Knowledge, attitudes, practices of teenagers on sexual health in the district of Ambohidratrimo

Background: Talking about sex, sexuality, sexual health in many countries, including Madagascar, is very difficult because of the sacred and taboos that surround these questions but especially because of certain puritanism. The objective of this study was to assess the knowledge, attitudes and practices of adolescents in matters of sexual health.Methods: A retrospective, descriptive cross-sectional study was carried out in adolescents aged 10 to 19 seen in Ambohidratrimo district. The data were collected during the month of June and July 2019 and relate to data for the twelve months before the survey.Results: A total of 210 adolescents were recruited whose average age was 15.82±2.75 years and the sex ratio was 1:04. Eighty-six percent of the adolescents surveyed had heard of sexual health. Nine out of 10 adolescents would go to a health worker if they contract an STI. Almost a quarter or 23.8% of respondents declared having already had sexual intercourse.Conclusions: At the end of this study on the knowledge, attitudes and practices of adolescents on sexual health, they certainly have knowledge but considered average. Therefore, there is a need for sexuality education, for improving knowledge and understanding of sexual development, human procreation, healthy and adapted sexual behavior and different means of contraception, on the part of adolescents, but also with the aim of improving communications between adolescents and their parent

The Prosthetic Obturator Appliance In The Treatment Of Cleft Lip And Palate In Newborns: Series Of Cases

Cleft lip and cleft palate are common defects in head and neck area. The treatment is mainly surgical but while waiting for the primary surgery which is not immediate, a pre-surgical management must be undertaken for the success of the diet and the surgery. In the present study, the use of the passive palatal obturator was chosen to demonstrate its efficacy in the pre-surgical management of cleft lip and/or palate in newborns.This is a serial case report of newborns with cleft lip and / or palate aged 2 to 27- day-old. Two suffered from BCLP (bilateral cleft palate), one from UCLP (unilateral cleft palate) and one IBCP (incomplete bilateral cleft palate). The conventional palatal obturator design-manufacturing stages was adopted. The impression was made with Polyvinyl siloxane impression material and flexible thermal-forming (ethylene vinyl acetate sheet) material was used for manufacturing the feeding obturator. A combined method (feeding obturator and lactation education) has been adopted for feeding success.As results, with palatal obturator in the mouth, each newborn exhibited good sucking-swallowing-breathing coordination at the time of suckling. During the 3-month follow-up period, weight gain was observed in the reported infants in which those affected by UCLP and CP gained more (1920g, 2200g) than others (700g, 1100g).The combined use of a palatal obturator and lactation education was associated with weight gain

More than just talk: the framing of transactional sex and its implications for vulnerability to HIV in Lesotho, Madagascar and South Africa

Background 'Transactional sex' was regarded by the mid-1990s as an important determinant of HIV transmission, particularly in sub-Saharan Africa. Little attention has been paid to what the terms used to denote transactional sex suggest about how it is understood. This study provides a nuanced set of descriptions of the meaning of transactional sex in three settings. Furthermore, we discuss how discourses around transactional sex suggest linkages to processes of globalization and hold implications for vulnerability to HIV. Methods The analysis in this article is based on three case studies conducted as part of a multi-country research project that investigated linkages between economic globalization and HIV. In this analysis, we contextualize and contrast the 'talk' about transactional sex through the following research methods in three study sites: descriptions revealed through semi-structured interviews with garment workers in Lesotho; focus groups with young women and men in Antananarivo, Madagascar; and focus groups and in-depth interviews with young women and men in Mbekweni, South Africa. Results Participants' talk about transactional sex reveals two themes: (1) 'The politics of differentiation' reflects how participants used language to demarcate identities, and distance themselves from contextually-based marginalized identities; and (2) 'Gender, agency and power' describes how participants frame gendered-power within the context of transactional sex practices, and reflects on the limitations to women's power as sexual agents in these exchanges. Talk about transactional sex in our study settings supports the assertion that emerging transactional sexual practices are linked with processes of globalization tied to consumerism. Conclusions By focusing on 'talk' about transactional sex, we locate definitions of transactional sex, and how terms used to describe transactional sex are morally framed for people within their local context. We take advantage of an opportunity to comparatively explore such talk across three different study sites, and contribute to a better understanding of both emerging sexual practices and their implications for HIV vulnerability. Our work underlines that transactional sex needs to be reflected as it is perceived: something very different from, but of at least equal concern to, formal sex work in the efforts to curb HIV transmission

Smallholder Zebu and Forage Production Development in Central Madagascar

Poverty in the Central Highlands of Madagascar is partly driven by inefficient exploitation of native forages and poor livestock nutrition. Zebus are of importance as cultural symbols, but this tradition has grown disconnected from agricultural policy. This project is working with three central highland communities near the protected areas of Itremo, Ibity and Ankafobe, to boost rangeland productivity and trial management methods which will support key forage grasses and improve livestock nutrition. A severe nitrogen deficiency compounded by extremely acidic soil conditions and low phosphorus is observed across the three sites. The lowest grazing capacity of an estimated 0.7 livestock unit per hectare and biomass production of 1600 kg/ha is observed at Ankafobe, the highest elevation windy site with fires that are almost annual. Low production is due to acidic soils with a lack of phosphorus as well as likely iron toxicity. The project works with 90 households owning a total 150 female zebu, 1-5 per household. The project initiated 3 demonstration farms to show the planting of sorghum for silage, harvesting of the native grasses for hay, and building a secure barn meeting at least minimum animal care standards, using local materials to protect the livestock from the weather and theft which is sadly perceived to be common. In the first year the project produced the highest yields in the most remote and fertile site of Itremo, with 365 kg of sorghum silage from 0.5 ha and 165 kg of Brachiaria hay from 0.5 ha. Five households based in the milk producing region of eastern Ibity have completed new barns. Fifty percent of households at Ibity successfully fed silage and hay to their zebu for the first time. Madagascar remains famous for subsistence farming and rural poverty with a long-term decline in livestock, but substantial opportunity nevertheless exists for integrated crop and livestock production, alongside the protection of biodiversity in nearby forests

Prioritizing Health-Sector Interventions for Noncommunicable Diseases and Injuries in Low- and Lower-Middle Income Countries: National NCDI Poverty Commissions

Health sector priorities and interventions to prevent and manage noncommunicable diseases and injuries (NCDIs) in low- and lower-middle-income countries (LLMICs) have primarily adopted elements of the World Health Organization Global Action Plan for NCDs 2013–2020. However, there have been limited efforts in LLMICs to prioritize among conditions and health-sector interventions for NCDIs based on local epidemiology and contextually relevant risk factors or that incorporate the equitable distribution of health outcomes. The Lancet Commission on Reframing Noncommunicable Diseases and Injuries for the Poorest Billion supported national NCDI Poverty Commissions to define local NCDI epidemiology, determine an expanded set of priority NCDI conditions, and recommend cost-effective, equitable health-sector interventions. Fifteen national commissions and 1 state-level commission were established from 2016–2019. Six commissions completed the prioritization exercise and selected an average of 25 NCDI conditions; 15 conditions were selected by all commissions, including asthma, breast cancer, cervical cancer, diabetes mellitus type 1 and 2, epilepsy, hypertensive heart disease, intracerebral hemorrhage, ischemic heart disease, ischemic stroke, major depressive disorder, motor vehicle road injuries, rheumatic heart disease, sickle cell disorders, and subarachnoid hemorrhage. The commissions prioritized an average of 35 health-sector interventions based on cost-effectiveness, financial risk protection, and equity-enhancing rankings. The prioritized interventions were estimated to cost an additional US$4.70–US$13.70 per capita or approximately 9.7%–35.6% of current total health expenditure (0.6%–4.0% of current gross domestic product). Semistructured surveys and qualitative interviews of commission representatives demonstrated positive outcomes in several thematic areas, including understanding NCDIs of poverty, informing national planning and implementation of NCDI health-sector interventions, and improving governance and coordination for NCDIs. Overall, national NCDI Poverty Commissions provided a platform for evidence-based, locally driven determination of priorities within NCDIs.publishedVersio

Liens entre moustiques vecteurs et environnement: apport des méthodes de télédétection satellite

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