Evaluation De La Denutrition Chez Les Enfants Ages De 2 A 60 Mois Hospitalises Aux Services De Pediatrie Des Hopitaux De Ziguinchor (Senegal)

Introduction: Malnutrition is a public health problem in developing countries. The prevalence of malnutrition at the national level hardly reflects the reality in hospitals. It is in this context that we assessed the nutritional status of children from 2 months to 5 years hospitalized in the pediatric ward of the regional hospital and the Ziguinchor Peace Hospital. Materials and methods: This was a prospective study from June 1 to October 30, 2016. Children aged 2 to 60 months, hospitalized in one of the two services, were included. Children with esdato-ascetic syndrome were not included. Epidemiological, anthropometric data, and associated diagnosis were studied. Results: We included 114 children (70 boys and 44 girls). The average age was 21.9 months [4-59]. Forty-two point one percent (42.1%) of infants <6 months were breastfed exclusively with breast milk. The weaning of children was done early in 55.3%. The mean age of mothers was 26.6 years [17-38]. The socioeconomic level was low in 62.3% of cases. The prevalence of malnutrition averaged 35.5% for underweight; 32.9% for wasting and 32.0% for stunting. Acute respiratory infections (ARI) and acute gastroenteritis were the most common associated conditions. Mean hospital stay was 8 days ± 009 [3-28]. About two thirds of the patients (n = 72) had a hospital stay of more than 7 days. Malnutrition was significantly associated with multiparity, low socioeconomic status, hospital stay of more than 7 days and infectious diseases. Conclusion: Infections and a hospital stay longer than a week are factors favoring malnutrition in children from 2 months to 5 years

Anemia among Apparently Healthy Senegalese Children Aged 9-15 Months

In Senegal, despite its high frequency, there is no real program to fight against anemia among infants. This work was carried out in the Dakar suburb from 1st September, 2009 to 27th January, 2010 among apparently healthy children aged 9-15 months at the time of their immunization against yellow fever and measles. They showed no known chronic condition or acute infection at the time of the survey. The objectives were to study the diet, prevalence, type and risk factors of anemia. The questionnaire was about whether the father and the mother were working and about the children’s diet during the first six months of their life. All the children underwent anthropometric measurements (weight and height) and a complete blood count. We considered children as anemic if the hemoglobin rate was below 11g/dl. Of the 245 children, 212 were anemic, which was a prevalence of 86.5%. This anemia, frequently of the microcytic hypochromic type (68. 86%) was significantly (p < 0.0003) observed among the children of housewives compared with those whose mothers were employed. Among anemic children, 60.8% were only taking breast milk with or without cereal porridge as a food supplement. The absence of consumption of protein, vegetables, fruits and dairy products was a risk factor for the occurrence of anemia (p <0.0001). In total, at the time immunization is stopped, almost all Senegalese children, while apparently healthy, still face nutritional anemia. The adverse consequences of anemia on child health require the implementation in developing countries of a specific program of struggle against anemia. The activity of vaccination might be the best opportunity to provide the nutritional education these mothers need

Contribution of Dehydration and Malnutrition to the Mortality of Children 0-59 Month of Age in a Senegalese Pediatric Hospital

In-hospital mortality is an indicator of the quality of care. We analyzed the mortality of under five years children of Pediatric ward of Aristide Le Dantec teaching hospital to update our data, after an previous study conducted ten years earlier.Methods: This was a retrospective study involving children 0-59 months of age, hospitalized from January 1, 2012 to December 31, 2012.For each child, nutritional status was assessed according to 2006 World Health Organization growth standards; clinical and biological data were recorded. The outcome of the disease was specified. Bivariate and multivariable were used to identify risk factors for death.Results: 393 children were included. Overall mortality rate was 10% (39/393). Factors associated with death were severe wasting [OR = 8.27, 95% CI [3.79-18], male gender (OR = 2.98, 95% CI [1.25-7.1]), dehydration (OR = 5.4, 95% CI [2.54-13.43]) in the model using the weight-for- height z score, male gender (OR = 2.5, 95% CI [1.11-5.63]), dehydration (OR = 8.43, 95% CI [3.83-18.5]) in using the height- for- age z score, male gender (OR = 2.7, 95% CI [1.19-6.24]), dehydration (OR = 7.5, 95% CI [3.39-16.76]), severe underweight (OR = 2.4, 95% CI [1.11-5.63]), in the model using the weight-for- age z score, and male gender (OR = 2.5, 95% CI [1.11-5.63]), dehydration (OR = 8.43, 95% CI [3.83-18.5]) in that using MUAC.Dehydration and malnutrition are two independent factors of mortality. Our management protocols of dehydration and malnutrition have to be updated. Screening malnutrition has to be done systematically for each child by anthropometric measurements using WHO growth standards

Évaluation de la qualité des semences de coton sur la base des tests préliminaires au laboratoire de trois sites de multiplication dans le bassin cotonnier du Sénégal

Les semences de coton constituent un important facteur de production dont la maîtrise conditionne le rendement de la culture. Son approvisionnement dans ce cadre est caractérisé par un système de production de qualité, revêt une importance stratégique et constitue un préalable indispensable à toute action d'amélioration des rendements de la filière cotonnière sénégalaise. A chaque cycle de multiplication, des risques de contaminations peuvent entraîner la baisse de la qualité d’où l’objectif de mettre en place des mécanismes de tests préliminaires permettant d’évaluer la variabilité des différents paramètres afin de caractériser le comportement de chaque lot de semences issue des zones de multiplication. L’expérimentation a été réalisée entre 2018, 2019 et 2020 sur les semences multipliées dans les sites de Kédougou, Linkering et Pakour. Les résultats de cette étude ont montré des différences significatives sur la qualité des semences en fonction des sites et des années de production. La forte corrélation entre les différents paramètres de qualité montre la pertinence de l’évaluation du seed index, le pourcentage de graines immatures et le taux de graine en amandes parasitées pour une bonne appréciation sur le choix de la qualité des semences vêtues destinées à l’unité de délintage. Les semences issues de la zone de Kédougou ont donné les meilleurs résultats sur chacun des paramètres par rapport à celles de Linkering et de Pakour, nonobstant un niveau de parasitisme important (près de 15%) constaté en fin de campagne qui a fait chuter le taux de germination à 80% suite à un triage inadéquat de la table densimétrique causé par un seed index très élevé entre 2018 et 2019. L’évolution du taux de germination de la semence de Linkering et Pakour à 85% montre l’impact positif du délintage sur la qualité de la semence et du bon triage adéquat de la table quand le seed index est faible. La récolte précoce du coton graine, la fertilisation, le suivi de l’itinéraire technique, les traitements insecticides appliqués entre l’éclatement des capsules et la récolte ainsi que la maîtrise du réglage de la table permettront de mieux gérer la qualité des semences de coton au Sénégal. Mots clés: Semence, coton, délintage, table densimétrique, seed index, parasitisme, Sénéga

Nutritional status of HIV-infected patients during the first year HAART in two West African cohorts

Objective: To examine the association between nutritional markers at initiation and during follow up in two different cohorts of HIV-infected adults initiating highly active antiretroviral therapy (HAART) in West Africa. Methods: The ATARAO study was a one year prospective study carried in Mali. It consisted of a sample of consecutive patients initiating HAART in one of four participating centers during that period. Data were collected at time of treatment initiation (baseline) and every 3 months thereafter. The ANRS 1290 study followed Senegalese patients recruited in similar conditions. Bivariate analyses were used to identify nutritional and immunological covariates of malnutrition at baseline. Longitudinal trajectories of body mass index, hemoglobin and albumin, and their associated factors, were evaluated using mixed linear models. Results: In ATARAO, 250 participants were retained for analyses; of which, 36% had a BMI < 18.5 kg/m2, nearly 60% were anemic and 47.4% hypoalbuminemic at time of treatment initiation. At baseline, low hemoglobin, hypoalbuminemia and low CD4 levels were associated with a BMI < 18.5 kg/m2. Similarly, low BMI, low albumin and low CD4 counts were linked to anemia; while, hypoalbuminemia was associated with low hemoglobin levels and CD4 counts. In ANRS, out of the 372 participants retained for analyses, 31% had a low BMI and almost 70% were anemic. At baseline, low BMI was associated with low hemoglobin levels and CD4 counts, while anemia was associated with low CD4 counts and female sex. While treatment contributed to early gains in BMI, hemoglobin and albumin in the first 6 months of treatment, initial improvements plateaued or subsided thereafter. Despite HAART, malnutrition persisted in both cohorts after one year, especially in those who were anemic, hypoalbuminemic or had a low BMI at baseline. Conclusion: In ATARAO and ANRS, malnutrition was common across all indicators (BMI, hemoglobin, albumin) and persisted despite treatment. Low BMI, anemia and hypoalbuminemia were associated with attrition, and with a deficient nutritional and immunological status at baseline, as well as during treatment. In spite of therapy, malnutrition is associated with negative clinical and treatment outcomes which suggests that HAART may not be sufficient to address co-existing nutritional deficiencies

Une lesion cutanée persistante non cicatricielle depuis 3 ans: le pyoderma gangrenosum

Le pyoderma gangrenosum (PG) est une dermatose neutrophilique non infectieuse rare souvent méconnue. Il se présente généralement par des ulcérations cutanées inflammatoires, très douloureuses et d'évolution rapide. Il est fréquemment retrouvé dans un contexte de néoplasie, de pathologies inflammatoires digestives, rhumatologiques et/ou hématologiques. Son diagnostic est très souvent tardif après de multiples échecs thérapeutiques. Nous rapportons un cas de pyoderma gangrenosum dont le diagnostic n'a pas été criant. Un patient a été admis dans notre service pour une lésion dermatologique persistante et d'évolution défavorable malgré les débridements et l'administration d'antibiotiques. Il était suivi pour un cancer de la prostate, une hypertension artérielle et un asthme. Du fait des anomalies biologiques observées telles qu'une hyperleucocytose à polynucléaires neutrophiles avec myélémie à myélocytes et métamyélocytes, sans blastose sanguine et une anémie normochrome normocytaire, une leucémie myéloïde chronique a été évoquée chez ce patient. Elle a par la suite été infirmée devant les différents examens complémentaires non concluants. C'est ainsi que le diagnostic de PG a été évoqué et confirmé à l'examen anatomopathologique montrant un aspect histopathologique d'un tissu de granulation concordant avec un pyoderma gangrenosum et une absence de signe histologique de malignité. L'institution d'un traitement à base de corticothérapie a abouti à la guérison

Tuberculose intestinale révélée par une occlusion intestinale aigüe au cours d’une réaction paradoxale au traitement anti-tuberculeux chez un patient immunocompétent: à propos d’un cas et revue de la littérature

La tuberculose intestinale représente 3 à 5% de toutes les localisations viscérales. Malgré l'efficacité démontrée des anti-tuberculeux, des cas d'exacerbation du tableau clinique initial ont été décrits à l'initiation du traitement. Ces réactions dites «paradoxales» sont cependant rarement rapportées chez les immunocompétents et beaucoup moins sous forme d'occlusion intestinale. Nous rapportons un cas de tuberculose intestinale révélée par une occlusion intestinale aigüe au cours d'une réaction paradoxale aux anti-tuberculeux. Il s'agit d'un patient de 26 ans, immunocompétent qui a présenté un syndrome occlusif à un mois de traitement d'une tuberculose pleuro-pulmonaire. La tomodensitométrie (TDM) abdominale était en faveur d'une occlusion intestinale grêlique. La laparotomie objectivait une masse intra-péritonéale avec de multiples adhérences. L'examen anatomopathologique de la pièce opératoire était en faveur d'une tuberculose intestinale. L'évolution était favorable après la poursuite du traitement anti-tuberculeux initial

Description of the cattle and small ruminants trade network in Senegal and implication for the surveillance of animal diseases

Livestock mobility, particularly that of small and large ruminants, is one of the main pillars of production and trade in West Africa: livestock is moved around in search of better grazing or sold in markets for domestic consumption and for festival-related activities. These movements cover several thousand kilometers and have the capability of connecting the whole West African region, thus facilitating the diffusion of many animal and zoonotic diseases. Several factors shape mobility patterns even in normal years and surveillance systems need to account for such changes. In this paper, we present an approach based on temporal network theory to identify possible sentinel locations, i.e., locations where pathogens circulation can be detected in the early phase of the epidemic (before the peak), using two indicators: vulnerability (i.e., the probability of being reached by the disease) and time of infection (i.e., the time of first arrival of the disease). Using these indicators in our structural analysis of the changing network enabled us to identify a set of nodes that could be used in an early warning system. As a case study, we simulated the introduction of transboundary animal diseases in Senegal and used data taken from 2020 Sanitary certificates (laissez-passer sanitaire (LPS)) issued by the Senegalese Veterinary Services to reconstruct the national mobility network. Our analysis showed that a static approach can significantly overestimate the speed and the extent of disease propagation, whereas temporal analysis revealed that the reachability and vulnerability of the different administrative departments (used as nodes of the mobility network) change over the course of the year. For this reason, several sets of sentinel nodes were identified in different periods of the year, underlining the role of temporality in shaping patterns of disease diffusion

Economic assessment of animal disease burden in Senegalese small ruminants.

Small ruminant production in sub-Saharan Africa is limited by a range of constraints, including animal health issues. This study aimed at estimating the impact of these issues on the small ruminant production in Senegal in a holistic manner, using an approach developed by the Global Burden of Animal Diseases (GBADs) programme. The estimation focused on the mixed crop-livestock system, representing a large proportion (>60 %) of the small ruminant population in the country. It was based on existing data collected via a systematic literature review, acquisition of secondary datasets from local stakeholders, and expert elicitation. A dynamic population model was used to calculate the gross margin of the sector under both the current health constraints and an ideal health state, where animals are not exposed to causes of morbidity and mortality. The difference between the current and ideal health scenarios, termed the Animal Health Loss Envelope (AHLE), provides a quantitative measure of the farm-level cost of disease in the system. The all-cause AHLE was estimated at 292 billion FCFA (468 million USD, with 95 % prediction interval 216 - 366 billion FCFA) per year for 2022, for a population of 8.8 million animals. The contribution of Peste des Petits Ruminants (PPR) was modelled separately, as an example of attributing part of the AHLE to a specific disease cause. PPR was estimated to contribute 5 % of the total AHLE. The animal disease burden experienced by Senegalese livestock keepers was largely due to loss in animals and production, with relatively small amounts of animal health expenditure. Implementation of this study contributed to the further development of the GBADs approach. Such estimates can support decision making at all levels, from investment decisions at the international level to local disease awareness campaigns targeting livestock keepers