Gender Inequality and Economic, Social and Policy Right: Situational Analysis with Women of De Locality of Velingara-Senegal

This study is stating the political and socio-economic rights on the conditions of women in the municipalities of Kounkan and Diaob -Kabendou Department of V lingara Senegal Method The study was made during the month of May 2013 After a documentary of policies and guidelines on the political and economic rights of women in terms of women s access to land and water a quantitative and qualitative aresearch from questionnaire interview and focus group was made Depending on the type of research software Epi- info and SPSS were used to capture control validate and analyse data Results The study was made with 448 women within the women s promotion group or not leaders or not with an age ranging from 18 to 92 years Pular 69 constitute the majority ethnic 85 5 of women were married 40 60 of women were not educated 48 80 of women were farmer However 35 5 were satisfied with the area They reported acquire farmland mainly from their husbands 45 40 and by inheritance 23 6 Generally Small businesses 44 4 and household activities 29 5 were women s occupations 56 5 of women had a national identity and voter registration card 60 90 of couples make decisions together 28 90 of women belonged to decision-making bodies 57 1 of women had experienced violence 73 40 of them were aware of the help and assistance structures However concerning violence within couples 64 of abused women within the couple noted a change in attitude after mediation F a mily 43 1 and the district chief or notable 32 8 are the remedies most famous women Conclusion Despite the positive development of human rights in Senegal many actions are to be undertaken in the municipalities of Kounkan and Diaob -Kabendou for the reality gap is known and fought for and that women enjoy and exercise like men fundamental rights recognized for good health to the person regardless of their gende

Prévalence de l’hypertension artérielle en milieu du travail : Cas du groupe Alucam au Cameroun: Prevalence of hypertension among workers : A case of the Alucam group in Cameroon

Context and objective. Hypertension (HTN), a silent killer, is a major global public health problem. Its magnitude remains however unknown in a professional environment. The objective of this study was to evaluate the frequency and risk factors associated with HTN among workers from the Alucam group in Cameroon. Method. A descriptive and analytical cross-sectional study of an exhaustive sample of workers from the Alucam Socatral industrial plant in Cameroon was conducted between January and September 2015. Parameters of interest included data on the determinants of the individual, the company, and Karasek’s psychosocial risk assessment as well as clinical data (measurement of blood pressure, height and weight). The Chi-square tests of Pearson and De Snedecor were used to compare the proportions. Odds ratio (OR) was used to assess risk factors associated to HTN. The statistical significance level was set at 5% (p < 0.05). Results. 637 employees were enrolled. Their average age was 52 years old and all were male. The prevalence of HTN was 14.3%. We noted a very significant hypertension prevalence among older workers compared to younger (OR = 16.95, p< 0.0001). HTA was significantly related to obesity (OR = 4.7, p < 0.0001). Almost all of the workers (90%) had not changed their service since being hired with a seniority of more than 30 years in 54% of the cases. Active workers accounted for 91% of all HTNs. According to psychosocial risk, the majority of workers (63%) was in the dial “job strain”, of which 70% were operators. Social support and decision latitude decreased as psychological demand increased. Conclusion. One in seven workers in this company is hypertensive. Age, obesity and shift work are associated with hypertension in the present study population. Contexte & objectif. L’hypertension (HTA), tueur silencieux, est un problème majeur de santé publique à travers le monde. Son ampleur reste cependant inconnue en milieu professionnel. L’objectif de la présente étude était d’évaluer la fréquence et les facteurs associés à l’HTA chez les travailleurs du groupe Alucam, au Cameroun. Méthodes. Nous avons conduit une étude transversale descriptive et analytique auprès d’un échantillon exhaustif des travailleurs de l’établissement industriel Alucam Socatral, entre janvier et septembre 2015, au Cameroun. Les paramètres d’intérêt englobaient les données relatives aux déterminants de l’individu, de l’entreprise et l’évaluation du risque psychosocial par le modèle de Karasek ainsi que les données cliniques (mesure de la pression artérielle, taille et poids). Les tests Khi² de Pearson et de De Snedecor ont été utilisés pour comparer les proportions. Odds ratio (OR) a permis d’évaluer les facteurs associés à l’HTA. Le seuil de signification statistique a été fixé à 5% (p < 0,05). Résultats. 637 employés ont été enrôlés. Leur âge moyen était de 52 ans et tous étaient du sexe masculin La prévalence de l’HTA était de 14,3 %. On notait une prévalence d’HTA très significative chez les travailleurs âgés par rapport aux plus jeunes (OR = 16,95, p < 0,0001). L’HTA était significativement liée avec l’obésité (OR 4,7, p = 0,0001). La quasi-totalité des travailleurs (90 %) n’avait pas changé de service depuis l’embauche avec une ancienneté de plus de 30 ans dans 54% des cas. Les travailleurs actifs constituaient 91 % des HTA. Selon le risque psychosocial, la majorité des travailleurs (63%) était dans le cadran « job strain », parmi lesquels 70 % étaient opérateurs. Le soutien social et la latitude décisionnelle diminuaient alors que la demande psychologique augmentait. Conclusion. Un travailleur sur sept de cette entreprise est hypertendu. L’âge, l’obésité et le travail posté sont associés à l’HTA dans notre population d’étude

Spatial and temporal dynamics of West Nile virus between Africa and Europe

It is unclear whether West Nile virus (WNV) circulates between Africa and Europe, despite numerous studies supporting an African origin and high transmission in Europe. We integrated genomic data with geographic observations and phylogenetic and phylogeographic inferences to uncover the spatial and temporal viral dynamics of WNV between these two continents. We focused our analysis towards WNV lineages 1 (L1) and 2 (L2), the most spatially widespread and pathogenic WNV lineages. Our study shows a Northern-Western African origin of L1, with back-and-forth exchanges between West Africa and Southern-Western Europe; and a Southern African origin of L2, with one main introduction from South Africa to Europe, and no back introductions observed. We also noticed a potential overlap between L1 and L2 Eastern and Western phylogeography and two Afro-Palearctic bird migratory flyways. Future studies linking avian and mosquito species susceptibility, migratory connectivity patterns, and phylogeographic inference are suggested to elucidate the dynamics of emerging viruse

Gametocyte carriage in uncomplicated Plasmodium falciparum malaria following treatment with artemisinin combination therapy: a systematic review and meta-analysis of individual patient data

BACKGROUND: Gametocytes are responsible for transmission of malaria from human to mosquito. Artemisinin combination therapy (ACT) reduces post-treatment gametocyte carriage, dependent upon host, parasite and pharmacodynamic factors. The gametocytocidal properties of antimalarial drugs are important for malaria elimination efforts. An individual patient clinical data meta-analysis was undertaken to identify the determinants of gametocyte carriage and the comparative effects of four ACTs: artemether-lumefantrine (AL), artesunate/amodiaquine (AS-AQ), artesunate/mefloquine (AS-MQ), and dihydroartemisinin-piperaquine (DP). METHODS: Factors associated with gametocytaemia prior to, and following, ACT treatment were identified in multivariable logistic or Cox regression analysis with random effects. All relevant studies were identified through a systematic review of PubMed. Risk of bias was evaluated based on study design, methodology, and missing data. RESULTS: The systematic review identified 169 published and 9 unpublished studies, 126 of which were shared with the WorldWide Antimalarial Resistance Network (WWARN) and 121 trials including 48,840 patients were included in the analysis. Prevalence of gametocytaemia by microscopy at enrolment was 12.1 % (5887/48,589), and increased with decreasing age, decreasing asexual parasite density and decreasing haemoglobin concentration, and was higher in patients without fever at presentation. After ACT treatment, gametocytaemia appeared in 1.9 % (95 % CI, 1.7–2.1) of patients. The appearance of gametocytaemia was lowest after AS-MQ and AL and significantly higher after DP (adjusted hazard ratio (AHR), 2.03; 95 % CI, 1.24–3.12; P = 0.005 compared to AL) and AS-AQ fixed dose combination (FDC) (AHR, 4.01; 95 % CI, 2.40–6.72; P < 0.001 compared to AL). Among individuals who had gametocytaemia before treatment, gametocytaemia clearance was significantly faster with AS-MQ (AHR, 1.26; 95 % CI, 1.00–1.60; P = 0.054) and slower with DP (AHR, 0.74; 95 % CI, 0.63–0.88; P = 0.001) compared to AL. Both recrudescent (adjusted odds ratio (AOR), 9.05; 95 % CI, 3.74–21.90; P < 0.001) and new (AOR, 3.03; 95 % CI, 1.66–5.54; P < 0.001) infections with asexual-stage parasites were strongly associated with development of gametocytaemia after day 7. CONCLUSIONS: AS-MQ and AL are more effective than DP and AS-AQ FDC in preventing gametocytaemia shortly after treatment, suggesting that the non-artemisinin partner drug or the timing of artemisinin dosing are important determinants of post-treatment gametocyte dynamics

The effect of dose on the antimalarial efficacy of artemether-lumefantrine: a systematic review and pooled analysis of individual patient data

Background: Artemether-lumefantrine is the most widely used artemisinin-based combination therapy for malaria, although treatment failures occur in some regions. We investigated the effect of dosing strategy on efficacy in a pooled analysis from trials done in a wide range of malaria-endemic settings. Methods: We searched PubMed for clinical trials that enrolled and treated patients with artemether-lumefantrine and were published from 1960 to December, 2012. We merged individual patient data from these trials by use of standardised methods. The primary endpoint was the PCR-adjusted risk of Plasmodium falciparum recrudescence by day 28. Secondary endpoints consisted of the PCR-adjusted risk of P falciparum recurrence by day 42, PCR-unadjusted risk of P falciparum recurrence by day 42, early parasite clearance, and gametocyte carriage. Risk factors for PCR-adjusted recrudescence were identified using Cox's regression model with frailty shared across the study sites. Findings: We included 61 studies done between January, 1998, and December, 2012, and included 14 327 patients in our analyses. The PCR-adjusted therapeutic efficacy was 97·6% (95% CI 97·4-97·9) at day 28 and 96·0% (95·6-96·5) at day 42. After controlling for age and parasitaemia, patients prescribed a higher dose of artemether had a lower risk of having parasitaemia on day 1 (adjusted odds ratio [OR] 0·92, 95% CI 0·86-0·99 for every 1 mg/kg increase in daily artemether dose; p=0·024), but not on day 2 (p=0·69) or day 3 (0·087). In Asia, children weighing 10-15 kg who received a total lumefantrine dose less than 60 mg/kg had the lowest PCR-adjusted efficacy (91·7%, 95% CI 86·5-96·9). In Africa, the risk of treatment failure was greatest in malnourished children aged 1-3 years (PCR-adjusted efficacy 94·3%, 95% CI 92·3-96·3). A higher artemether dose was associated with a lower gametocyte presence within 14 days of treatment (adjusted OR 0·92, 95% CI 0·85-0·99; p=0·037 for every 1 mg/kg increase in total artemether dose). Interpretation: The recommended dose of artemether-lumefantrine provides reliable efficacy in most patients with uncomplicated malaria. However, therapeutic efficacy was lowest in young children from Asia and young underweight children from Africa; a higher dose regimen should be assessed in these groups. Funding: Bill and Melinda Gates Foundation

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

Selection of antimalarial drug resistance after intermittent preventive treatment of infants and children (IPTi/c) in Senegal.

Our study investigated the possible impact of SP-IPT given to infants and children on the prevalence of SP-resistant haplotypes in the Plasmodium falciparum genes Pfdhfr and Pfdhps, comparing sites with and without IPTi/c. P. falciparum positive samples (N = 352) collected from children < 5 years were analyzed to determine the prevalence of SP resistance-related haplotypes by nested PCR followed by sequence-specific oligonucleotide probe-enzyme-linked immunosorbent assay. The prevalence of the Pfdhfr triple mutant haplotype (CIRN) increased in both groups, but only significantly in the IPTi/c group from 41% to 65% in 2011 (P = 0.005). Conversely, the Pfdhps 437G mutation decreased in both groups from 44.6% to 28.6% (P = 0.07) and from 66.7% to 47.5% (P = 0.02) between 2010 and 2011 in the control and the IPTi/c groups, respectively. A weak trend for decreasing prevalence of quadruple mutants (triple Pfdhfr + Pfdhps 437G) was noted in both groups (P = 0.15 and P = 0.34). During the two cross-sectional surveys some significant changes were observed in the SP resistance-related genes

Community case management in malaria: review and perspectives after four years of operational experience in Saraya district, south-east Senegal.

BACKGROUND: Despite recent advances in malaria diagnosis and treatment, many isolated communities in rural settings continue to lack access to these life-saving tools. Community-case management of malaria (CCMm), consisting of lay health workers (LHWs) using malaria rapid diagnostic tests (RDTs) and artemisinin-based combination therapy (ACT) in their villages, can address this disparity. METHODS: This study examined routine reporting data from a CCMm programme between 2008 and 2011 in Saraya, a rural district in Senegal, and assessed its impact on timely access to rapid diagnostic tests and ACT. RESULTS: There was a seven-fold increase in the number of LHWs providing care and in the number of patients seen. LHW engagement in the CCM programme varied seasonally, 24,3% of all patients prescribed an ACT had a negative RDT or were never administered an RDT, and less than half of patients with absolute indications for referral (severe symptoms, age under two months and pregnancy) were referred. There were few stock-outs. DISCUSSION: This CCMm programme successfully increased the number of patients with access to RDT and ACT, but further investigation is required to identify the cause for over-prescription, and low rates of referrals for patients with absolute indications. In contrast, previous widespread stock-outs in Saraya's CCMm programme have now been resolved. CONCLUSION: This study demonstrates the potential for CCMm programmes to substantially increase access to life-saving malarial diagnostics and treatment, but also highlights important challenges in ensuring quality