13 research outputs found
Stability and estimation problems related to a stage-structured epidemic model
International audienceIn this work, we consider a class of stage-structured Susceptible-Infectious (SI) epidemic models which includes, as special cases, a number of models already studied in the literature. This class allows for n different stages of infectious individuals, with all of them being able to infect susceptible individuals, and also allowing for different death rates for each stage-this helps to model disease induced mortality at all stages. Models in this class can be considered as a simplified modelling approach to chronic diseases with progressive severity, as is the case with AIDS for instance. In contradistinction to most studies in the literature, we consider not only the questions of local and global stability, but also the observability problem. For models in this class, we are able to construct two different state-estimators: the first one being the classical high-gain observer, and the second one being the extended Kalman filter. Numerical simulations indicate that both estimators converge exponentially fast, but the former can have large overshooting, which is not present in the latter. The Kalman observer turns out to be more robust to noise in measurable data
Education Through Labor: From the deuxiĂšme portion du contingent to the Youth Civic Service in West Africa (Senegal/Mali, 1920s-1960s)
International audienceUnder the French colonial regime, the âsecond portionâ of the military was used as labour brigades, compelled to serve for two years in works of public nature. They were encamped in labor camp and were taught the value of work as well as discipline and basic rules of hygiene. After the independence of the francophone West African countries in 1960, postcolonial leaders in Senegal and Mali try to implement a civil service for the youth in order to offer them basic education. In reality, the civil service appears as a way to control and use the recruits for economic purposes echoing in some extent the former colonial âsecond portion du contingent.â More broadly, through the analysis of the legacies and continuities, I argue that the postcolonial elites perpetuate the âcivilizing mission,â no more for the so-called mise en valeur of the colonies but for the development of the territory
Facteurs de risque de démence dans une population de personnes ùgées sénégalaises
Description La dĂ©mence est devenue un problĂšme de santĂ© publique. Dans le but dâune prĂ©vention, il est important de connaitre son Ă©pidĂ©miologie au SĂ©nĂ©gal. Lâobjectif de cette Ă©tude Ă©tait dâidentifier les facteurs de risque de dĂ©mence dans une population de personnes ĂągĂ©es sĂ©nĂ©galaises. MĂ©thodesUne Ă©tude transversale a Ă©tĂ© rĂ©alisĂ©e du 01 Mars 2004 au 31 DĂ©cembre 2005 auprĂšs dâune population de 872 personnes ĂągĂ©es de 55ans et plus utilisant le Centre MĂ©dicosocial et Universitaire de lâInstitut de PrĂ©voyance Retraite du SĂ©nĂ©gal pour des soins. Par une Ă©tude en deux phases, des donnĂ©es sociodĂ©mographiques, sur le mode de vie, le rĂ©seau social, les antĂ©cĂ©dents ont Ă©tĂ© collectĂ©es Ă lâaide dâun questionnaire structurĂ© complĂ©tĂ© par un examen clinique et une Ă©valuation neuropsychologique. Le diagnostic de dĂ©mence reposait sur des critĂšres DSM IV-R
Safety monitoring of artemisinin combination therapy through a national pharmacovigilance system in an endemic malaria setting
Scale-up of home-based management of malaria based on rapid diagnostic tests and artemisinin-based combination therapy in a resource-poor country: results in Senegal
<p>Abstract</p> <p>Background</p> <p>Effective case management of malaria requires prompt diagnosis and treatment within 24 hours. Home-based management of malaria (HMM) improves access to treatment for populations with limited access to health facilities. In Senegal, an HMM pilot study in 2008 demonstrated the feasibility of integrated use of RDTs and ACT in remote villages by volunteer Home Care Providers (HCP). Scale-up of the strategy began in 2009, reaching 408 villages in 2009 and 861 villages in 2010. This paper reports the results of the scale-up in the targeted communities and the impact of the strategy on malaria in the formal health sector.</p> <p>Methods</p> <p>Data reported by the HCPs were used to assess their performance in 2009 and 2010, while routine malaria morbidity and mortality data were used to assess the impact of the HMM programme. Two high transmission regions where HMM was not implemented until 2010 were used as a comparison.</p> <p>Results and discussion</p> <p>From July 2009 through May 2010, 12582 suspected cases were managed by HCPs, 93% (11672) of whom were tested with an RDT. Among those tested, 37% (4270) had a positive RDT, 97% (4126) of whom were reported treated and cured. Home care providers referred 6871 patients to health posts for management: 6486 with a negative RDT, 119 infantsâ<â2 months, 105 pregnant women, and 161 severe cases. There were no deaths among these patients. In 2009 compared to 2008, incidence of suspected and confirmed malaria cases, all hospitalizations and malaria-related hospitalizations decreased in both intervention and comparison regions. Incidence of in-hospital deaths due to malaria decreased by 62.5% (95% CI 43.8-81.2) in the intervention regions, while the decrease in comparison regions was smaller and not statistically significant.</p> <p>Conclusion</p> <p>Home-based management of malaria including diagnosis with RDT and treatment based on test results is a promising strategy to improve the access of remote populations to prompt and effective management of uncomplicated malaria and to decrease mortality due to malaria. When scaled-up to serve remote village communities in the regions of Senegal with the highest malaria prevalence, home care providers demonstrated excellent adherence to guidelines, potentially contributing to a decrease in hospital deaths attributed to malaria.</p
EVALUATION DE LA STABILITE PHYSICO-CHIMIQUE ET MICROBIOLOGIQUE DE POCHES DE GANCICLOVIR SUR UNE ANNEE
International audienceIntroduction : Le ganciclovir (CYMEVANÂź) dispose dâun potentiel cancĂ©rogĂšne, mutagĂšne, gĂ©notoxique et reprotoxique reconnu. Ainsi, il est prĂ©parĂ© dans notre hĂŽpital au sein de lâUnitĂ© de PrĂ©paration CentralisĂ©e des ChimiothĂ©rapies. Cette Ă©tude a pour objectif dâĂ©valuer la stabilitĂ© physico-chimique et microbiologique du ganciclovir diluĂ© dans du NaCl 0,9% sur une durĂ©e de 12 mois.MatĂ©riel et mĂ©thodes : Les solutions de ganciclovir (0,5 mg/ml et 2 mg/ml) fabriquĂ©es selon les Bonnes Pratiques de PrĂ©paration (BPP) ont Ă©tĂ© conditionnĂ©es dans des poches souples en ethylvinyl acĂ©tate multicouche type BarriereÂź. Les essais de stabilitĂ© Ă©taient conduits conformĂ©ment aux recommandations des International Conference on Harmonisation, Ă J0, M1 M3, M6, M9 et M12. Les poches de ganciclovir ont Ă©tĂ© conservĂ©es au rĂ©frigĂ©rateur Ă 5°C ± 3°C et en enceinte climatique (Meditest 1300H, Froilabo) Ă 25°C ± 2°C pour Ă©tudier la simulation dâune rupture de la chaĂźne du froid pendant 24 heures Ă M1, M3, M6, et pendant 7 jours en fin dâĂ©tude de stabilitĂ© Ă M12. LâĂ©valuation de cette stabilitĂ© reposait sur la rĂ©alisation des analyses physico-chimiques par une vĂ©rification de lâaspect macroscopique, mesure de lâosmolalitĂ© (osmomĂštre FiskeÂź), comptage des particules non visibles (compteur optique Hiac/Royco 9103), dosage du ganciclovir (HPLC Agilent, phase mobile 98% EPPI et 2% AcĂ©tonitrile, dĂ©tection UV Ă 254nm), recherche de produits de dĂ©gradation, dosage du sodium (photomĂštre Sherwood), mesure du pH (HQ3d, Hach Lange) et analyses microbiologiques (essai des endotoxines bactĂ©riennes et essai de stĂ©rilitĂ©).RĂ©sultats : La mĂ©thode de dosage du ganciclovir a Ă©tĂ© validĂ©e (spĂ©cificitĂ©, linĂ©aritĂ©, exactitude, et fidĂ©litĂ©) et est indicatrice de stabilitĂ©. Le temps de rĂ©tention du ganciclovir Ă©tait de 0.5 ± 0,03 min. Les rĂ©sultats des contrĂŽles physico-chimiques et microbiologiques de J0 Ă M12 pour les solutions Ă 0,5 et 2 mg/ml ont tous Ă©tĂ© conformes aux spĂ©cifications attendues et aucun produit de dĂ©gradation nâa Ă©tĂ© mis en Ă©vidence.Discussion/conclusion : Cette Ă©tude est la premiĂšre Ă Ă©valuer la stabilitĂ© physico-chimique et microbiologique des poches de ganciclovir sur une annĂ©e. Le ganciclovir reste stable aprĂšs trois excursions de tempĂ©ratures pendant 24h et aprĂšs une semaine Ă 25°C. Les poches multicouches impermĂ©ables au CO2 permettent dâamĂ©liorer la stabilitĂ© physico-chimique. Ces rĂ©sultats vont nous permettre de proposer Ă lâensemble de notre hĂŽpital des prĂ©parations hospitaliĂšres conformes aux BPP, avec une rĂ©duction de lâexposition du personnel, une mise Ă disposition rapide des poches, et un gain Ă©conomique (rĂ©attribution de poches non administrĂ©es et optimisation de la gestion de stock)