[Myeloradiculitis due to Schistosoma haematobium: about an observation in Dakar (Senegal)]. / Myéloradiculite à Schistosoma haematobium : à propos d'une observation à Dakar (Sénégal).

Nervous localisations of schistosomiasis are rare. We report the case of a 25 year-old Senegalese patient admitted for a progressive myeloradiculitis onset, over a one week period. The diagnosis of Schistosoma haematobium myeloradiculitis was made in front of a positive serum serology for S. haematobium, presence of S. haematobium eggs in urine, hyperproteinorachia, endemicity of S. haematobium in the region where the patient was originating and a past medical history of macroscopic hematuria in a context of river bathing. There was also no arguments for another cause to these neurological manifestations. Our patient was treated with praziquantel, prednisone and physiotherapy. Evolution was marked 6 weeks after the beginning of treatment by a significant improvement of motor deficit, enabling the patient to walk again. There was also a regression of genitosphincter dysfunction. Work-up for patients presenting with paraplegia in tropical countries, should also include search for S. heamatobium infection.

[Quality assurance set-up in a blood transfusion facility: the experience of the National Blood Transfusion Center of Mali]. / Mise en Place de L'Assurance Qualite dans un Etablissement de Transfusion Sanguine: L'Experience du Centre National de Transfusion Sanguine du Mali.

AIM: The aim of this study was to help National Center for Blood Transfusion of Bamako in implementation of a quality assurance system. MATERIALS AND METHODS: Study was conducted in 2007 and 2008 at the National Center for Blood Transfusion of Mali in Bamako. We first evaluated the state of the quality system and studied the Knowledge, Attitude and Practices of the staff about quality assurance then carried out an plan of actions. We also made a check out of 2 critical processes in Blood transfusion: the whole blood collection process in fixed cabin and the temperature-monitored storage facilities for blood and reagents. RESULT: From the analysis of the state of assurance quality system, we found numerous failures. A policy of quality and guidelines for blood transfusion were absent. Most of the mains procedures and the flow chart of the center were also lacking. Sixty six of the personnel were aware about the notion of quality assurance and 36.7% were trained in this matter. The plan of actions was executed at 57.4%. Several failures were recorded in the processes of blood collection and in the temperature-monitored storage system. Corrective actions should be taken by training the staff in application of procedures. CONCLUSION: Despite of the great progress made in implementation of quality assurance at the CNTS of Mali, some insufficiencies were remaining. Development of quality system across all the stages of the blood transfusion chain is vital for CNTS. This require an adoption of national blood policy.

[Perceptions and motivations of public sector physicians in Dakar (Senegal)]. / Perception de la motivation chez les médecins du secteur public de la région de Dakar (Sénégal).

INTRODUCTION: To guide the human resources department within the Ministry of Health to optimize their capacities and skills, this study sought to evaluate perceptions and motivations among public sector physicians in the Dakar region, in Senegal. METHOD: This descriptive study included 246 of the 307 public sector physicians in Dakar (80.1%). They were interviewed by three investigators, using a pretested and revised questionnaire. Three categories of variables were studied: social, demographic and professional (remuneration, work conditions, involvement in decision-making, career perspectives, key motivating factors). Data were entered and analyzed with Epi Info 3.3.2 software, and averages and frequencies were calculated. RESULTS: The physicians' mean age was 41.7 years, and they had been practicing for a mean of 11 years: 26% were women, 82% married, 74% hospital staff physicians, and 88% general practitioners. 77% considered their remuneration insufficient; all had additional income, which 48% judged insignificant and 19% irregular. Most lived in a rented home (50%); and only 45% had a personal car. Overall, 55% reported the work environmental as poor, and 65% considered the department's equipment and supplies insufficient. Relationships with their supervisors were good for 37%, with colleagues 62%, with subordinates 51%, and with patients 54%. Overall, 23% reported no involvement in decision-making, and 60% no involvement in designing or setting up health programs. Letters of congratulations from supervisors, considered important by 96%, were obtained only by 59%. Ten percent of doctors belonged to a political party, 13% to a syndicate (union), and 25% to an association. Globally, 83% participated in continuing medical education; and 93% wanted specialist training. Their priorities for their professional careers were: management (27%), autonomy (25%), solidarity (23%), security (13%), and creativity (12%). In decreasing order of frequency, the key factors motivating them were: the work environment (41%), remuneration (38%), promotion (12%), and involvement in the planning process (9%). DISCUSSION-CONCLUSION: The primary motivating factors were not satisfactory for public sector physicians in the Dakar region, which the bulk of public sector resources are concentrated. Its performance affects the global results of the national health system. Recommendations for action by the State, by supervisors, and by medical personnel, concerning the work environment and remuneration might help to improve population health in Senegal.