Allocation optimale de l'eau dans le bassin versant du fleuve Sénégal

Chaque état riverain du fleuve Sénégal fait face à des problèmes similaires de pénuries et de demandes croissantes en énergie. La production énergétique de la centrale de Manantali, seul aménagement hydroélectrique fonctionnel sur le bassin couvre moins de 18% des besoins. De même on note un besoin pressant de maitriser les affluents majeurs du fleuve pour réduire les impacts de la sècheresse et des fortes crues sur l’environnement et faciliter la pratique d’activité connexes telle l’irrigation et la navigation au niveau de la vallée et du delta. La gestion des ressources en eau reste donc un enjeu capital pour la croissance économique des états riverains du fleuve L’objectif à long terme de l’Organisation pour la Mise en Valeur du fleuve Sénégal (OMVS) est de renforcer l’économie de ses états membre en plaçant la gestion et la mise en valeur collective des ressources en eau au centre de ses priorités. Il s’agit là, d’ici l’échéance fixé à 2025, d’étendre les aménagements hydroélectriques dans le haut bassin de manière à atteindre une puissance installée de 1050 MW et d’assurer un soutien d’étiage adéquat pour le développement de l’agriculture irriguée et de la navigation au niveau de la vallée et du delta. Cette étude analyse les impacts de ces éventuels aménagements sur le régime hydrologique du fleuve. Une approche analytique par scénario a été testée dans le système d’aide à la décision Water Evaluation And Planning (WEAP). Il s’agit d’un modèle de simulation et de gestion des bassins hydrographiques qui réalise un bilan volumique conservatif des masses d’eaux entrantes et sortantes sur l’ensemble de la durée de la chronique des apports compte tenu des consignes de gestion et des contraintes physiques du système. WEAP permet l’édition et l’analyse des grandeurs utiles relatives au fonctionnement des bassins hydrographiques Les résultats des simulations montrent que le contexte actuel d’aménagement du bassin permet de garantir (en moyenne 8 années sur 10) une production d’énergie annuelle de 700 GWh tout en satisfaisant les besoins en soutien des basses eaux de la vallée et du delta qui sont évalués à 1567 Mm3/an. Toutefois l’extension des aménagements agricoles et la prise en compte de la navigation fluviale entre Kayes et Saint-Louis aura pour conséquence d’établir une compétition entre la production d’énergie à Manantali et le soutien d’étiage, particulièrement durant la saison des basses eaux entre décembre et mai. Les déficits d’allocation observés varient entre 8 et 20% selon que l’état d’hydraulicité du fleuve est humide ou sec. Les impacts de l’aménagement du haut bassin par la mise en service des barrages de Koukoutamba, Boureya et Gourbassi dans le scénario 3 restent importants et positifs. En effet, autre l’accroissement de près de 410% de la production d’énergie hydroélectrique, Koukoutamba et Boureya régulent les débits entrants à Manantali durant la saison des basses eaux, se traduisant par une augmentation du niveau de fonctionnement du réservoir de Manantali et par conséquent une réduction de plus de 50% des déficits de soutien des basses eaux au niveau de la vallée et du delta. Durant la saison des hautes eaux, la réduction des volumes entrants à Manantali due au remplissage des retenues de Koukoutamba et Boureya réduit de près de 60% les déversements de Manantali durant les années humides et de 15% le niveau de fonctionnement de la centrale durant les années sèches consécutives

Evaluation De La Prematurite Superieure Ou Egale A 32 Semaine D’amenorhée A L’hopital Regional De Ziguinchor Au Sud Du Senegal (Afrique De L’ouest)

Introduction: Prematurity is one of the leading causes of neonatal death in Africa. The objective of this work was to assess the preterm birth at the pediatric service of the regional hospital of Ziguinchor. Material and methods: This was a prospective, descriptive and analytical study of the case of hospitalized newborns whose age was between 32 SA to 36SA + 6 days. The study was conducted from May 21, 2013 to May 21, 2014. We included all premature infants at age ≥ 32SA.Those presenting a malformation were not included. We studied maternal socio-demographic, obstetric and neonatal parameters. Results: We have identified 140 newborns out of a total of 342 Preterm births and 2292 maternity births, a prevalence of 40.9% compared to preterm infants and 6.10% in relation to all births. 51.4 percent of mothers came from urban areas, 63.5 percent were between 20 and 34 years of age, not attending school in 45.7 percent, married in 72.9 percent and without work in 94.3 percent. The average gestures represented 3.09 . Arterial hypertension was the most common medical condition (67.7%). The followup was done by a midwife (82.1%) and 23.5% had received at least 4 NPC. Eclampsia and pre-eclampsia (48.9%) and RPM (42.8%) were common obstetric pathologies. The delivery was by caesarian (51.4%), hospital (92.1%), cephalic presentation (80%), with an average weight of 1816.79 g. An RCIU (16.4%), an RPM (61.9%). At birth, a DR (16.4%) was noted due to MMH (43.7%) and transitory tachypnea (50%). Asphyxia was reported in 3.5%. During hospitalization (6.7 days on average), 6.4% had RD caused by infection (77.7%). Other complications were infection (64.4%), hypoglycemia (28.5%), digestive hemorrhage (7.01%). The fatality rate was 7.9% due to infection (63.3%), DR (18%), haemorrhage (9%). The anthropometric measurements at the exit: P 1887.9g, T: 38.3cm, PC: 30.9cm; at 1 month P: 2387.1g, T: 46.6cm, PC: 32.8cm; at 30 months P: 12.1kg, T: 89.5cm, PC: 48.4cm. Conclusion: Moderate preterm birth accounts for almost half of the cases of prematurity in our series. Their optimal management would go through a better obstetric-neonatal collaboration but above all by the installation of kangaroo mother unit

Foetal instrumental extractions (IE) at the maternity at Nabil Choucair Health Center (Senegal) from 2005 to 2016: epidemio-clinical and prognostic aspects

Background: The main objective was to take stock of practices on instrumental extractions at the maternity of Nabil Choucair Health Center.Methods: This was a prospective, descriptive study from 1 January 2005 to 31 April 2016. The collection was carried out through the data sheet completed on the basis of an analysis of files, the delivery register and the anaesthesia register of the operating room. The data was entered using the Sphinx software version 5 and the data analysis performed by Epi info version 3.5.Results: 240 instrumental extraction cases were compiled, and their frequency was 0.4%. The mean age of patients was 24.8 years. Obstetric vacuum was the most commonly used instrument (66.4%) and an episiotomy was performed in 73.6%. Maternal complications were dominated by simple perineal tears (6.2%).Conclusions: Instrumental extractions should be rehabilitated in our maternity facilities to combat the outbreak of the caesarean section. Instrumental extractions indications and techniques should be controlled to avoid complication

L’éléphantiasis vulvo-clitoridien: à propos d’un nouveau cas

L'éléphantiasis vulvo-clitoridien d'origine filarienne est une affection très rare. Nous rapportons un nouveau cas chez une femme de 33 ans suivie dans un service de Maladies Infectieuses pour filariose lymphatique. Elle avait une masse vulvo-clitoridienne qui évoluait depuis plus de 10 ans. Une résection clitoridienne et une plastie vulvaire a été réalisée. Les résultats fonctionnels et esthétiques étaient satisfaisants.Key words: Eléphantiasis, filariose, vulvo-clitoridie

Study of variations in the broncho-arterial pedicles of the upper right lung lobe

Bronchial distribution and functional arterial vascularization of the upper lobe of the right lung are subject to many anatomical variations. The control of  these variations is essential for endoscopic and agiographic examinations. It also offers a better guarantee for safe and controlled surgery. In this  preliminary work, the exploitation of 15 heart-lung blocks treated by the injection corrosion method allowed us to study the general arrangement of the  broncho-arteries of the right upper lung lobe and their anatomical variations in the Senegalese population. Our results were as follows: the right upper  lobar bronchus was born on average at 1.25 cm from the tracheal bifurcation, with an average length of 1.13 cm. It ended with trifurcation into apical  (B1), dorsal (B2) and ventral (B3) segmental bronchi in 10 cases (66.66%); in 3 cases (20%), it ended with bifurcation into the dorsal segmental bronchus  and the apico-ventral trunk (B1+B3) (1 case), the apico-dorsal trunk (B1+B2) and the ventral segmental bronchus (B3), finally, in ventral and dorsal  segmentary bronchi giving each one an apical branch (1 case); in a last case, it ended by quadrifurcation, giving an external parabronche. The right upper  lobe was vascularized by 1 to 4 arteries, with eight modes of vascularization. It received more frequently two arteries. The anterior mediastinal  artery was the most common (100%). These results allowed us to discuss anatomical variations in the bronchial tree of the right upper lung lobe and the  pulmonary arterial distribution in that lobe. These variations must be taken into account during endoscopic examinations of imaging and surgery of  pulmonary excision, under penalty of accidents.&nbsp

Sensitivity of IFN-γ Release Assay to Detect Latent Tuberculosis Infection Is Retained in HIV-Infected Patients but Dependent on HIV/AIDS Progression

BACKGROUND: Detection and treatment of latent TB infection (LTBI) in HIV infected individuals is strongly recommended to decrease morbidity and mortality in countries with high levels of HIV. OBJECTIVE: To assess the validity of a newly developed in-house ELISPOT interferon-gamma release assay (IGRA) for the detection of LTBI amongst HIV infected individuals, in comparison with the Tuberculin Skin Test (TST). METHODOLOGY/PRINCIPAL FINDINGS: ESAT6/CFP10 (EC) ELISPOT assays were performed, together with a TST, in 285 HIV infected individuals recruited in HIV clinics in Dakar, Senegal, who had no signs of active TB at time of enrolment. Thirty eight of the subjects (13.3%) failed to respond to PHA stimulation and were excluded from the analysis. In the 247 remaining patients, response to PHA did not vary according to CD4 cell count categories (p = 0.51). EC ELISPOT was positive in 125 (50.6%) subjects, while 53 (21.5%) had a positive TST. Concordance between EC ELISPOT and TST was observed in 151 patients (61.1%) (kappa = 0.23). The proportion of subjects with a positive response to the EC ELISPOT assay decreased with declining CD4 counts (p trend = 0.001), but were consistently higher than the proportion of TST responders. In multivariate analysis, the risk of being EC-ELISPOT positive in HIV infected individuals was associated with age, CD4 count and HIV-1 strain. CONCLUSION: Our study indicates that IGRAs using M. tuberculosis specific antigens are likely to retain their validity for the diagnosis of LTBI among HIV positive individuals, but may be impaired by T-cell anergy in severely immuno-suppressed individuals

The evolving SARS-CoV-2 epidemic in Africa: Insights from rapidly expanding genomic surveillance

INTRODUCTION Investment in Africa over the past year with regard to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) sequencing has led to a massive increase in the number of sequences, which, to date, exceeds 100,000 sequences generated to track the pandemic on the continent. These sequences have profoundly affected how public health officials in Africa have navigated the COVID-19 pandemic. RATIONALE We demonstrate how the first 100,000 SARS-CoV-2 sequences from Africa have helped monitor the epidemic on the continent, how genomic surveillance expanded over the course of the pandemic, and how we adapted our sequencing methods to deal with an evolving virus. Finally, we also examine how viral lineages have spread across the continent in a phylogeographic framework to gain insights into the underlying temporal and spatial transmission dynamics for several variants of concern (VOCs). RESULTS Our results indicate that the number of countries in Africa that can sequence the virus within their own borders is growing and that this is coupled with a shorter turnaround time from the time of sampling to sequence submission. Ongoing evolution necessitated the continual updating of primer sets, and, as a result, eight primer sets were designed in tandem with viral evolution and used to ensure effective sequencing of the virus. The pandemic unfolded through multiple waves of infection that were each driven by distinct genetic lineages, with B.1-like ancestral strains associated with the first pandemic wave of infections in 2020. Successive waves on the continent were fueled by different VOCs, with Alpha and Beta cocirculating in distinct spatial patterns during the second wave and Delta and Omicron affecting the whole continent during the third and fourth waves, respectively. Phylogeographic reconstruction points toward distinct differences in viral importation and exportation patterns associated with the Alpha, Beta, Delta, and Omicron variants and subvariants, when considering both Africa versus the rest of the world and viral dissemination within the continent. Our epidemiological and phylogenetic inferences therefore underscore the heterogeneous nature of the pandemic on the continent and highlight key insights and challenges, for instance, recognizing the limitations of low testing proportions. We also highlight the early warning capacity that genomic surveillance in Africa has had for the rest of the world with the detection of new lineages and variants, the most recent being the characterization of various Omicron subvariants. CONCLUSION Sustained investment for diagnostics and genomic surveillance in Africa is needed as the virus continues to evolve. This is important not only to help combat SARS-CoV-2 on the continent but also because it can be used as a platform to help address the many emerging and reemerging infectious disease threats in Africa. In particular, capacity building for local sequencing within countries or within the continent should be prioritized because this is generally associated with shorter turnaround times, providing the most benefit to local public health authorities tasked with pandemic response and mitigation and allowing for the fastest reaction to localized outbreaks. These investments are crucial for pandemic preparedness and response and will serve the health of the continent well into the 21st century

Plaies trachéales post intubations dans la chirurgie cervicale: à propos de 3 cas

Nous rapportons 3 cas rares de plaies trachéales post-intubations découvertes au cours de chirurgie cervicale. Il s’agissait de 3 patientes âgées de 27, 30 et 42 ans admises au bloc opératoire pour une thyroïdectomie totale sous anesthésie générale indiquée devant un goitre hétéro-multinodulaire. L’intubation était orotrachéale à l’aide d’un guide rigide avec une sonde N°7,5 munie d’un ballonnet. Nous avons découvert en per opératoire une protrusion du ballonnet dans le champ opératoire à travers une effraction trachéale postéro-latérale. Le traitement avait consisté en une fermeture de la brèche trachéale dans 2 cas et une abstention chirurgicale dans le troisième cas suivi d’un drainage de la loge thyroïdienne. Les suites opératoires étaient simples. Les plaies trachéales post-intubations sont rares. Leur découverte per opératoire au cours d’une chirurgie cervicale est exceptionnelle. Les causes sont multiples. Il s’agit des difficultés d’intubation, d’une déchirure de la membraneuse par le bec de la sonde d’intubation, par un guide rigide, un effort de toux avec ballonnet gonflé au réveil, un sur-gonflage du ballonnet, de la modification structurale et anatomique de la trachée dans les goitres anciens. Il n’y a pas de consensus dans le traitement.Mots clés: Intubation, thyroïdectomie, chirurgie cervicaleEnglish Title: Post-intubation tracheal lacerations during cervical spine surgery: about 3 casesEnglish AbstractWe report 3 rare cases of post-intubation tracheal lacerations detected during cervical spine surgery. Our study involved 3 patients aged 27, 30 and 42 years admitted to the operating room for total thyroidectomy for heterogeneous multinodular goitre under general anesthesia. Orotracheal intubation using 7.5 rigid guide probe and balloon cuff was performed. During surgery we discovered a protrusion of the balloon cuff at the surgical site through posterolateral tracheal rupture. The treatment was based on closure of the tracheal rupture in 2 cases and on surgical abstention in the third case, followed by a drainage of the thyroid lodge. The postoperative course was uneventful. Post-intubation tracheal lacerations are rare. Intraoperative detection during cervical spine surgery is exceptional. They have multiple causes: intubation difficulties, membranous rupture caused by probe beak, by a rigid guide, coughing effort with inflated balloon at the awakening, balloon hyperinflation, structural and anatomical changes of the trachea in patients with chronic goiter. There is no consensus about treatment.Keywords: Intubation, thyroidectomy, cervical spine surger