Assessing the Food Availability and Food Insecurity Situation among Communities of Matam Region, Senegal.

Matam is one of the poorest and most food-insecure regions of Senegal. In the past years, repeated environmental shocks such as drought have limited the access to food and it is unclear whether food insecurity is more a function of food availability (FA) and accessibility at the community level (CL) or more related to FA at the household level (HL). To better understand the FA and food security (FS) situation in this region, in 2018, a cross-sectional study was conducted in 103 households living in four villages. Through focus group discussions and direct observations, data on food available at HL and CL were collected as well as on food affordability and household FS. Overall, between 49 and 64 different foods, mostly from plant source, were identified. Around 75% of households had 0 to 3 foods and 7%, 7 to 10; 64% of all households were severely food insecure. FA at HL and its socioeconomic status were positively associated with household FS whereas FA at the CL was negatively associated. Although food assistance may be required to respond to shocks in the area, investments could be made to improve households` socioeconomic level to enhance their access to food.

Falling, Dying Sheep, and the Divine: Notes on Thick Therapeutics in Peri-Urban Senegal.

Peri-urban Senegal lies outside the influence of both the nation's historic public mental health model and contemporary global mental health. This paper examines how cultural logics in this underserved region spill over from social domains to widen the therapeutic sphere of psychoses and epilepsy. Observations and 60 carer and/or patient interviews concerning 36 patients afflicted by one or both conditions illustrate how the "crisis of the uncanny", a spectacular eruption of psychoses and seizures into the everyday, triggers trajectories across these domains. To resolve the crisis, patients and carers mobilize debts and obligations of extended kin and community, as well as a gift economy among strangers. The therapeutic and non-therapeutic are further linked through the semantics of falling, which associates this local term for the crisis with divine ecstasy and the slide from human to non-human forms of life. We introduce the concept of thick therapeutics to capture how the logics of sheep- other animal-human relationality, secular-divine politics of giving, and payment/sacrifice for healing imbue a therapeutic assemblage continually constructed through actions of patients, carers and healers. We ask what implications therapeutic thickening might have for mental health futures, such as monetized payment under global mental health.

When Cultural Norms Discourage Talking to Babies: Effectiveness of a Parenting Program in Rural Senegal.

In some areas of rural Africa, long-standing cultural traditions and beliefs may discourage parents from verbally engaging with their young children. This study assessed the effectiveness of a parenting program designed to encourage verbal engagement between caregivers and infants in Wolof-speaking villages in rural Senegal. Caregivers (n = 443) and their 4- to 31-month-old children were observed at baseline in 2013 and 1 year later at follow-up. Results showed that caregivers in program villages nearly doubled the amount of child-directed speech during a play session compared to baseline, whereas caregivers in matched comparison villages showed no change. After 1 year, children in program villages produced more utterances, and showed greater improvement in vocabulary and other language outcomes compared to children in comparison villages.

Delayed haemolysis after artesunate therapy in a cohort of patients with severe imported malaria due to Plasmodium falciparum.

INTRODUCTION: Delayed haemolytic anaemia is one of the more frequent events after treatment with intravenous artesunate in patients with severe malaria. Little is known about its frequency and the outcomes of patients with this condition. METHODS: A retrospective study was conducted to describe the incidence of delayed haemolysis in a cohort of patients with severe malaria by Plasmodium falciparum treated with artesunate between August 2013 and July 2015. RESULTS: The study included 52 patients with malaria due to Plasmodium falciparum, with 21 having severe malaria. The majority were male (66.7%), and the median age was 43 years. Four patients (19%) presented post-artesunate delayed haemolysis 11-13 days from the initiation of treatment. Two patients required hospital admission and red blood cell transfusion. CONCLUSION: Post-artesunate delayed haemolysis is frequent in patients with severe malaria treated with intravenous artemisinins. These patients should be monitored for 4 weeks after treatment is started.

Multistate modelling extended by behavioural rules: An application to migration.

We propose to extend demographic multistate models by adding a behavioural element: behavioural rules explain intentions and thus transitions. Our framework is inspired by the Theory of Planned Behaviour. We exemplify our approach with a model of migration from Senegal to France. Model parameters are determined using empirical data where available. Parameters for which no empirical correspondence exists are determined by calibration. Age- and period-specific migration rates are used for model validation. Our approach adds to the toolkit of demographic projection by allowing for shocks and social influence, which alter behaviour in non-linear ways, while sticking to the general framework of multistate modelling. Our simulations yield that higher income growth in Senegal leads to higher emigration rates in the medium term, while a decrease in fertility yields lower emigration rates.

[Generalized exanthematous pustular dermatophytid, a rare clinical presentation of dermatophytid reaction]. / La dermatophytide exanthématique et pustuleuse généralisée (DEPG), une présentation clinique rare de dermatophytide.

BACKGROUND: Dermatophytids are immunologically mediated dermatologic presentations secondary to sensitization to a dermatophyte infection. They are most frequently associated with toe-web intertrigo and usually present as localized, palmar, pruriginous vesicular eruptions. We report three original cases of generalized exanthematous pustular dermatophytid associated with kerions. PATIENTS: Two boys aged 11 and 6 years, and one girl aged 6 years initially presented with kerion secondary to Trichophyton tonsurans (case 1), Trichophyton soudanense (case 2) and Trichophyton mentagrophytes (case 3), respectively. Two to three days after initiation of griseofulvin treatment, all patients presented with a pustular eruption extending from the head to the trunk, associated in one case with fever of 39°C and inflammatory chondritis. Samples obtained from the pustular lesions were sterile, serum inflammatory markers were within the normal range and skin lesions resolved on oral corticosteroid treatment (prednisone 0.75 mg/kg, case 1) or high-potency topical steroids (cases 2 and 3) given as an adjunct to griseofulvin treatment (19 to 23 mg/kg/d). DISCUSSION: Dermatophytids occur during the acute phase of infection or within a few days of treatment initiation. Lesions are remote from the infection site, contain no dermatophyte, and resolve after treatment of the infection. We report three original cases of generalized exanthematous pustular dermatophytid, associated in one case with fever and inflammatory chondritis. The main differential diagnosis is acute generalized exanthematous pustulosis secondary to antifungal drugs. Differences in clinical presentation between the two enable the appropriate diagnosis to be made as well as continued use of the antifungal medication needed to cure the patient. General or topical steroids may also be used in combination.

[Sagittal photogrammetric evaluation of the soft tissue profile between two different racial groups: a comparative study]. / Caractéristiques photogrammétriques sagittales de profil des tissus mous chez deux groupes raciaux. Etude comparative.

INTRODUCTION: Facial soft-tissue analyses made from photographic records (photogrammetric analysis of the soft tissues) showed interracial dimorphism. Standard of these facial analyses, originally obtained from Caucasian might not be appropriate for the diagnosis and treatment planning of other groups of orthodontic patients. The purpose of this study was to compare the sagittal photogrammetric soft tissue profile characteristics between Senegalese and Moroccan adults. MATERIALS AND METHODS: A cross-sectional study was performed in a group of Senegalese and Moroccan students in the Faculty of Medicine, Pharmacy and Dentistry of Dakar. Standardized facial-profile photographs were taken with each student in natural head position, centric relation, and relaxed lip posture. Twenty four linear parameters were measured on paper sheet using a graduated ruler. For each variable mean and SD were calculated. In addition independent samples t-test was performed to detect sexual and racial dimorphism. Results were regarded as significant at p = 0.05. RESULTS: Senegalese subjects had significantly more lips protrusion than Moroccan who had significantly a more elongated and more anterior positioned nose, a more chin prominence and a tendency to cutaneous class II than Senegalese. CONCLUSION: Further studies including different age groups subjects would allow having longitudinal data according to age.

When phylogenetic analysis complements the epidemiological investigation: a case of HIV-2 infection, Italy.

Human immunodeficiency virus type 2 (HIV-2) infection is geographically restricted, affecting West African countries such as Guinea- Bissau and Cape Verde. We describe a recent case of HIV-2 infection in an Italian patient. Phylogenetic analysis of the V3 region of HIV-2 indicated that the Italian patient was infected by HIV-2 subtype A2. The sequence obtained from the Italian patient clustered significantly with a sequence isolated from Senegal. A phylogenetic doubt may arise from a Guinea Bissau sequence because it was in a major clade with the Italian and Senegal sequences, but was not statistically significant. The discovery of another Italian case over a short time frame stresses the importance of strengthening the surveillance system for HIV-2 because of the increase in migration from endemic areas to Italy.

Distribution of volumes of individual glomeruli in kidneys at autopsy: association with physical and clinical characteristics and with ethnic group.

We have demonstrated considerable variability in the volumes of different glomeruli in given individuals (individual glomerular volume: IGV) in a stereologic study of kidneys at forensic autopsy performed to investigate sudden or unexpected death in people without manifest kidney disease. We review some important associations of IGV by subject characteristics and by ethnic groups. IGVs were measured by the Cavalieri method in 30 glomeruli in each of 111 adult males who belonged to 4 ethnic groups, i.e. US Whites, African-Americans, Africans from Senegal, and Australian Aborigines. Correlations of pooled IGV values with certain subject characteristics were evaluated in the US Whites. Pooled IGV data were compared in subjects across the 4 ethnic groups. In US Whites, mean IGV and its variance were greater with higher age, lower nephron number, lower birth weight, and with gross obesity, hypertension and cardiovascular death. In comparisons by ethnic group, mean IGV and IGV ranges were higher in African-Americans and Australian Aborigines than in US Whites and African Senegalese subjects. We conclude that glomerular enlargement with volume heterogeneity marks more advanced age, relative nephron deficiency, lower birth weight, obesity, hypertension, and advanced cardiovascular disease. The findings in African-Americans and Australian Aborigines suggest that larger IGVs and volume heterogeneity might mark populations with accentuated susceptibility to hypertension and kidney disease, but the data need to be further examined in the context of the determining characteristics defined in the US Whites.

[Amicrobial pustulosis of the skin folds and autoimmune erythroblastopenia]. / Pustulose aseptique des plis et érythroblastopénie auto-immune.

INTRODUCTION: Amicrobial pustulosis of the skin folds represents a new entity within the spectrum of neutrophilic dermatoses. This disease is characterized by acute onset of pustular lesions in the skin folds, association with an autoimmune disorder, and improvement under systemic corticosteroids. OBSERVATION: A 24-year-old woman had been presenting pustular dermatosis for several months involving the inguinal folds and the scalp. The pustules coalesced to form oozing and crusting plaques. Eczematous lesions were located on the trunk. She also presented macrocytic anemia related to autoimmune erythroblastopenia. Bacteriological culture was negative. Antinuclear antibodies were found with anti-SSA specificity. Histopathological examination of a skin biopsy specimen showed pustules in the epidermis together with an inflammatory dermal infiltrate. Cutaneous direct immunofluorescence testing was negative. The patient responded to systemic corticosteroids. DISCUSSION: Thirty-six cases of amicrobial pustulosis of the skin folds have been reported in the literature. All but two previously reported patients were females with an autoimmune disorder (chiefly systemic lupus erythematosus). The clinical picture is characterized by aseptic pustular lesions of the major and minor skin folds of the scalp and the anogenital area associated with eczematous lesions. Diagnostic criteria have recently been proposed. This disease responds to systemic corticosteroids. We report a new case of amicrobial pustulosis of the skin folds associated with autoimmune erythroblastopenia, which to the best of our knowledge has been described only once in the literature.

[Mamadou or anxiety resulting from a departure for the European Eldorado]. / Mamadou ou l'angoisse d'un départ vers l'Eldorado européen.

Candidates for emigration are susceptible to a psychotic breakdown accompanied by feelings of guilt arising from abandoning their community of origin. The elimination of this guilt involves, essentially, a denial of identity with a touch of megalomania which makes treatment difficult.

Leprosy: report of a case with severe peripheral neuropathy.

Leprosy (Hansen's disease) is a chronic granulomatous infectious disease, caused by Mycobacterium leprae, with cutaneous and neurological manifestations. Leprosy is very rare in Europe but some cases are reported, especially among people coming from endemic areas. Here, we report a case of Hansen's disease and emphasize the importance of a prompt diagnosis and treatment also in non-endemic areas.

West African immigrant families from Mauritania and Senegal in Cincinnati: a cultural primer on children's health.

Similar to many cities in the US, the Greater Cincinnati area has recently had an increase in immigrants from other countries. In particular, there is a small but growing population of West African immigrants especially from Senegal and Mauritania. In order to better understand children's health of West African families in the Cincinnati area, in-depth, in-home narrative interviews were conducted with ten West African immigrant parents from Senegal and Mauritania. Four salient themes about cultural information related to children's health were derived from the qualitative analysis: (1) health care practice and expectations including barriers; (2) cultural values and identity; (3) health beliefs and traditions/customs; and (4) quality of life. It is essential that health care providers understand the nuances of working with West African immigrants including cultural differences, strengths, challenges and perceptions in order to provide these individuals with the most effective health care services.

Cross-cultural perceptions of facial resemblance between kin.

Humans use facial comparisons to identify their relatives and adjust their behavior accordingly. However, the mechanisms underlying the assessment of facial similarities are poorly known. Here, we investigate the role of exposure to particular faces for the detection of facial similarities by asking judges to detect parent-child pairs using faces from different origins. In a first phase, French and Senegalese judges assessed facial resemblance in French and Senegalese families. In a second phase, Senegalese judges who had immigrated to France, as well as French and Senegalese stationary judges, were asked to rate a second set of Senegalese and French families. The judges showed no differences in their ability to detect parent-child pairs in French and Senegalese families in both the first and second phases. For judges who changed their country of residence, the answer time and duration of stay in the new country were not associated with correct assignment rates. Our results suggest that exposure has a limited role in the ability to process facial resemblance in others, which contrasts with facial recognition processing. We also discuss whether processing facial similarities is a by-product of the facial recognition system or an evolved ability to assess kinship relationships.

Metrics of Survival: Post-Abortion Care and Reproductive Rights in Senegal.

Drawing on ethnographic fieldwork conducted in Senegal between 2010 and 2011, I demonstrate how health professionals have deployed indicators such as number of women and abortion type treated in government hospitals to demonstrate commitment to global mandates on reproductive rights. These indicators obscure discrimination against women suspected of illegal abortion as health workers negotiate obstetric treatment with the abortion law. By measuring hospitals' capacity to keep women with abortion complications alive, post-abortion care (PAC) indicators have normalized survival as a state of reproductive well-being.

Chylothorax in a patient with HIV-related Kaposi's sarcoma.

We present a case of a 33-year-old man with a background of HIV and Kaposi's sarcoma (KS), who presented with a right sided chylothorax. He was managed with percutaneous chest drainage and talc pleurodesis, in addition to his chemotherapy and antiretroviral therapy for KS and HIV, respectively. Good clinical control of the chylothorax remained 4 months post drainage. This case report summarises the approach to investigating and managing pleural effusion, and in particular chylothorax, in HIV patients.

Is the Incipient Community of Senegalese Emigrants to Spain in Favor of the Donation of Related Renal Live?

BACKGROUND: Senegalese populations are massively migrating to the southern parts of the European Union, especially Spain, France, and Italy. The attitude towards living kidney donation in this group is little known. The objective of this study was to analyze the attitude toward living kidney donation of subjects from the population of Senegalese residents in Spain. METHODS: The study subjects were the Senegalese population residing in Spain aged >15 years stratified according to age and sex, according to census data and immigrant support associations. The evaluation instrument used was an attitude questionnaire toward renal live transplant ("PCID-DVR" Rios: The questionnaire of the International Collaborative Donor Project about Living Kidney Donation ["Proyecto Colaborativo Internacional Donante sobre Donación de Vivo Renal" in Spanish] developed by Dr. Ríos). Support of African immigration associations was used to advise on the location of potential respondents. Fulfillment of the questionnaire was anonymous and self-administered. Verbal consent was requested for collaboration in the study. Student t tests, the χ2 test, Fisher exact test, and a logistic regression analysis were used in the statistical analysis. RESULTS: The study included 293 respondents. Overall, 62% (n = 181) were in favor of renal live donation (relatives and close friends); 38% (n = 112) did not consider the possibility of renal live donation or they had doubts. This attitude is not related to social variables or general information (P > .05). The variables associated with this attitude (P < .05) were related to the family environment (especially with the partner) and the risk assessment of donating a living kidney. CONCLUSIONS: Based on these results, the Senegalese population that has immigrated to Spain has a very unfriendly attitude toward renal live donation.