An evaluation of groundwater vulnerability assessment methods in a rapidly urbanizing city: evidence from Dakar, Senegal

In rapidly growing cities in the tropics, unregulated urban development presents a major risk to groundwater quality. Here, we assess the vulnerability of an unconfined aquifer of Quaternary sands in the Thiaroye area of Dakar (Senegal) to contamination using four GIS-based indices (DRASTIC, DRASTIC_N, SINTACS, SI). Our correlation of assessed vulnerability to observed impact is semi-quantitative, relating observed groundwater quality, based on nitrate concentrations and tryptophan-like fluorescence to vulnerability degrees (i.e. coincidence rates). We show that considerably more of the Thiaroye area has a “very high vulnerability” according to SI (36%) relative to DRASTIC (5%) and SINTACS (9%); “high vulnerability” is estimated using DRASTIC_N (100%), DRASTIC (66%) and SINTACS (69%). Single-parameter sensitivity tests show that groundwater depth, soil, topography, land use and redox parameters strongly influence assessments of groundwater vulnerability. Correlation with observed nitrate concentrations reveals aquifer vulnerability is better represented by SI (coincidence rates of 56%) relative to DRASTIC_N (43%), SINTACS (38%) and DRASTIC (34%). The underestimation of groundwater vulnerability in Dakar using DRASTIC, DRASTIC_N and SINTACS is attributed to their reliance on an assumed capacity of the unsaturated zone to attenuate surface or near-surface contaminant loading, which in the low-income (Thiaroye) area of Dakar is thin and affords limited protection. The inclusion of a land-use parameter in SI improves the characterization of groundwater vulnerability in this low-income, rapidly urbanizing area of Dakar

Thrombocytose au cours d’un syndrome d’activation macrophagique compliquant un lupus érythémateux systémique

Le syndrome d'activation macrophagique (SAM) est une complication du lupus érythémateux systémique  (LES), due à l'activation et la prolifération incontrôlée des macrophages dans la moelle osseuse. La  bycytopénie voire la pancytopénie est constante. Nous rapportons un cas atypique de SAM diagnostiqué au même moment qu'un LES chez une patiente noire de 17 ans. Le tableau initial associait une fièvre, un  syndrome inflammatoire, une anémie, un taux normal de leucocytes et plus surprenant, une thrombocytose.Key words: Syndrome d´activation macrophagique, Lupus érythémateux systémique, Cytopénie, Thrombocytose, Afrique Subsaharienn

Grave's disease associated with myasthenia gravis: a case report

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In-situ fluorescence spectroscopy indicates total bacterial abundance and dissolved organic carbon

We explore in-situ fluorescence spectroscopy as an instantaneous indicator of total bacterial abundance and faecal contamination in drinking water. Eighty-four samples were collected outside of the recharge season from groundwater-derived water sources in Dakar, Senegal. Samples were analysed for tryptophan-like (TLF) and humic-like (HLF) fluorescence in-situ, total bacterial cells by flow cytometry, and potential indicators of faecal contamination such as thermotolerant coliforms (TTCs), nitrate, and in a subset of 22 samples, dissolved organic carbon (DOC). Significant single-predictor linear regression models demonstrated that total bacterial cells were the most effective predictor of TLF, followed by on-site sanitation density; TTCs were not a significant predictor. An optimum multiple-predictor model of TLF incorporated total bacterial cells, nitrate, nitrite, on-site sanitation density, and sulphate (r2 0.68). HLF was similarly related to the same parameters as TLF, with total bacterial cells being the best correlated (ρs 0.64). In the subset of 22 sources, DOC clustered with TLF, HLF, and total bacterial cells, and a linear regression model demonstrated HLF was the best predictor of DOC (r2 0.84). The intergranular nature of the aquifer, timing of the study, and/or non-uniqueness of the signal to TTCs can explain the significant associations between TLF/HLF and indicators of faecal contamination such as on-site sanitation density and nutrients but not TTCs. The bacterial population that relates to TLF/HLF is likely to be a subsurface community that develops in-situ based on the availability of organic matter originating from faecal sources. In-situ fluorescence spectroscopy instantly indicates a drinking water source is impacted by faecal contamination but it remains unclear how that relates specifically to microbial risk in this setting

Tryptophan-like and humic-like fluorophores are extracellular in groundwater: implications as real-time faecal indicators

Fluorescent natural organic matter at tryptophan-like (TLF) and humic-like fluorescence (HLF) peaks is associated with the presence and enumeration of faecal indicator bacteria in groundwater. We hypothesise, however, that it is predominantly extracellular material that fluoresces at these wavelengths, not bacterial cells. We quantified total (unfiltered) and extracellular (filtered at < 0.22 µm) TLF and HLF in 140 groundwater sources across a range of urban population densities in Kenya, Malawi, Senegal, and Uganda. Where changes in fluorescence occurred following filtration they were correlated with potential controlling variables. A significant reduction in TLF following filtration (ΔTLF) was observed across the entire dataset, although the majority of the signal remained and thus considered extracellular (median 96.9%). ΔTLF was only significant in more urbanised study areas where TLF was greatest. Beneath Dakar, Senegal, ΔTLF was significantly correlated to total bacterial cells (ρs 0.51). No significant change in HLF following filtration across all data indicates these fluorophores are extracellular. Our results suggest that TLF and HLF are more mobile than faecal indicator bacteria and larger pathogens in groundwater, as the predominantly extracellular fluorophores are less prone to straining. Consequently, TLF/HLF are more precautionary indicators of microbial risks than faecal indicator bacteria in groundwater-derived drinking water

Nitrate contamination of urban groundwater and heavy rainfall: Observations from Dakar, Senegal

Abstract In low‐income urban areas of major cities in Africa, sanitation provision derives primarily from onsite systems often comprising septic tanks and pit latrines. Such systems rely upon the ability of the surrounding soil and substratum to attenuate contaminants like nitrate and pathogenic microorganisms in wastewater. Here, we assess soil–water and solute dynamics in Quaternary aeolian sands underlying a densely populated suburb (Keur Massar) of Dakar (Senegal) using high‐frequency monitoring and vadose zone modeling (Hydrus‐1D). Observations of rainfall intensity, soil moisture content, and shallow groundwater‐level fluctuations and nitrate concentrations were carried out at an experimental site adjacent to a septic tank supplied by toilets used by a primary school. Rapid rises in soil moisture content and episodic recharge contributions observed in groundwater levels caused by heavy (>10 mm h−1) and extreme (>20 mm h−1) rainfall are well modeled (R2 = .79–.83; RMSE = 0.012–0.019) by pore‐matrix flow in the unsaturated zone by the Darcy–Richards equation. Spot sampling around the most intense rainfall of 2020 (45 mm h−1) reveals a fivefold rise and fall in the concentration of nitrate in soil moisture (∼500 to ∼2,500 mg L−1). These measurements provide new insight into the hydrological dynamics by which shallow groundwater is grossly contaminated (>500 mg L−1) by nitrate through episodic flushing by heavy rainfall of wastewater from a vast estimated network of over 250,000 septic tanks underlying this suburb of Dakar

Aspects épidémiologique, clinique, thérapeutique et évolutif de la maladie de Basedow en Médecine Interne au CHU Ledantec Dakar (Sénégal)

La maladie de Basedow est une affection auto immune associant une thyrotoxicose à des manifestations de fréquence variable comme le goitre, l'ophtalmopathie et le myxœdème prétibial. Son diagnostic est souvent facile, tandis que sa prise en charge demeure encore difficile. L'instauration d'un traitement médical simple expose à un risque de récidive. Au Sénégal et en Afrique Sub-saharienne peu d'études ont porté sur la maladie de Basedow. L'objectif de l'étude était de décrire les aspects épidémiologique, clinique, thérapeutique et évolutif de la maladie de Basedow en milieu hospitalier à Dakar. Il s'agissait d'une étude rétrospective menée du 1er janvier 2010 au 31 décembre 2013 dans le service de Médecine Interne du centre hospitalier universitaire Aristide Le Dantec. Durant la période, 108 patients suivis en consultation externe pour maladie de Basedow, ont été inclus sur un total de 834 patients suivis en consultation externe. le diagnostic a été retenu devant les signes cliniques, biologiques et immunologiques. Cent huit patients, atteints de maladie de Basedow ont été inclus sur un total de 834 consultations. Le sex ratio était de 7,3 et la moyenne d'âge de 34,6 ans. Les principaux motifs de consultation étaient : les palpitations et l'amaigrissement dans respectivement 46,3% et 39,8% des cas. Le syndrome de thyrotoxicose était présent chez 93,5% des patients, un goitre était noté chez 87% des patients et une exophtalmie chez 78,7% des patients. La principale complication était à type de cardiothyréose retrouvée chez 11,1% des patients. Tous les patients ont eu un traitement par antithyroïdiens de synthèse. L'évolution a été favorable dans 19,4% des cas. Une récidive à été notée dans 57% des cas et dans 23,1% des cas les patients ont été perdus de vue. La maladie de Basedow est la cause de la plus fréquente d'hyperthyroïdie. Le tableau est dominé par les manifestations cliniques liées à l'hyper métabolisme de l'organisme. Dans cette étude, il apparait que la thyroïdectomie n'est pas de première intention si l'on connait le nombre élevé de récidive après le traitement médical.The Pan African Medical Journal 2016;2

Setting priorities for disaster management in the East African sub-region

La localisation cervicale de la tuberculose est rare et peut prendre l'apparence d'un cancer du col utérin. La présentation pauci-symptomatique et l'évolution insidieuse sont à l'origine d'un retard diagnostique. Les symptômes communément rencontrés sont non spécifiques, ce qui contribue au retard thérapeutique et majore le risque d'infertilité qui reste la séquelle quasi inéluctable. Nous rapportons un cas de tuberculose du col utérin dont le diagnostic de prime abord n'a pas été évident. En effet une patiente a été adressée à notre département pour suspicion de cancer du col utérin. Le diagnostic de suspicion de cancer a été alors retenu devant un col qui saignait au contact avec une tomodensitométrie abdomino-pelvienne en faveur d'une tumeur du col utérin. Une biopsie de confirmation histologique a été indiquée. On a retrouvé à l'examen anatomopathologique, un granulome épithélio-giganto-cellulaire avec nécrose caséeuse, compatible avec une tuberculose cervicale. La recherche d'un terrain était négative. Un traitement antituberculeux instauré a conduit à la guérison. Retenue souvent sur la base d'éléments présomptifs, la décision diagnostique et thérapeutique de tuberculose du col cervicale reconnait la place de l'examen anatomopathologique