a primary role in the epidemiology of this parasite. The results raise concern about the zoonotic potential of Plagiorchis sp. in local communities of the Lake Guiers region, and highlight food-borne trematodiases and their link to land-use change as a neglected public health issue in regions of West Africa

Facteurs de risque de démence dans une population de personnes âgées sénégalaises

Description La démence est devenue un problème de santé publique. Dans le but d’une prévention, il est important de connaitre son épidémiologie au Sénégal. L’objectif de cette étude était d’identifier les facteurs de risque de démence dans une population de personnes âgées sénégalaises. MéthodesUne étude transversale a été réalisée du 01 Mars 2004 au 31 Décembre 2005 auprès d’une population de 872 personnes âgées de 55ans et plus utilisant le Centre Médicosocial et Universitaire de l’Institut de Prévoyance Retraite du Sénégal pour des soins. Par une étude en deux phases, des données sociodémographiques, sur le mode de vie, le réseau social, les antécédents ont été collectées à l’aide d’un questionnaire structuré complété par un examen clinique et une évaluation neuropsychologique. Le diagnostic de démence reposait sur des critères DSM IV-R

Plasma neurofilament light chain protein is not increased in treatment-resistant schizophrenia and first-degree relatives

Objective: Schizophrenia, a complex psychiatric disorder, is often associated with cognitive, neurological and neuroimaging abnormalities. The processes underlying these abnormalities, and whether a subset of people with schizophrenia have a neuroprogressive or neurodegenerative component to schizophrenia, remain largely unknown. Examining fluid biomarkers of diverse types of neuronal damage could increase our understanding of these processes, as well as potentially provide clinically useful biomarkers, for example with assisting with differentiation from progressive neurodegenerative disorders such as Alzheimer and frontotemporal dementias. Methods: This study measured plasma neurofilament light chain protein (NfL) using ultrasensitive Simoa technology, to investigate the degree of neuronal injury in a well-characterised cohort of people with treatment-resistant schizophrenia on clozapine (n = 82), compared to first-degree relatives (an at-risk group, n = 37), people with schizophrenia not treated with clozapine (n = 13), and age- and sex-matched controls (n = 59). Results: We found no differences in NfL levels between treatment-resistant schizophrenia (mean NfL, M = 6.3 pg/mL, 95% confidence interval: [5.5, 7.2]), first-degree relatives (siblings, M = 6.7 pg/mL, 95% confidence interval: [5.2, 8.2]; parents, M after adjusting for age = 6.7 pg/mL, 95% confidence interval: [4.7, 8.8]), controls (M = 5.8 pg/mL, 95% confidence interval: [5.3, 6.3]) and not treated with clozapine (M = 4.9 pg/mL, 95% confidence interval: [4.0, 5.8]). Exploratory, hypothesis-generating analyses found weak correlations in treatment-resistant schizophrenia, between NfL and clozapine levels (Spearman’s r = 0.258, 95% confidence interval: [0.034, 0.457]), dyslipidaemia (r = 0.280, 95% confidence interval: [0.064, 0.470]) and a negative correlation with weight (r = −0.305, 95% confidence interval: [−0.504, −0.076]). Conclusion: Treatment-resistant schizophrenia does not appear to be associated with neuronal, particularly axonal degeneration. Further studies are warranted to investigate the utility of NfL to differentiate treatment-resistant schizophrenia from neurodegenerative disorders such as behavioural variant frontotemporal dementia, and to explore NfL in other stages of schizophrenia such as the prodome and first episode

Ethnobotanical study of cowpea (Vigna unguiculata (L.) Walp.) in Senegal

Open Access Article; Published online: 05 Feb 2022Cowpea (Vigna unguiculata) plays a key role in family farming systems in Senegal. It makes an essential contribution to economic, nutritional and food security. Although it is crucial, little is known about how farmers classify the diversity of local varieties or about the social practices associated with them. The aim of this study is to characterize the farming practices associated with growing cowpea in Senegal. Surveys were conducted involving 335 rural farmers living in 37 villages, spread across seven regions that produce cowpea. An average of ten farmers were randomly selected in each village. The results reveal that cowpea is a key feature of cropping systems in the studied area. Our findings highlight the high diversity of local cowpea varieties with 59 local names inventoried. In 75% of cases, the name refers to the seed’s morphology or color. Cowpea production is more diverse in Diourbel and Louga and less diverse in the south. More than half the farmers (57%) acquired their cowpea seeds (early, semi-early and late maturity varieties) outside their village, either from markets, seed suppliers or NGOs. This new understanding of farmers’ expertize in the management of cowpea and its local variability will help to valorize local diversity in breeding programs