Risk management and communication in informal dairy sector in Côte d’Ivoire: Options for sustainable livelihoods

Intervention in food and nutrition was the best investment for our collective future in terms of managing co-morbidity in population. This investment should combine agricultural system with health and education. Fermented dairy products (FDP) played an important role for prolonged shelf life, microbial safety and nutrition. FDP was proved to be contaminated in Kenya, Somalia, Mali and Côte d'Ivoire by foodborne pathogens including Staphylococcus aureus and Escherichia coli. Recently, it was showed that FDP was predominated by a novel Streptococcus infantarius subsp. infantarius (Sii) variant. Sii-produced bacteriocin and fermentation activity could contribute to the suppression of pathogens and possibly mitigate socioeconomic and health risks. However, Sii as member of Streptococcus bovis group was associated with human and animal infections. Therefore, a potential application of Sii as adapted African starter culture for enhanced food safety required a thorough safety assessment. In order to improve hygiene and quality as well as to increase production for school canteens, urban consumption and sustainable livelihoods, a cross-sectional study was conducted in Korhogo (Côte d’Ivoire) from May to August 2014. The objective was to assess local technologies and the dairy value chain in relation to Sii prevalence, followed by a participatory stakeholder workshop to validate findings and derive adapted interventions. The study showed that the dairy value chain contributed to livelihoods and household income. About 90% of milk produced (range: 12-44 liters/collector) were sold via collectors, generating 6-20 Euros per day shared among herder, collector and vendor. The remaining 10% were consumed within the household. However, dairy production was low and scattered due to informal practices resulting in poor quality product. Basic hygiene such as cleaning, washing, disinfecting was lacking. Milk quality depreciated with the local practices, access to clean water and energy. Future interventions identified by stakeholders comprised (i) awareness on local dairy hygiene and nutritional value for the population especially school children, (ii) stakeholders organization around cooperative to develop sustainable dairy model (public dairy with private management); (iii) promote healthy milk products for school canteen programme in Korhogo through adapted local dairy technology

Psterior urethral valves (PUV) in neonates: which treatment should be applied in Africa? Experience of the university Hospital, Treichville

Objective: African studies on posterior urethral valves (PUV) are rare. Early diagnosis and treatment of this pathology in sub-Saharan Africa are difficult. This study was carried out to describe – based on our experience – the diagnostic and therapeutic problems of PUV in Africa and to determine an adequate management in the neonate. Patients and Methods: This is a retrospective study based on 25 files of neonates treated at the Department of Pediatric Surgery, University Hospital of Treichville, Abidjan, Ivory Coast, between 1987 and 2002. The children's age ranged from 1 to 27 days. They were admitted for pre-natally diagnosed PUV in 2, post-natally diagnosed PUV in 2, acute urinary retention in 6, dysuria in 12, hematuria in 2 and abdominal mass in 1 patient. Treatment consisted of suprapubic catheterization (Cystocath®) in 4, vesicostomy in 11 and endoscopic resection in 10 cases. Results: Of the 4 patients treated with suprapubic catheterization, 2 were lost to follow up and 2 died. Vesicostomy showed a favorable outcome in 9 patients, while 2 patients died. Nine of the 10 patients treated by endoscopic resection showed a satisfactory outcome; the remaining patient died. The 9 patients that had survived vesicostomy were then subjected to endoscopic resection of the PUV. Mean follow up was 17 months (range 6 months – 3 years). After resection of the valves two of the 18 children that had survived were lost to follow up, while the 16 remaining ones were followed up for more than one year. Conclusion: In our environment, mortality associated with complications of posterior urethral valves is still high. It could be reduced by early diagnosis and endoscopic resection of the valves in the neonate. Urinary diversion may be a life-saving procedure in severe cases. Antenatal surgery is not yet applicable in our working environment. On the other hand, it is not likely to improve renal function. The renal function has to be regularly checked until adulthood to avoid renal insufficiency.African Journal of Urology Vol. 12 (4) 2006: pp. 193-19