Myiase scrotale chez l’enfant : à propos d’un cas

No Abstrac

Trading HIV for sheep: Risky sexual behavior and the response of female sex workers to Tabaski in Senegal

We use a cohort of female sex workers (FSWs) in Senegal to show how large anticipated economic shocks lead to increased risky sexual behavior. Exploiting the exogenous timing of interviews, we study the effect of Tabaski, the most important Islamic festival celebrated in Senegal, in which most households purchase an expensive animal for sacrifice. Condom use, measured robustly via the list experiment, falls by between 27.3 percentage points (pp) (65.5%) and 43.1 pp (22.7%) in the 9 days before Tabaski, or a maximum of 49.5 pp (76%) in the 7 day period preceding Tabaski. The evidence suggests the economic pressures from Tabaski are key to driving the behavior change observed through the price premium for condomless sex. Those most exposed to the economic pressure from Tabaski were unlikely to be using condoms at all in the week before the festival. Our findings show that Tabaski leads to increased risky behaviors for FSWs, a key population at high risk of HIV infection, for at least 1 week every year and has implications for FSWs in all countries celebrating Tabaski or similar festivals. Because of the scale, frequency, and size of the behavioral response to shocks of this type, policy should be carefully designed to protect vulnerable women against anticipated shocks

General insights on obstacles to dog vaccination in Chad on community and institutional level

Domestic dogs are responsible for 95% of all human rabies cases worldwide and continue to be the main reservoir for this fatal virus in African and Asian countries. Interrupting the spread of the disease in the domestic dog population is therefore necessary for long-term, sustainable rabies control. Chad has been recognized as a rabies-endemic country since 1961, but no national control strategy is in place to date and dog vaccination coverage is very low. This qualitative, descriptive study aims to describe the main barriers to dog vaccination on both the community and the institutional level from a socio-anthropological point of view in Chad. The study was embedded in an overall project conducted from 2016 to 2018, to determine rabies burden and vaccine demand in West and Central Africa, funded by GAVI, the vaccine alliance. Data collection was conducted on the occasion of the project's closing workshops with stakeholders organized between August to September 2018 in the four (4) project areas: Logone Occidental, Ouaddai, Hadjer Lamis and Chari Baguirmi. We conducted interviews and focus group discussions (FGD) among veterinary officers and dog owners. Participants were selected purposively based on their place of residence (dog owners) or work place (veterinary officers) and their previous contact with the project through reporting (dog owner) or management (veterinary officers) of a suspect dog rabies case. In each region, one FGD was organized with dog owners, and one FGD with heads of veterinary posts. At the end of the FGDs, a few participants were randomly selected for interviews. In addition, in each region an interview was conducted with the head of the livestock sector, the chief district medical officers and the head of a civil society association. The identified barriers to dog vaccination access are grouped into three main aspects: the economic, the socio-cultural and the institutional level. Economic constraints encountered relate to the cost of the vaccine itself and the expenses for transporting the dogs to the vaccination site. The cultural belief that the vaccine will have an impact on the therapeutic properties of dog meat for consumers (observed in Southern Chad), and the fact that dogs are considered impure animals in Muslim faith, which prohibits handling of dogs, are obstacles identified on the sociocultural level. At the institutional level, the unavailability of vaccines in veterinary services, the lack of communication about the law on dog vaccination, the absence of rabies in the training curricula of veterinary agents, and the lack of intersectoral collaboration limit vaccination coverage. In order to improve vaccination coverage and rabies surveillance with a view to eradicate rabies by 2030, communication strategies that are adapted to the context and that take cultural obstacles into account must be put in place in a synergy of interdisciplinary action. In addition, factors such as affordability, geographical access and availability of dog rabies vaccines needs to be addressed throughout the country. Although our study design did not allow a detailed analysis of obstacles related to socio-economic level, gender and age the broad insights gained can provide general guidance for future interventions in Chad and similar countries

Textilome Abdominal Chez L’enfant: Les Trois Premières Observations au Sénégal

Les cas pédiatriques de textilomes sont rares. Ils sont caractérisés par le poly-morphisme clinique, les errances diagnostiques et le retard de prise en charge. L’objectif était de rapporter les trois premiers cas pédiatriques au Sénégal et d’identifier les facteurs de risque. La tomodensitométrie abdominale avait permis de poser le diagnostic dans les trois cas. La laparotomie exploratrice confirmait les textilomes. Les suites opératoires étaient simples. Pediatric cases of gossipyboma are rare. They are characterized by clinical pol-ymorphism, misdiagnosis and delayed management. The aim was to report the first three pediatric cases in Senegal and to identify their risk factors. Abdominal CT scan made the diagnosis in all three cases. Exploratory laparotomy con-firmed textilomas. Postoperative follow-up was uneventful

Consumer perception on purchase decision factors and health indicators related to the quality and safety of meat sold in dibiteries in Dakar, Senegal

Accelerated socio-economic and demographic changes have led to the transformation of eating habits in sub-Saharan African cities including Dakar, Senegal. The result is the proliferation of informal fast-food establishments, such as the 'dibiteries' serving braised sheep meat. However, owing to poor hygiene practices, consumption of dibiterie meat poses a public health concern. It was unclear how the dibiterie meat quality and safety were perceived among customers who define their own purchasing social norms. A total of 165 meat consumers were randomly selected and interviewed, from 165 dibiteries sampled by convenience in the Dakar region using a structured questionnaire. Results showed that purchase decisions were guided by trust in the salesperson's expertise, the taste of the product, perceived risk of meat contamination, tenderness, price, the nutritional value, the smell and the colour and freshness of the meat. The perceived quality and safety of dibiterie meat was expressed by the 'organoleptic quality', 'environment and service' and 'price and trust of the product's safety' factors. The majority of consumers (61%) were 'less concerned' about the safety of dibiterie meat, and the acceptable price range of the product was between $5.08 and$7.62. As this food product is gaining popularity in Dakar and the majority of our participating consumers do not show high levels of concern, we suggest stricter standards

Détermination du débit de filtration glomérulaire (DFG) au cours du diabète : Cockroft et Gault, MDRD ou CKD-EPI ?

Plusieurs paramètres peuvent être étudiés pour évaluer le rein. Parmi ceux-ci, le débit de filtration glomérulaire (DFG) a été déterminé avec les formules de Cockroft et Gault (CG), du Modification of Diet in Renal Disease (MDRD) et du Chronic Kidney Disease EPIdemiology Collaboration (CKD-EPI) et la formule la mieux adaptée pour le diabétique a été recherchée. Chez 59 diabétiques de type 1 (DT1) et 70 diabétiques de type 2 (DT2), le DFG a été déterminé avec les formules de CG, du MDRD et du CKD-EPI. Avec l’analyse statistique, les seuils de significativité ont été fixés pour p<0,05 ; T0α>1,96 et Z0α>1,96. Le MDRD est superposable au CKD-EPI chez les DT1 et DT2. Chez les DT1, le DFG moyen et la corrélation entre 1/créatininémie et DFG ne varient pas si CG ou CKD-EPI ; cependant, les sujets à DFG réduit (< 90 ml/min/1,73 m²) sont plus nombreux avec CG plutôt qu’avec CKD-EPI (66,10% vs 47,46% ; T0α=2,05). Chez les DT2, le DFG moyen et la proportion de sujets à DFG réduit sont indépendants de la formule utilisée, mais la corrélation entre 1/créatininémie et DFG est plus forte si CKD-EPI que CG (0,961 vs 0,632 ; Z0α=7,02). Ainsi, la formule la mieux adaptée pour la détermination du DFG serait CG chez les DT1 et CKD-EPI chez les DT2, sachant que CKD-EPI est équivalent à MDRD quel que soit le type de diabète.Mots clés : Cockroft et Gault - MDRD - CKD-EPI – débit de filtration glomérulaire (DFG) – diabète

Positive Impact of Increases in Condom Use among Female Sex Workers and Clients in a Medium HIV Prevalence Epidemic: Modelling Results from Project SIDA1/2/3 in Cotonou, Benin

Background A comprehensive, HIV prevention programme (Projet Sida1/2/3) was implemented among female sex workers (FSWs) in Cotonou, Benin, in 1993 following which condom use among FSWs increased threefold between 1993 and 2008 while FSW HIV prevalence declined from 53.3% to 30.4%. Objective Estimate the potential impact of the intervention on HIV prevalence/incidence in FSWs, clients and the general population in Cotonou, Benin. Methods and Findings A transmission dynamics model parameterised with setting-specific bio-behavioural data was used within a Bayesian framework to fit the model and simulate HIV transmission in the high and low-risk population of Cotonou and to estimate HIV incidence and infections averted by SIDA1/2/3. Our model results suggest that prior to SIDA1/2/3 commercial sex had contributed directly or indirectly to 93% (84–98%) of all cumulative infections and that the observed decline in FSWs HIV prevalence was more consistent with the self-reported post-intervention increase in condom use by FSWs than a counterfactual assuming no change in condom use after 1993 (CF-1). Compared to the counterfactual (CF-1), the increase in condom use may have prevented 62% (52–71%) of new HIV infections among FSWs between 1993 and 2008 and 33% (20–46%) in the overall population. Conclusions Our analysis provides plausible evidence that the post-intervention increase in condom use during commercial sex significantly reduced HIV prevalence and incidence among FSWs and general population. Sex worker interventions can be effective even in medium HIV prevalence epidemics and need to be sustained over the long-term

Energetic crisis and space reconstruction in Senegal: traditional crops vs biofuels?

La crise énergétique mondiale est fortement ressentie par les pays pauvres importateurs de pétrole. Les stratégies élaborées par les gouvernements de ces États sont certes diversifiées, mais les résultats semblent encore peu efficaces. Parmi ces stratégies, un important programme de biocarburant est mis en oeuvre au Sénégal, à travers un dispositif de culture de pourghère ( Jatropha curcas L). Ce programme du Gouvernement du Sénégal constitue une nouvelle politique énergétique conçue pour atténuer la dépendance vis-à-vis de l’extérieur. Le programme est bâti sur une base de production utilisant les réserves foncières dans les différentes Communautés rurales du Sénégal. Une projection de 1000 hectares de Jatropha par Communauté rurale est envisagée. Cette disposition a plusieurs implications, dont l’utilisation de la terre, source de revenus, mais aussi de conflits sociaux. Dans cette posture, les incertitudes concernant l’alimentation sont-elles écartées ? L’analyse diachronique de l’occupation des sols et des superficies utilisées pour la culture du Jatropha montre que le mode d’utilisation de la terre peut être facteur de risque pour la sécurité alimentaire. En effet, les systèmes de culture de Jatropha Curcas reposent sur une association des cultures avec les céréales, les légumineuses, les cultures oléagineuses ; ou sur une culture en plein champs (souvent prise en charge par des opérateurs privés ayant obtenu des collectivités locales le droit d’usage par voie de délibération du Conseil rural). Les modalités de contractualisation constituent des facteurs déterminants dans l’utilisation des espaces cultivés et l’allocation de superficies pour la culture bioénergétique. Cependant, l’implication des acteurs (les producteurs, particulièrement) dans une stratégie d’extension/substitution des superficies destinées aux cultures traditionnelles vivrières et de rente aux cultures énergétiques dépendra des débouchés offerts par les biocarburants mais également des performances économiques de cette filière