La formation des formateurs aux technologies éducatives comme vecteur d’amélioration de la qualité de l’offre de formation professionnelle et technique au Sénégal : cas du Lycée d’enseignement technique et de formation professionnelle de Thiès

Quels sont les usages actuels des TICE chez les formateurs en formation professionnelle et technique au Sénégal et quels sont leurs besoins de formation ? Pour répondre à ces questions, notre étude de cas a été menée auprès de 38 enseignants répartis dans les cinq filières professionnelles du Lycée d’enseignement technique et de formation professionnelle de Thiès. Un questionnaire d’enquête administré à 45 enseignants a permis de recueillir les données ayant servi de bases pour répondre aux questions de recherche. L’analyse puis l’interprétation de ces données ont été faites en référence au cadre théorique avec un modèle d’intégration de référence, le modèle ASPID. Ces données ont révélé que les enseignants ayant participé à cette étude sont répartis entre le niveau d’adoption et le niveau de substitution du modèle ASPID. Néanmoins, l’étude a révélé la non-maitrise de l’approche par compétences par certains formateurs : seulement 45 % des répondants affirment avoir une bonne maitrise de l’approche pédagogique. Cela pourrait placer certains enseignants dans la phase de détérioration du modèle ASPID, car l’usage des technologies ne se fait pas toujours en adéquation avec les contenus des référentiels, ce qui pourrait fortement accentuer les lacunes pédagogiques du fait d’un mauvais usage des technologies en contexte scolaire. Par ailleurs, la discussion a permis d’étayer les axes de renforcement des capacités individuelles des enseignants à travers la définition des compétences auxquelles il faudrait les former afin de bien avancer dans les phases de progrès puis d’innovation du modèle ASPID.What are the current uses of ICT in vocational and technical training by trainers in Senegal And what are their training needs? To answer these questions, our case study was conducted with 38 teachers in the five vocational streams of the Technical and Vocational Training High School in Thiès. A survey questionnaire administered to 45 teachers collected the data used as a basis for answering the research questions. The analysis and interpretation of these data was done with reference to the theoretical framework with a reference integration model, the ASPID model. These data revealed that the teachers who participated in this study are divided between the level of adoption and the level of substitution of the ASPID model. Nevertheless, the study revealed that the lack of mastery of the competency-based approach by some trainers, with only 45% who claim to have a good mastery of the pedagogical approach. This could put some teachers in the deterioration phase of the ASPID model because the use of technologies is not in line with the content of the standards. This could greatly accentuate the educational gaps due to the misuse of technologies in the school context. In addition, the discussion helped to support the areas of individual capacity building for teachers through the definition of the skills to which teachers should be trained in order to make good progress in the progress and innovation phases of the ASPID model

Fracture-décollement de l’épiphyse médiale de la clavicule: à propos de 6 cas et revue de la littérature

Le but de ce travail est de décrire les caractéristiques épidémiologiques et les différentes entités anatomo-cliniques de la fracture-séparation del’épiphyse claviculaire médiale mais également de rapporter les résultats morphologiques et fonctionnelsde de la réduction sanglante suivie del’ostéo-suture au fil non résorbable. Cinq garçons et 1 fille âgés en moyenne de 14 ans ont présenté un traumatisme fermé et isolé de la ceinturescapulaire. L’examen clinique et l’imagerie médicale surtout la TDM ont permis de poser le diagnostic de décollement épiphysaire, de classer ledegré d’ossification de l’épiphyse claviculaire médiale en précisant le sens du déplacement, ainsi que la nature du décollement selon Salter-Harris.Une réduction sanglante suivie d’une ostéo-suture au fil non résorbable décimale n°1 a été réalisées chez 3 patients. Un patient a bénéficié d’unembrochage croisé. Les deux plus jeunes ont été traités orthopédiquement. Le déplacement du moignon claviculaire était antérieur chez 3 patientset rétro-sternal chez les 3 autres. Les formes postérieures ont été compliquées d’une odynophagie (n=2) et d’une compression asymptomatique dela veine sous Clavière (n=1). L’une des formes postérieuresétait associée a une fracture ipsilatérale du 1 / 3 médial de la clavicule. La consolidationa été obtenue chez tous les malades avec une mobilité de l’épaule conservée. La fracture-décollement de l’extrémité médiale de la clavicule mimeau plan clinico-radiologique la luxation sterno-claviculaire. Elle peut être grave en raison du risque de compression viscérale et vasculaire dans saforme postérieure. La tomodensitométrie reste irremplaçable pour un diagnostic précis. Notre préférence va à la réduction sanglante suivie d’uneostéo-suture au fil non métallique. This study aims to describe the epidemiological characteristics and the different anatomo-clinical entities of the fracture-separation of the medialclavicular epiphysis but also to relate the morphological and functional results of bloody reduction followed by osteosuture using non absorbablethread. Five boys and one girl (mean age 14 years) showed a closed and isolated shoulder girdle trauma. Clinical examination and medicalimaging, especially CT scan, allowed the diagnosis of epiphyseal separation and to classify the degree of medial clavicular epiphysiseal ossificationindicating the direction of displacement as well as the nature of displacement according to the Salter-Harris classification. Bloody reductionfollowed by osteosuture using non absorbable thread (No. 1 decimal) was performed in 3 patients. One patient underwent cross-pinning the twoyounger patients were treated orthopedically. The displacement of the clavicle stump was anterior in 3 patients and retro-sternal in 3 patients.Posterior forms were complicated by odynophagia (n = 2) and asymptomatic compression of the subclavian vein (n = 1). One of the posteriorforms was associated with an ipsilateral fracture of the medial one third of the clavicle. Consolidation was achieved in all patients with preservationof shoulder mobility. The fracture-separation of the medial end of the clavicle mimes clinically and radiologically the sternoclavicular dislocation. Itcan be serious because of the risk of visceral and vascular compression in its posterior form. Tomdensitometry is irreplaceable for an accuratediagnosis. Our preference is for bloody reduction followed by osteosuture using non metallic thread

Ascite fébrile chez la femme, ne pas méconnaitre une tumeur de Krukenberg

Les tumeurs de Krukenberg (TK) se définissent comme des métastases ovariennes d'un cancer, le plus souvent digestif. Elles représentent 5 à 15% des tumeurs malignes ovariennes. Notre objectif était de décrire les caractéristiques épidémiologiques, diagnostiques, thérapeutiques et évolutives.Nous  rapportons deux observations de tumeur de Krukenberg découvertes à l'occasion de l'exploration d'une ascite fébrile.Il s'agit de deux patientes multipares âgées respectivement de 32 ans et 50 ans. Les signes d'appel étaient essentiellement digestifs. La découverte de ces métastases ovariennes était survenue à distance des foyers primitifs. L'atteinte des ovaires était bilatérale dans le premier cas et unilatérale  droite dans le second cas. Le diagnostic est apporté par la tomodensitométrie abdominopelvienne dans les deux cas. La fibroscopie oesogastroduodénale avait permis de retrouver le foyer primitif  respectivement sous forme d'un processus bourgeonnant et d'un ulcère en position antrale avec des stigmates d'hémorragies. L'examen anatomopathologique des biopsies réalisées mettait en évidence un adénocarcinome tubuleux moyennement différencié de l'estomac avec composante mucineuse dans la première observation et un adénocarcinome de type intestinal moyennement différencié dans la seconde. Le traitement chirurgical confirme le diagnostic histologique. Dans notre série, le traitement n'a pu être que symptomatique en raison de l'existence constante d'une carcinose péritonéale et de l'altération profonde de l'état général. Les deux patientes ont été confiées à l'institut de cancérologie pour une chimiothérapie palliative. La première est décédée 1 mois après. La tumeur de Krukenberg est une  maladie rare. Le diagnostic est facilité par la radiologie et confirmé par l'histologie. Son pronostic  demeure encore très sombre. Le seul espoir réside dans les mesures préventives.Key words: Métastases ovariennes, tumeur de Krukenberg, pronostic sombre

Evaluation of the pulse wave velocity in African rheumatoid arthritis subjects

Background: Rheumatoid arthritis is a systemic disease with often fatal vascular events. In addition to traditional cardiovascular risk factors, disease-specific elements contribute to this cardiovascular mortality. The aim of this study was to assess arterial stiffness in rheumatoid arthritis and to determine the factors involved.Methods: We have recruited the black African patients followed in rheumatology and had rheumatoid arthritis diagnosis. Only patients between 18 and 60 years and meeting the American College of Rheumatology criteria were included. All controls were healthy. We evaluated the propagation velocity of the pulse wave finger-toe (PWVft) measured by the pOpmètre®.Results: Present study shows that the PWVft was significantly elevated in over half of patients (55.10%). Besides, the mean patients PWVft was significantly higher than that of the control (respectively 9.40±0.51 and 7.22±0.33 p=0.001). In the patients, no factor was significantly involved in the arterial stiffness, but cons in the control group, the PWVft was significantly correlated with age (p=0.023 and r=0.55).Conclusions: Rheumatoid arthritis patients had higher PWVft compared to controls. Due to the importance of its cardiovascular morbidity and mortality, arthritis requires a regular monitoring element as arterial stiffness, which is currently a major vascular parameter monitoring

Mass testing and treatment for malaria followed by weekly fever screening, testing and treatment in Northern Senegal: feasibility, cost and impact.

BACKGROUND NlmCategory: BACKGROUND content: Population-wide interventions using malaria testing and treatment might decrease the reservoir of Plasmodium falciparum infection and accelerate towards elimination. Questions remain about their effectiveness and evidence from different transmission settings is needed. - Label: METHODS NlmCategory: METHODS content: "A pilot quasi-experimental study to evaluate a package of population-wide test and treat interventions was conducted in six health facility catchment areas (HFCA) in the districts of Kanel, Lingu\xC3\xA8re, and Ran\xC3\xA9rou (Senegal). Seven adjacent HFCAs were selected as comparison. Villages within the intervention HFCAs were stratified according to the 2013 incidences of passively detected malaria cases, and those with an incidence\xE2\x80\x89\xE2\x89\xA5\xE2\x80\x8915 cases/1000/year were targeted for a mass test and treat (MTAT) in September 2014. All households were visited, all consenting individuals were tested with a rapid diagnostic test (RDT), and, if positive, treated with dihydroartemisinin-piperaquine. This was followed by weekly screening, testing and treatment of fever cases (PECADOM++) until the end of the transmission season in January 2015. Villages with lower incidence received only PECADOM++ or case investigation. To evaluate the impact of the interventions over that transmission season, the incidence of passively detected, RDT-confirmed malaria cases was compared between the intervention and comparison groups with a difference-in-difference analysis using negative binomial regression with random effects on HFCA." - Label: RESULTS NlmCategory: RESULTS content: "During MTAT, 89% (2225/2503) of households were visited and 86% (18,992/22,170) of individuals were tested, for a combined 77% effective coverage. Among those tested, 291 (1.5%) were RDT positive (range 0-10.8 by village), of whom 82% were\xE2\x80\x89<\xE2\x80\x8920\xC2\xA0years old and 70% were afebrile. During the PECADOM++ 40,002 visits were conducted to find 2784 individuals reporting fever, with an RDT positivity of 6.5% (170/2612). The combination of interventions resulted in an estimated 38% larger decrease in malaria case incidence in the intervention compared to the comparison group (adjusted incidence risk ratio\xE2\x80\x89=\xE2\x80\x890.62, 95% CI 0.45-0.84, p\xE2\x80\x89=\xE2\x80\x890.002). The cost of the MTAT was $14.3 per person." - Label: CONCLUSIONS NlmCategory: CONCLUSIONS content: It was operationally feasible to conduct MTAT and PECADOM++ with high coverage, although PECADOM++ was not an efficient strategy to complement MTAT. The modest impact of the intervention package suggests a need for alternative or complementary strategies

Mass testing and treatment for malaria followed by weekly fever screening, testing and treatment in Northern Senegal: feasibility, cost and impact.

BACKGROUND: Population-wide interventions using malaria testing and treatment might decrease the reservoir of Plasmodium falciparum infection and accelerate towards elimination. Questions remain about their effectiveness and evidence from different transmission settings is needed. METHODS: A pilot quasi-experimental study to evaluate a package of population-wide test and treat interventions was conducted in six health facility catchment areas (HFCA) in the districts of Kanel, Linguère, and Ranérou (Senegal). Seven adjacent HFCAs were selected as comparison. Villages within the intervention HFCAs were stratified according to the 2013 incidences of passively detected malaria cases, and those with an incidence ≥ 15 cases/1000/year were targeted for a mass test and treat (MTAT) in September 2014. All households were visited, all consenting individuals were tested with a rapid diagnostic test (RDT), and, if positive, treated with dihydroartemisinin-piperaquine. This was followed by weekly screening, testing and treatment of fever cases (PECADOM++) until the end of the transmission season in January 2015. Villages with lower incidence received only PECADOM++ or case investigation. To evaluate the impact of the interventions over that transmission season, the incidence of passively detected, RDT-confirmed malaria cases was compared between the intervention and comparison groups with a difference-in-difference analysis using negative binomial regression with random effects on HFCA. RESULTS: During MTAT, 89% (2225/2503) of households were visited and 86% (18,992/22,170) of individuals were tested, for a combined 77% effective coverage. Among those tested, 291 (1.5%) were RDT positive (range 0-10.8 by village), of whom 82% were < 20 years old and 70% were afebrile. During the PECADOM++ 40,002 visits were conducted to find 2784 individuals reporting fever, with an RDT positivity of 6.5% (170/2612). The combination of interventions resulted in an estimated 38% larger decrease in malaria case incidence in the intervention compared to the comparison group (adjusted incidence risk ratio = 0.62, 95% CI 0.45-0.84, p = 0.002). The cost of the MTAT was $14.3 per person. CONCLUSIONS: It was operationally feasible to conduct MTAT and PECADOM++ with high coverage, although PECADOM++ was not an efficient strategy to complement MTAT. The modest impact of the intervention package suggests a need for alternative or complementary strategies

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

An observatory shared on the Web: OSER70

The company IAD-Informatique and the research center ThéMA were mandated by the Regional Development Agency of Franche-Comte to design and develop a socio-economic observatory adapted to the local context. The tool relies is based on a regional data storage platform, shared between agencies wich are producers and / or users of information. The aim of the tool developed is to allow to : - Pool resources; - Enhance socio-economic information, both quantitatively and qualitatively, multiplying the generic and specialized sources;soul - Enhance de value of the socio-economic information by making it accessible to a wider circle of actors; - Promote the emergence of a regional network of territorial intelligence. The idea is to provide a tool able to integrat a large variety of data (numerical values, documents, maps), to pool, update, cross, sort them and perform the necessary calculations to build strategic indicators in relation to a specific space. With a dedicated web site (http://www.oser70.com) users can submit / extract data from the platform and see indicators after statistical treatments. The indicators are returned in different forms of representation (dashboard, maps, graphs). A profile of territory may be continuously updated with data grouped by themes (population, housing, business, employment, household resources, ...). We offer here to discover the main functionalities of this tool.IAD-Informatique et le laboratoire ThéMA ont été mandatés par l'Agence Régionale de Développement de Franche- Comté pour concevoir et développer une solution technique d'observation socio-économique adaptée au contexte local. L'outil s'appuie sur une plateforme régionalisée de stockage de données, mutualisée entre les organismes producteurs et utilisateurs de l'information. L'objectif de l'outil développé est de permettre de : - mutualiser les ressources existantes ; - enrichir l'information socio-économique, tant quantitativement que qualitativement, en multipliant les sources génériques et spécialisées ; - capitaliser l'information socio-économique en la rendant accessible à un cercle élargi d'acteurs ; - favoriser l'émergence d'un réseau régional " d'intelligence territoriale ". L'idée de départ est donc de proposer un outil permettant d'intégrer des données (valeurs numériques, documents, cartes), de les mutualiser, de les mettre à jour, de pouvoir les croiser, les trier et d'effectuer les calculs nécessaires pour construire des indicateurs stratégiques en relation avec un territoire. Une interface web dédiée (http://www.oser70.com) permet de déposer/extraire les données de la plateforme et consulter des indicateurs issus de traitements statistiques. Les indicateurs sont restitués sous différentes formes de représentation (tableau de bord, profil de territoire, cartes, graphiques). Un profil de territoire peut ainsi être actualisé en permanence à partir de données regroupées par thèmes (population, habitat, entreprises, emploi, ressources des ménages, ...). Nous vous proposons de découvrir ici les principales fonctionnalités de cet outil