Les carences nutritionnelles dans les PVD

Les caractéristiques anthropométriques (poids, taille) de 373 enfants congolais d'âge préscolaire issus de milieux favorisés de Brazzaville ont été relevées. La distribution des critères anthropométriques est très voisine de celle de la population de référence NCHS qu'il s'agisse du poids ou de la taille en fonction de l'âge. Les retards de taille et les maigreurs sont des phénomènes peu fréquents et d'apparition brève contrairement à ce qui est observé dans d'autres échantillons représentatifs de populations urbaines et rurales. Ainsi, les différences ethniques ou raciales s'avèrent négligeables par rapport à celles liées à l'environnement. (Résumé d'auteur

Preschool stunting, age at menarche and adolescent height: a longitudinal study in rural Senegal

Objective: To study the impact of preschool stunting on adolescent height and age at menarche in rural West Africa. Design: A longitudinal, population-based study. Setting: The Niakhar study area in Central Senegal. Subjects: 1650 children aged 12-17y with known height-for-age at the age of 2-5y. Main outcome measures: Adolescent height; mean age at menarche of girls estimated by the status quo method. Results: The subjects were divided into three groups of preschool height-for-age: < -2, -2 to -1 and > -1 z-score of the NCHS reference. The mean height during adolescence differed significantly according to preschool height-for-age for both boys and girls (P < 0.001). Relative risk of adolescent stunting according to preschool stunting varied from 2.0-4.0 depending on age and sex. Estimated mean age at menarche was 17.2 (95% fiducial confidence interval: 16.6-18.7), 16.5 (16.1-17.2) and 15.6 (15.2-16.0) y, respectively, for the three groups of preschool height-for-age (P < 0.001). Mean increment from age 5 y to adolescence did not differ significantly among the boys according to preschool stunting, but among the girls aged 16-17 y, the increment was higher for those who had been stunted during preschool life ( P < 0.01). Conclusion: Some evidence of catch-up growth between the ages of 5 and 17 y was found for stunted girls. The significant delay in sexual maturation of the stunted girls suggests that stunted children of both sexes have a possibility of catch-up growth after the age of 17 y. Sponsorship: The preschool study was supported by the EEC (TSD-036)

Enquête nationale sur l'état nutritionnel des enfants d'âge préscolaire au Congo

Une enquête nutritionnelle nationale a été réalisée au Congo en milieu rural en 1987 sur un échantillon représentatif des enfants de moins de cinq ans. Dans une perspective de surveillance nutritionnelle, son objectif principal était de fournir des données de base pour l'orientation et l'évaluation ultérieure d'impact du programme national d'éducation nutritionnelle et de surveillance de la croissance (NUTED). Les résultats essentiels portent ainsi sur : l'estimation de l'état nutritionnel mesuré par des indices anthropométriques standardisés; le type, l'ampleur et la distribution des malnutritions; la recherche de facteurs associés aux malnutritions en vue d'une identification des groupes et zones à risque. D'autres données sont également présentées dans les domaines d'intervention de NUTED : modes alimentaires et conduite du sevrage; diarrhées et réhydratation par voie orale; surveillance de la croissance. Sur la base des résultats obtenus des recommandations sont formulées. (Résumé d'auteur

Philosophy as political technē: The tradition of invention in Simondon’s political thought

Gilbert Simondon has recently attracted the interest of political philosophers and theorists, despite he is rather renowned as a philosopher of technics – as the author of Of the Mode of Existence of Technical Objects – who also elaborated a general theory of complex systems in Individuation in the Light of the Notions of Form and Information. A group of scholars has developed Gilles Deleuze’s early suggestion that Simondon’s social ontology might offer the basis for a re-theorisation of radical democracy. Others, following Herbert Marcuse, have instead focused on Simondon’s analysis of the relationship between technology and society. However, only a joint study of Simondon’s two major works can reveal their implicit political stakes. As I will argue, Simondon’s anti-Aristotelianism and his anti-Heideggerian understanding of the Greek origins of philosophy, allow us to conceive philosophical thought as a ‘tradition of invention’, that is, a pedagogical technē endowed with the political task of maintaining the openness of the social system and allowing normative invention to emerge from within

A Trial of the Efficacy, Safety and Impact on Drug Resistance of Four Drug Regimens for Seasonal Intermittent Preventive Treatment for Malaria in Senegalese Children

UNLABELLED: In the Sahel, most malaria deaths occur among children 1-4 years old during a short transmission season. A trial of seasonal intermittent preventive treatment (IPT) with sulfadoxine-pyrimethamine (SP) and a single dose of artesunate (AS) showed an 86% reduction in the incidence of malaria in Senegal but this may not be the optimum regimen. We compared this regimen with three alternatives. METHODS: 2102 children aged 6-59 months received either one dose of SP plus one dose of AS (SP+1AS) (the previous regimen), one dose of SP plus 3 daily doses of AS (SP+3AS), one dose of SP plus three daily doses of amodiaquine (AQ) (SP+3AQ) or 3 daily doses of AQ and AS (3AQ+3AS). Treatments were given once a month on three occasions during the malaria transmission season. The primary end point was incidence of clinical malaria. Secondary end-points were incidence of adverse events, mean haemoglobin concentration and prevalence of parasites carrying markers of resistance to SP. FINDINGS: The incidence of malaria, and the prevalence of parasitaemia at the end of the transmission season, were lowest in the group that received SP+3AQ: 10% of children in the group that received SP+1AS had malaria, compared to 9% in the SP+3AS group (hazard ratio HR 0.90, 95%CI 0.60, 1.36); 11% in the 3AQ+3AS group, HR 1.1 (0.76-1.7); and 5% in the SP+3AQ group, HR 0.50 (0.30-0.81). Mutations associated with resistance to SP were present in almost all parasites detected at the end of the transmission season, but the prevalence of Plasmodium falciparum was very low in the SP+3AQ group. CONCLUSIONS: Monthly treatment with SP+3AQ is a highly effective regimen for seasonal IPT. Choice of this regimen would minimise the spread of drug resistance and allow artemisinins to be reserved for the treatment of acute clinical malaria

The family as a determinant of stunting in children living in conditions of extreme poverty: a case-control study

BACKGROUND: Malnutrition in children can be a consequence of unfavourable socioeconomic conditions. However, some families maintain adequate nutritional status in their children despite living in poverty. The aim of this study was to ascertain whether family-related factors are determinants of stunting in young Mexican children living in extreme poverty, and whether these factors differ between rural or urban contexts. METHODS: A case-control study was conducted in one rural and one urban extreme poverty level areas in Mexico. Cases comprised stunted children aged between 6 and 23 months. Controls were well-nourished children. Independent variables were defined in five dimensions: family characteristics; family income; household allocation of resources and family organisation; social networks; and child health care. Information was collected from 108 cases and 139 controls in the rural area and from 198 cases and 211 controls in the urban area. Statistical analysis was carried out separately for each area; unconditional multiple logistic regression analyses were performed to obtain the best explanatory model for stunting. RESULTS: In the rural area, a greater risk of stunting was associated with father's occupation as farmer and the presence of family networks for child care. The greatest protective effect was found in children cared for exclusively by their mothers. In the urban area, risk factors for stunting were father with unstable job, presence of small social networks, low rate of attendance to the Well Child Program activities, breast-feeding longer than six months, and two variables within the family characteristics dimension (longer duration of parents' union and migration from rural to urban area). CONCLUSIONS: This study suggests the influence of the family on the nutritional status of children under two years of age living in extreme poverty areas. Factors associated with stunting were different in rural and urban communities. Therefore, developing and implementing health programs to tackle malnutrition should take into account such differences that are consequence of the social, economic, and cultural contexts in which the family lives