Laparoscopic Appendectomy in Children: Preliminary Study in Pediatric Hospital Albert Royer, Dakar

Appendiceal pathology’s management has benefited in recent years from the advent of laparoscopic surgery. This study is to make a preliminary assessment of laparoscopic management of acute and complicated appendicitis in children after a few months of practice at the University Hospital Albert Royer, Dakar. This is a retrospective study of 22 cases of patients, all operated on by the same surgeon. The parameters studied were age, sex, clinical data and laboratory features, radiological data, and results of surgical treatment. The mean age of patients was 9.5 years with a male predominance. The series includes 14 cases of acute appendicitis and 8 complicated cases. Appendectomy anterograde is practiced in 81% of cases. Appendectomy was associated with peritoneal wash in 17 patients including 9 cases of acute appendicitis. Drainage of Douglas pouch is performed in 2 patients with complicated appendicitis; the average production was 300 cc of turbid liquids and any complications were not founded. An abscess of Douglas pouch is noted in 2 patients with complicated appendicitis undrained. These Douglas abscesses were treated medically. No conversion of laparotomy was performed in the series. After an average of 8 months no other problems were noted

Chorologie, Ecologie et Usages des espèces sauvages apparentées aux légumes feuilles cultivées du genre Solanum L. au Sénégal : Cas de la zone des Niayes

Le genre Solanum est l'un des plus importants de la flore du Sénégal tant par sa richesse spécifique que par sa valeur socio-économique. Cependant, si les espèces cultivées font l’objet d’étude sous diverses formes, les sauvages sont fréquemment éliminées. L’étude vise à renseigner sur la chorologie, l’écologie et les usages des espèces sauvages apparentées de légumes feuilles cultivées. Des enquêtes ont été menées auprès des populations et les résultats obtenus ont été complétés par la recherche bibliographique et les informations mentionnées dans les parts d’herbier. L’étude révèle que ces espèces occupent des milieux divers. Au Sénégal, elles sont présentes dans toutes les zones agroécologiques avec une grande diversité dans la zone des Niayes. Elles se rencontrent aussi bien en milieux arides où la végétation est de type steppe qu’en milieux humides composées principalement de savanes et affectionnent mieux les sols ferrugineux tropicaux. L’étude ethnobotanique réalisée a révélé cinq types d’utilisation : médicinale (47,87%), alimentaire (27,66 %), culturelle (14,89%), fourragère 8,51% et artisanale 1,06%. Les organes affectés à ces utilisations sont la feuille (43,36%) suivie de la racine (30,97%), du fruit (24,78%) et de la tige (0,88%). La connaissance des espèces favorise une meilleure valorisation de celles qui vivent dans des écosystèmes en proie à une forte urbanisation.   The genus Solanum is one of the most important of the flora of Senegal both for its specific richness and its socio-economic value. However, while cultivated species are studied in various forms, wild species are frequently eliminated. The study aims to provide information on the chorology, ecology and uses of wild relatives of cultivated leafy vegetables. Population surveys were conducted and the results obtained were supplemented by literature search and information mentioned in the herbarium parts. The study revealed that these species occupy diverse environments. In Senegal, they are present in all agro-ecological zones with a great diversity in the Niayes zone. They are found in arid environments where the vegetation is steppe type as well as in humid environments composed mainly of savannah and are more fond of tropical ferruginous soils. The ethnobotanical study carried out revealed five types of use: medicinal (47.87%), food (27.66%), cultural (14.89%), fodder (8.51%) and artisanal (1.06%). The organs assigned to these uses are the leaf (43.36%) followed by the root (30.97%), the fruit (24.78%) and the stem (0.88%). The knowledge of the species favors a better valorization of those living in ecosystems in prey to a strong urbanization

Diversité Et Importance Socio-Economique Des Espèces Fruitières Sauvages Comestibles En Zone Kasa (Sud-Ouest Du Sénégal)

Wild fruit species provide local people with subsistence products and cash income. In addition to their food value, different used organs can, eventually, compromise the availability of these resources. This study aims to identify edible woody species in Kasa Zone and to analyze their socioeconomic importance. An ethnobotanical survey was conducted with 82 informants. Data collected were analyzed using Epi Info software and uses of species were classified into six categories. A Factorial Correspondence Analysis (FCA) highlighted species-organ relationships. Frequency of citations, fidelity index, selling price were used to show the socio-economic importance of the species. Results identified 62 edible species belonging to 31 families and 54 genera. These species were dominated by Annonaceae, Apocynaceae and generic diversity was more pronounced among Anacardiaceae. Identified species were mainly used for food (53%), energy (16%), technology (12%) and medicinal purposes (12%). The FCA showed three organ-use groups with a strong correlation between fruit and root on the one hand and leaf, bark and wood on the other. The study also identified 16 commercialized species. The fruit was the main organ consumed and marketed. The highest number of organs commercialized were recorded for Elaeis guineensis (4 organs) and Borassus aethiopium (3). These products, often collected and sold by women and children, came from villages and transited to markets through the "bana bana". Their prices depended on the locality isolation and the production period. These results open up perspectives for better management of the supply and commercialization of these forest resources

Gallstones: Management of the Sickle Cell Child

Gallstone is rare in children; however, sickle cell disease is associated with an increased risk of gallstone formation. We aimed to report particularity of diagnosis and management of gallstones in sickle cell children. We conducted a cross-sectional multicentric study in four hospitals of Dakar, in Senegal, during 18 years. We studied frequency, diagnostic particularities, management, and outcome. Among the 105 pediatric patients managed for gallstones, 87 (82.85%) had sickle cell disease. Among the latter, 18 (17.14%) were asymptomatic. Laparoscopic cholecystectomy was performed in 71 patients (67.62%). Following surgery, sickle cell patients were systematically hospitalized in the intensive care unit for 24 hours. Complications occurred in 7.6% and mortality in 1.9%. Gallstone is frequent in sickle cell children. Its management has good outcomes when taking in account particularities of these patients

Feasibility and safety of integrating mass drug administration for helminth control with seasonal malaria chemoprevention among Senegalese children: a randomized controlled, observer-blind trial

BACKGROUND: The overlap in the epidemiology of malaria and helminths has been identified as a potential area to exploit for the development of an integrated control strategy that may help to achieve elimination of malaria and helminths. A randomized, controlled, observer-blind trial was conducted to assess the feasibility and safety of combining mass drug administration (MDA) for schistosomiasis and soil transmitted helminths (STH) with seasonal malaria chemoprevention (SMC) among children living in Senegal. METHODS: Female and male children aged 1-14 years were randomized 1:1:1, to receive Vitamin A and Zinc on Day 0, followed by SMC drugs (sulfadoxine-pyrimethamine and amodiaquine) on Days 1-3 (control group); or praziquantel and Vitamin A on Day 0, followed by SMC drugs on Days 1-3 (treatment group 1); or albendazole and praziquantel on Day 0, followed by SMC drugs on Days 1-3 (treatment group 2). Safety assessment was performed by collecting adverse events from all children for six subsequent days following administration of the study drugs. Pre- and post-intervention, blood samples were collected for determination of haemoglobin concentration, malaria microscopy, and PCR assays. Stool samples were analyzed using Kato-Katz, Merthiolate-iodine-formalin and PCR methods. Urine filtration, PCR and circulating cathodic antigen tests were also performed. RESULTS: From 9 to 22 June 2022, 627 children aged 1-14 years were randomized into the three groups described above. Mild, transient vomiting was observed in 12.6% (26/206) of children in treatment group 2, in 10.6% (22/207) in group 1, and in 4.2% (9/214) in the control group (p = 0.005). Pre-intervention, the geometric mean value of Plasmodium falciparum parasite density was highest among children who received albendazole, praziquantel with SMC drugs. Post-intervention, the parasite density was highest among children who received SMC drugs only. Children who received praziquantel and SMC drugs had a lower risk of developing severe anaemia than their counterparts who received SMC drugs alone (OR = 0.81, 95% CI 0.13-5.00, p = 0.63). CONCLUSIONS: Integration of MDA for helminths with SMC drugs was safe and feasible among Senegalese children. These findings support further evaluation of the integrated control model. TRIAL REGISTRATION: The study is registered at Clinical Trial.gov NCT05354258

Provider and User Acceptability of Integrated Treatment for the Control of Malaria and Helminths in Saraya, South-Eastern Senegal.

Integration of vertical programs for the control of malaria, schistosomiasis, and soil-transmitted helminthiasis has been recommended to achieve elimination of malaria and neglected tropical diseases (NTD) by 2030. This qualitative study was conducted within the context of a randomized controlled trial to explore the perceptions and views of parents/caregivers of at-risk children and healthcare providers to determine their acceptability of the integrated malaria-helminth treatment approach. Randomly selected parents/caregivers of children enrolled in the trial, healthcare providers, trial staff, malaria, and NTD program managers were interviewed using purpose-designed topic guides. Transcripts obtained from the interviews were coded and common themes identified using content analysis were triangulated. Fifty-seven study participants comprising 26 parents/caregivers, 10 study children aged ≥ 10 years, 15 trial staff, four healthcare providers, and two managers from the Senegal Ministry of Health were interviewed. Thirty-eight of the participants (66.7%) were males, and their ages ranged from 10 to 65 years. Overall, the integrated malaria-helminth treatment approach was considered acceptable, but the study participants expressed concerns about the taste, smell, and side effects associated with amodiaquine and praziquantel in the combination package. Reluctance to accept the medications was also observed among children aged 10 to 14 years due to peer influence and gender-sensitive cultural beliefs. Addressing concerns about the taste and smell of amodiaquine and praziquantel is needed to optimize the uptake of the integrated treatment program. Also, culturally appropriate strategies need to be put in place to cater for the inclusion of children aged 10 to 14 years in this approach

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

Genotypic trade-offs between water productivity and weed competition under the system of rice intensification in the Sahel

Yield, water productivity and weed-inflicted Relative Yield Losses (RYL) under Recommended Management Practices (RMP) were compared with the System of Rice Intensification (SRI) under double-cropping for two seasons and at two locations in the Senegal River Valley. Seven genotypes from Oryza sativa and Oryza glaberrima species and their interspecific crosses, were grown under weed-free conditions and in competition with weeds. Weed-free grain yields in SRI were never significantly different than those obtained with RMP. An average of 27% (range 18–46%) less water was applied to SRI than required for continuous flooding in RMP, resulting in consistently higher water productivity with SRI. However, when subjected to weed competition, mean SRI yields were significantly lower than RMP in three of four experimental iterations (an average of 28% less). Across experiments, weed-inflicted RYL was greater in SRI than RMP in 81% of observed cases. Weeds reduced the water productivity enhancing benefits of SRI by an average of 38% compared to weed-free treatments, resulting in significantly lower water productivity with SRI in three of four experiments. Rice genotypes Jaya and Sahel-202 were identified as relatively weed-competitive under each crop management system, however both have intermediate-length cycles and required more irrigation than shorter-duration genotypes. When weeds are carefully controlled, good yields and significant water savings can be achieved with SRI. However, this specific requirement of careful weed control might be difficult to meet by farmers coping with high weed infestations or with limited access to tools, inputs or labor to address them. Weed-competitive genotypes could help reduce weed-inflicted yield losses associated with SRI and other water-saving rice production systems, though future breeding efforts should address the trade-offs between weed competitive traits, water productivity and crop duration to meet the needs of farmers practicing double rice cropping

Étude ethnotaxonomique des espèces fruitières spontanées comestibles chez l’ethnie Diola d’Oussouye (Sénégal)

Natural products of plant meet a renewed interest for a decade. However, climate change and human action have led to a degradation of the natural ecosystems and extinction for certain plant. This study contributes to a better knowledge of popular classification systems of spontaneous plants. Ethnobotanics survey based on an open semi structured interview, exchanges oral and direct observations were made in the field. They took place in 33 villages of Oussouye department which is the Diola’s bastion. They mobilized 82 informants including 30 groups and 52 individuals with male predominance. In fact, we had 80.77 % men against 19.23 % women. Our results showed that among 62 wild botanical species, only 4 were domesticated. They are for the greater part tree and bush, and are more present in the vegetable circles. The dominant families are Annonaceae and Apocynaceae and the most important use values are noted in Arecaceae with 10.52 and Anacardiaceae with 8 ; the generic diversity is mostly marked by Anacardiaceae. The population uses 17 classifications systems of nomination of plants. The classification “bu” is mostly used on localities such as : Huluf, Esulalu, Ejamat, Her and those of “ni”, “nu” in Dyiwat. In addition 7 tables reference are mentioned and order of importance are : use, animal, morphology, ecology onomatopoeia and metaphor. The results bring out different edible fruit species, the age group of people which master better the knowledge related to these plants and methods of popular classification

Étude ethnotaxonomique des espèces fruitières spontanées comestibles chez l’ethnie Diola d’Oussouye (Sénégal)

Les produits naturels végétaux connaissent un regain d’intérêt depuis des décennies. Toutefois, les changements climatiques et l’action humaine entrainent une dégradation des écosystèmes naturels et la disparition de certaines plantes. Cette étude contribue à une meilleure connaissance des systèmes de classification populaire des végétaux spontanés. Des enquêtes ethnobotaniques basées sur un guide d’entretien ouvert semi-structuré, des échanges oraux et des observations directes faites sur le terrain ont été menées. Elles se sont déroulées dans 33 villages du département d’Oussouye, fief des Diola. Elles ont mobilisé 82 informateurs dont 30 groupes et 52 individus avec une prédominance masculine de 80,77 % contre 19,23 % pour les femmes. Nos résultats ont montré que parmi les 62 espèces végétales, seules 4 sont domestiquées. Ces espèces sont en majorité des arbres et des arbustes et sont plus présentes dans les milieux potagers. Les familles dominantes sont les Annonaceae et Apocynaceae et les valeurs d’usage les plus importantes sont notées chez les Arecaceae avec 10,52 et les Anacardiaceae avec 8 ; la diversité générique est plus marquée chez les Anacardiaceae. La population utilise 17 classificateurs pour nommer les plantes. Le classificateur bu est majoritairement employé dans les localités An Alufay, Esulalu, Ejamat, Her et ceux de ni, nu dans Dyiwat. De plus 7 référentiels mentionnés et par ordre d’importance sont : usage, animal, propriété, morphologie, écologie, onomatopée et métaphore. Les résultats font ressortir différentes espèces fruitières comestibles, la tranche d’âge qui maitrise mieux les savoirs liés à ces plantes et les différents modes de classification populaire.Natural products of plant meet a renewed interest for a decade. However, climate change and human action have led to a degradation of the natural ecosystems and extinction for certain plant. This study contributes to a better knowledge of popular classification systems of spontaneous plants. Ethnobotanics survey based on an open semi structured interview, exchanges oral and direct observations were made in the field. They took place in 33 villages of Oussouye department which is the Diola’s bastion. They mobilized 82 informants including 30 groups and 52 individuals with male predominance. In fact, we had 80.77 % men against 19.23 % women. Our results showed that among 62 wild botanical species, only 4 were domesticated. They are for the greater part tree and bush, and are more present in the vegetable circles. The dominant families are Annonaceae and Apocynaceae and the most important use values are noted in Arecaceae with 10.52 and Anacardiaceae with 8; the generic diversity is mostly marked by Anacardiaceae. The population uses 17 classifications systems of nomination of plants. The classification “bu” is mostly used on localities such as: Huluf, Esulalu, Ejamat, Her and those of “ni”, “nu” in Dyiwat. In addition 7 tables reference are mentioned and order of importance are: use, animal, morphology, ecology onomatopoeia and metaphor. The results bring out different edible fruit species, the age group of people which master better the knowledge related to these plants and methods of popular classification