Maternal and perinatal outcomes in multiple versus singleton pregnancies in Dakar, Senegal: a cross sectional study over 10 years

Background: The birth of twins is a singular event in most societies, and even more when it comes to multiple births. The objective of this study was to investigate maternal and perinatal outcomes in multiple versus singleton pregnancies.Methods: Cross-sectional study carried out at Philippe Maguilen Senghor health center in Dakar, Senegal from January 1, 2011 to June 30, 2019. Data were extracted from this E-perinatal electronic database and then analyzed in statistical package for social science software (SPSS 24, Mac version).Results: A total 42,870 mothers delivered 44,149 newborns including 1250 twins (2.8%) and 29 triplets. The mean maternal age was 27 years. Mothers with multiple pregnancies had 3 times the odds of poor maternal outcome compared to mothers with single pregnancies (OR 2.42, 95% CI; 1.98-2.94, p <0.001, for high blood pressure; OR, 2.66; 95% CI, 2.11-3.32, p= <0.001, for severe pre-eclampsia; and OR, 3.04; 95% CI, 1.64-5.66, p <0.001, for postpartum hemorrhage). Likewise, women with multiple gestations had significantly higher rates of preterm birth (OR 5.62; 95% CI: 4.91-6.41, p <0.001), breech presentations (OR = 11.02; CI = 9.68-12.53, p <0.001) and neonatal deaths (OR = 2.94; CI = 9.6852-12.5328 p= 0.004) as compared to women with singleton gestations. Furthermore, women with multifetal gestations had increased risk for caesarean section (OR 2.14; 95% CI: 1.91-2.41, p <0.001) compared with their singleton counterparts. The risks for episiotomy and perineal injuries were higher for women with singleton gestations as compared to multiple gestation mothers.Conclusions: This study results are in line with previous findings and contradict others. Particular attention should always be paid to multiple pregnancies’ management. However, the pattern of certain complications traditionally correlated with multiple pregnancies is to be confirmed

Adaptation à la sécheresse et création variétale : le cas de l’arachide en zone sahélienne

Drought is a multiform constraint expressing at different plant organisation levels. It is recognised as the first factor limiting the agriculture production in the world. The Sahel subtropical regions were the most exposed to the devasting effects of the recent climate change. A state of knowledge referring to the plant responses to drought is a fundamental initial step to any program of selection. This review concerns more particularly groundnut (Arachis hypogaea L.), which is a very common legume in the Sahel areas. Critical evaluations of traits as relevant selection criteria for a breeding program aiming at improving yield and yield stability under drought constraint were made. The genetic specificities of the species are exposed in the first part. Then a detailed description of the grain-legume traits related to drought adaptation is presented. The review was widened to other plants for the molecular responses to water deficit, supposed to be more general. Finally, the last part supplied an updated synthesis of the recent advances in biotechnology on groundnut with special focus on drought tolerance

Adaptation à la sécheresse et création variétale : le cas de l’arachide en zone sahélienne

Drought is a multiform constraint expressing at different plant organisation levels. It is recognised as the first factor limiting the agriculture production in the world. The Sahel subtropical regions were the most exposed to the devasting effects of the recent climate change. A state of knowledge referring to the plant responses to drought is a fundamental initial step to any program of selection. This review concerns more particularly groundnut (Arachis hypogaea L.), which is a very common legume in the Sahel areas. Critical evaluations of traits as relevant selection criteria for a breeding program aiming at improving yield and yield stability under drought constraint were made. The genetic specificities of the species are exposed in the first part. Then a detailed description of the grain-legume traits related to drought adaptation is presented. The review was widened to other plants for the molecular responses to water deficit, supposed to be more general. Finally, the last part supplied an updated synthesis of the recent advances in biotechnology on groundnut with special focus on drought tolerance

Facteurs déclenchant la crise épileptique chez une population de patients suivis à la cliniqque neurologique du CHU de Fann et au centre de santé de Pikine, Dakar-Sénégal

Introduction: Epilepsy is a real health problem with great consequences, which can be avoid by a good control of seizures with an earlier and optimal treatment. But, antiepileptic drugs availability can be difficult in countries with limited resources, and then, overpowering seizures precipitants help to a good control of epilepsy. Participants and methods: We did a transversal study during 8 months (November 2009 - June 2010) in a suburban hospital (Centre santé Pikine) and the university teaching hospital of Fann in Dakar (CHUN de Fann). It concerns 400 persons with epilepsy between 15 and more years old, using antiepileptic drugs since more than 3 months. Results: Patients, principally men (52,3%) had a middle age of 44, 5 years. Seizures was generalized in 67,6% of cases with an abnormal electroencephalography (EEG) in 70,3% of cases. Memory troubles was associated with epilepsy in 50,6% of cases. The majors’ seizures precipitants was big emotions, tiredness, lack of sleep, stress, too much drinking and also music. Conclusion: « Epilepsy out of shadows » needs patients’ education about all aspects of epilepsy, in particular provocative factors, for a better control of seizures and their consequences.Introduction : L’épilepsie, maladie universelle, chronique et potentiellement grave, est guérissable par un traitement optimal et précoce. Dans les pays en développement, la disponibilité des médicaments antiépileptiques est problématique et pousse à une meilleure maitrise des facteurs favorisant la survenue des crises, d’où cette étude. Participants et méthodes : Etude transversale de 8 mois (Novembre 2009 - Juin 2010) dans un hôpital périphérique de la banlieue de Dakar (Centre santé Pikine) et un hôpital universitaire (CHUN de Fann), concernant 400 patients épileptiques âgés de 15 ans et plus, sous médicaments antiépileptiques (MAE) depuis plus de 3 mois. Résultats : Les patients, principalement des hommes (52,3%) avait un âge moyen de 44, 5 ans. 67,6% des crises étaient généralisées avec un EEG anormal dans 70,3%. Les principaux facteurs favorisant incriminés dans la survenue de la crise épileptique étaient les émotions vives, la fatigue, le manque de sommeil, le stress et l’excès de boissons, mais également la musique. Conclusion : « Sortir l’épilepsie de l’ombre » et un bon contrôle des crises et de ses conséquences nécessitent des séances de sensibilisation sur tous les aspects de l’épilepsie notamment ses facteurs déclenchant

Quality assessment of malaria microscopic diagnosis at the Aristide Le Dantec University Hospital of Dakar, Senegal, in 2020

Abstract Background Following WHO guidelines, microscopy is the gold standard for malaria diagnosis in endemic countries. The Parasitology-Mycology laboratory (LPM) is the National Reference Laboratory and is currently undergoing ISO 15189 accreditation. In this context, we assessed the performance of the laboratory by confirming the reliability and the accuracy of results obtained in accordance with the requirements of the ISO 15189 standards. This study aimed to verify the method of microscopic diagnosis of malaria at the LPM, in the Aristide Le Dantec hospital (HALD) in Dakar, Senegal. Methods This is a validation/verification study conducted from June to August 2020. Twenty (20) microscopic slides of thick/thin blood smear with known parasite densities (PD) selected from the Cheick Anta Diop University malaria slide bank in Dakar were used for this assessment. Six (6) were used to assess microscopists’ ability to determine PD and fourteen (14) slides were used for detection (positive vs negative) and identification of parasites. Four (4) LPM-HALD microscopists read and recorded their results on prepared sheets. Data analysis was done with Microsoft Excel 2010 software. Results A minimum threshold of 50% concordance was used for comparison. Of the twenty (20) slides read, 100% concordance was obtained on eight (8) detection (positive vs negative) slides. Four (4) out of the six (6) parasite density evaluation slides obtained a concordance of less than 50%. Thirteen (13) out of the fourteen (14) identification slides obtained a concordance greater than 50%. Only one (1) identification slide obtained zero agreement from the microscopists. For species identification a concordance greater than 80% was noted and the microscopists obtained scores between 0.20 and 0.4 on a scale of 0 to 1 for parasite density reading. The microscopists obtained 100% precision, sensitivity, specificity and both negative and positive predictive values. Conclusion This work demonstrated that the microscopic method of malaria diagnosis used in the LPM/HALD is in accordance with the requirements of WHO and ISO 15189. Further training of microscopists may be needed to maintain competency