[Sexuality assessment of homozygous adult sickle cell patients with a history of priapism in Senegal]. / Évaluation de la sexualité des drépanocytaires adultes homozygotes ayant des antécédents de priapisme au Sénégal.

OBJECTIVES: The objective of this study was to evaluate the sexuality of SS sickle cell patients with a history of priapism. METHODS: This was a case-control study of adult SS sickle cell patients. The occurrence of priapism as well as the nature of the priapism had been investigated. The patients were subdivided into three groups: Group 1 (no priapism), Group 2 (intermittent priapism) and Group 3 (acute priapism). The patients' sexuality was studied using the IIEF-15 questionnaire. RESULTS: We interviewed 191 SS sickle cell patients. The mean age was 27.1±7.1 years. Priapism was observed in 43.5 %. Only 77 patients were eligible for the IIEF15 questionnaire. Groups 1 and 2 performed significantly better than group 3 on erectile function (EF) and orgasmic function (OF) scores. There was no significant difference in the EF and OF scores between groups 1 and 2. No significant difference was observed between the three groups for the scores of sexual desire (SD), intercourse satisfaction (IS), and overall satisfaction (OS). The impairment of erectile function in group 2 was related to the age of the first episode of priapism and the last episode. The impairment of erectile function in group 3 was related to the duration of evolution (P<0.05). CONCLUSION: This study shows that priapism is responsible for impaired erectile function in SS adult sickle cell patients. A program to prevent intermittent episodes of priapism should be put in place.

[Mycoses and antifungals: What is the situation in Senegal in the current context?] / Mycoses et antifongiques : quelle est la situation du Sénégal dans le contexte actuel ?

In the context of increasing incidence of fungal infections worldwide, the availability of antifungal drugs was studied in Senegal, a country with limited resources where diagnosis of invasive fungal infections is not often established by lack of specialists and/or diagnostic tools. After a background on the country's situation with regard to fungal infections and the drug distribution network in Senegal, a compilation of the various available antifungals was presented before concluding with recommendations to prepare for a situation that could allow to treat appropriately invasive mycoses.

Particle size and endosperm type of dry corn grain altered duodenal flow of B vitamins in lactating dairy cows.

The objective of the experiment was to determine if factors such as endosperm type (floury vs. vitreous) and particle size (fine vs. medium) of dry corn grain, known to affect starch digestibility in the rumen, modify apparent ruminal synthesis and duodenal flow of B vitamins in lactating dairy cows. Eight lactating multiparous Holstein cows equipped with rumen and duodenal cannulas were assigned randomly to a treatment sequence according to a 2 × 2 factorial arrangement in duplicate 4 × 4 Latin square design experiment. Duration of each experimental period was 21 d. When expressed per unit of dry matter intake (DMI), floury treatments increased duodenal flow and apparent ruminal synthesis of niacin and folates but tended to increase apparent degradation of thiamin in the rumen. Duodenal flow of thiamin, riboflavin, niacin, folates, and vitamin B12, expressed per unit of DMI, decreased with an increase in particle size. Similarly, apparent degradation of thiamin and riboflavin was greater and apparent synthesis of niacin, folates, and vitamin B12 was reduced when cows were fed coarser dry corn grain particles. Neither endosperm type nor particle size had an effect on duodenal flow and apparent ruminal synthesis of vitamin B6. Apparent ruminal syntheses, expressed per unit of DMI, of all studied B vitamins but thiamin were negatively correlated with apparent ruminal digestibility of neutral detergent fiber. Duodenal flow of microbial N was positively correlated with apparent ruminal synthesis of riboflavin, niacin, vitamin B6, and folates. Under the conditions of the present experiment, except for thiamin, the effects of factors increasing starch digestibility of dry corn grain in the rumen on the amounts of B vitamins available for absorption by the dairy cow seem to be mediated through differences on ruminal digestibility of neutral detergent fiber and, to a lesser extent, on duodenal microbial N flow.

Apparent ruminal synthesis of B vitamins in lactating dairy cows fed diets with different forage-to-concentrate ratios.

Effects of the forage-to-concentrate ratio on apparent ruminal synthesis of thiamine, riboflavin, niacin, vitamin B6, folates, and vitamin B12 were evaluated in an experiment using 14 ruminally and duodenally cannulated Holstein cows. The experiment was a crossover design with two 15-d treatment periods and a 14-d preliminary period in which cows were fed a diet intermediate in composition between the treatment diets. Treatments were diets containing low-forage (44.8% forage, 32.8% starch, 24.4% neutral detergent fiber) or high-forage (61.4% forage, 22.5% starch, 30.7% neutral detergent fiber) concentrations. Both diets were formulated with different proportions of the same ingredients. Concentrations of B vitamins were analyzed in feed and duodenal digesta. Apparent ruminal synthesis of each B vitamin was calculated as the duodenal flow minus the intake. The high-forage diet had the highest concentrations of riboflavin, niacin, vitamin B6, and folates, whereas the low-forage diet had the highest thiamine concentration. Vitamin B12 in the diets was under the level of detection. Consequently, despite a reduction in dry matter intake when the cows were fed the high-forage diet, increasing dietary forage concentration increased or tended to increase intakes of riboflavin, niacin, and vitamin B6 but reduced thiamine and folate intakes. Increasing dietary forage concentration reduced apparent ruminal degradation of thiamine and apparent ruminal synthesis of riboflavin, niacin, and folates and increased ruminal degradation of vitamin B6, but had no effect on ruminal synthesis of vitamin B12. As a consequence, increasing the forage-to-concentrate ratio had no effect on the amounts of thiamine, riboflavin, and vitamin B12 reaching the small intestine but decreased the amounts of niacin, vitamin B6, and folates available for absorption. Apparent ruminal syntheses of riboflavin, niacin, folates, and vitamin B12 were correlated positively with the amount of starch digested in the rumen and duodenal flow of microbial N, whereas these correlations were negative for thiamine. Apparent ruminal syntheses of thiamine and vitamin B6 were negatively correlated with their respective intakes, whereas folate intake was positively correlated with its synthesis in the rumen.

Effects of forage family on apparent ruminal synthesis of B vitamins in lactating dairy cows.

Effects of forage family (legume vs. grass) on apparent ruminal synthesis (ARS) and postruminal supply of B vitamins were evaluated in 2 experiments. Diets containing either alfalfa (AL) or orchardgrass (OG) silages as the sole forage were offered to ruminally and duodenally cannulated lactating Holstein cows in crossover design experiments. Experiment 1 compared diets containing AL and OG [~23% forage neutral detergent fiber (NDF) and ~27% total NDF] offered to 8 cows in two 15-d treatment periods. Experiment 2 compared diets containing AL and OG (~25% forage NDF and ~30% total NDF) offered to 13 cows in two 18-d treatment periods. Thiamin, riboflavin, niacin, vitamin B6, folates, and vitamin B12 were analyzed in feeds and duodenal digesta. Apparent ruminal synthesis was calculated as the duodenal flow of each vitamin minus its intake. Forage family affected B vitamin intakes, duodenal flow, and ARS. In both experiments, AL diets increased vitamin B6 and decreased folate intakes. In experiment 1, riboflavin and niacin intakes were greater with the OG diet, whereas in experiment 2 thiamin intake was greater but riboflavin intake was smaller with the OG diet. In spite of the low contribution of either silage to the dietary folate content, folate intake was greater with OG diets than AL due to the difference in soybean meal contribution between diets. Niacin and folate ARS were not affected by the forage family. Duodenal microbial nitrogen flow was positively correlated with ARS of riboflavin, niacin, vitamin B6, folates, and vitamin B12, but tended to be negatively correlated with thiamin ARS. Apparent ruminal synthesis of folates and vitamin B12 appear to be related to microbial biomass activity. Changes in nutrient composition of the diets likely affected the microbial population in the rumen and their B vitamin metabolism.

Colonization of the Mediterranean basin by the vector biting midge species Culicoides imicola: an old story.

Understanding the demographic history and genetic make-up of colonizing species is critical for inferring population sources and colonization routes. This is of main interest for designing accurate control measures in areas newly colonized by vector species of economically important pathogens. The biting midge Culicoides imicola is a major vector of orbiviruses to livestock. Historically, the distribution of this species was limited to the Afrotropical region. Entomological surveys first revealed the presence of C. imicola in the south of the Mediterranean basin by the 1970s. Following recurrent reports of massive bluetongue outbreaks since the 1990s, the presence of the species was confirmed in northern areas. In this study, we addressed the chronology and processes of C. imicola colonization in the Mediterranean basin. We characterized the genetic structure of its populations across Mediterranean and African regions using both mitochondrial and nuclear markers, and combined phylogeographical analyses with population genetics and approximate Bayesian computation. We found a west/east genetic differentiation between populations, occurring both within Africa and within the Mediterranean basin. We demonstrated that three of these groups had experienced demographic expansions in the Pleistocene, probably because of climate changes during this period. Finally, we showed that C. imicola could have colonized the Mediterranean basin in the Late Pleistocene or Early Holocene through a single event of introduction; however, we cannot exclude the hypothesis involving two routes of colonization. Thus, the recent bluetongue outbreaks are not linked to C. imicola colonization event, but rather to biological changes in the vector or the virus.

Importance of vector-borne infections in different production systems: bovine trypanosomosis and the innovation dynamics of livestock producers in Senegal.

In Senegal, a project has been undertaken to eradicate a population of tsetse flies (Glossina palpalis gambiensis) from a prime area for intensifying livestock production--the coastal region of Niayes. The project is intended to remove the constraint of trypanosomosis and allow the ecological intensification of cattle production. A cross-sectional analysis of ten case studies was the inductive phase of an assessment to gauge the impact of removing trypanosomosis on livestock production strategies. The methodology used was comprehensive analysis, with participatory epidemiology tools to understand farmers' rationales. The authors analysed the strategies of three main types of livestock producer (agro-pastoralists, mixed crop/livestock farmers and intensive dairy farmers). The strategies were in line with the farmers' goals and their ability to mobilise the socio-technical network. The risk management of trypanosomosis has been incorporated into livestock management practices through the use of trypanotolerant breeds, medical prophylaxis or placing livestock in low-risk areas. Removing the risk of disease would therefore have a major impact on decisions about the composition and strategic direction of herds. This change in the animal health environment would steer livestock production along different routes of intensification in a highly competitive environment. The indicators of innovation capacity revealed by this study will be used to quantitatively monitor various change scenarios, taking livestock producers' reasoning into account, in order to assess the socio-economic impact of eradicating the tsetse fly population in this area. The methodology presented in the study can be used to understand the impact of controlling other vector-borne infections on the innovation dynamics of livestock producers.

Implementing haemophilia care in Senegal, West Africa.

Despite significant progres on haemophilia care in developed world, this disease remains unknown in many sub-Saharan African countries. The objectives of this article were to report Senegalese experience on the management of haemophilia care through 18 years of follow-up. This cohort study included 140 patients (127 haemophilia A, 13 haemophilia B), followed in Dakar's haemophilia treatment centre from 1995 to 2012. Our study reported a prevalence of 2.3/100,000 male births, accounting for 11.6% of what is expected in Senegal. From the period 1995-2003 to 2004-2012, significant progress was seen including 67.9% increase in new patient's identification, 11.3 years reduction in mean age at diagnosis (from 15.5 to 4.2 years), lower mortality rate (from 15.3% to 6.8%) and age at death evolved from 6.5 to 23.3 years. Of the 50 haemophilia A patients who were tested for inhibitor presence, 10 were positive (eight severe and two moderate) that is prevalence of 20%. All patients were low responders since inhibitor titre was between 1.5 and 3.8 BU. Disabilities were seen in 36.5% of patients above 20 years old who had musculoskeletal sequels and 39% had no scholar or professional activities in our setting. Implementing haemophilia care in sub-Saharan Africa is a great challenge as this disease is not yet counted in national health problems in many countries. Lessons learned from this study show a significant improvement in diagnosis and prognosis parameters. This emphasizes the needs to set up such follow-up initiatives and to enhance medical and lay cooperation for better results.

[Relationship between bizygomatic width and the size of maxillary anterior teeth among young Senegalese black people recruited in army]. / Corrélation entre la distance bizygomatique et la largeur des dents antéromaxillaires chez les jeunes sénégalais mélanodermes recrutés dans le service militaire.

INTRODUCTION: Prosthetic teeth size and placement must be in perfect harmony with the bucco-facial structures for a successful and esthetic removable prosthesis. This study aimed to determine among young Senegalese black people facial index estimating maxillary central incisor width and distance between canine points starting from bizygomatic width. PATIENTS AND METHODS: 621 black Senegalese participated to this transversal study. Measurements were made using anthropometric slide caliper and electronic slide caliper. The comparative analysis was carried out by the test t of Student. The correlative analysis used the chi-square test. The risk of error was fixed at 5%. RESULTS: Positive correlations were found between variables. Distance between canine points was significantly (p = 0.000) correlated to bizygomatic width and central incisor width. Using bizygomatic width, the average dividing factors to estimate central incisor width and distance between canine points were respectively 15.13 and 3.75. CONCLUSION: Distance between canine points and central incisor width can be given starting from bizygomatic width, as guide of selecting maxillary anterior prosthetic teeth width.

[Correlations between colorimetric parameters of teeth, eyes and skin. Perspectives in the choice of tooth shade for complete denture]. / Correlations entre les parametres colorimétriques des dents, des yeux et de la peau. Perspectives dans le choix de la teinte des dents en prothèse adjointe complète.

Rehabilitation with complete denture include among other objectives, improvement of facial and dental esthetics. To these ends, the artificial teeth should mimic as far as possible, healthy and natural dentition. The main objective of this study was to investigate factors associated with tooth color among black African subjects. One hundred and two subjects (72 men and 30 women) were included in this investigation. The colorimetric parameters of their teeth as well as those of the conjunctiva of their eyes and skin were recorded from standardized photographs. Two software, Mesurim and Photoshop were used for that purpose. Univariate and linear regression analysis were run to assess the association between tooth color and the variables age, gender and colorimetric parameters of eyes and skin. It appears from the result of this study that tooth color was positively and significantly associated with age. Stepwise multiple regression analysis further revealed that tooth hue can be best predicted by a combination of skin complexion and brightness and eye lightness.

Adult groin hernia surgery in sub-Saharan Africa: a 20-year systematic review and meta-analysis.

PURPOSE: To realize a systematic review to evaluate groin hernia surgery for adults in sub-Saharan Africa. METHODS: We conducted a systematic review and meta-analysis, the primary objective of which was to determine the surgical techniques used for unilateral groin hernia surgery in sub-Saharan Africa. Studies published in the last 20 years were considered. A meta-analysis estimated the pooled prevalence with 95% confidence interval (CI) of mortality, chronic pain and recurrence. A subgroup analysis compared the rate of complications between complicated or uncomplicated hernia. RESULTS: We included 113 articles. The most used technique was Bassini in 40.1%, followed by Lichtenstein in 29.9% and Shouldice in 12.6%. The overall mortality rate was 0.6% (95% CI 0.4-0.9). The pooled recurrence rate was 1.4% (95% CI 1.05-1.9). The pooled rate of chronic pain was 2.7% (95% CI 1.9-3.7). We found that mortality rate for complicated hernias (6.4%) was higher compared to uncomplicated hernias (0.2%). This difference was statistically significant [p ≤ 0.001; OR = 47.7; 95 CI (27.2-83.47)]. CONCLUSION: This review showed that pure tissue repairs are the most used techniques with Bassini and Shouldice as leading procedures. The post-operative rates of recurrence and chronic pain are low. However, there is a high heterogeneity between studies than can underestimate these pooled prevalences. The consultation at complication stage remains frequent and associated with a higher mortality. Futures studies should focus on improving the quality of studies in terms of design and follow-up to increase the degree of evidence.

Infected urachal cyst in an adult, report of two observations.

INTRODUCTION: Urachus is an embryonic remnant that usually involutes before birth. Abnormal persistence of this structure gives embryologic malformation like an urachal cyst. Infection or malignancy degeneration can complicated it. CASE PRESENTATION: Case 1: We report 20 years old female patient consulted with acute abdominal pain. Clinical examination showed fever and infra-umbilical tender mass. The abdominal Computerized Tomography showed pelvic mass between umbilicus and bladder. The open laparotomy found infra-abdominal semi-solid mass. A complete resection was done and histological exam confirmed infected urachal cyst. Case 2: A 19 years old male patient presented with abdominal pain and fever. Physical examination found tenderness in lower abdomen. Biology revealed leukocytosis, and Ultrasonography found a heterogeneous infra-umbilical mass. Surgical exploration by mini-laparotomy found an abscess urachal cyst that is confirm by histological exam after complete resection. CLINICAL DISCUSSION: Urachal cyst in adult patient is rare. Clinical symptoms without complications are insignificant. Because of malignancy risk, adult urachal cyst are managed by surgery. CONCLUSION: Infection cyst is the most common complication of urachal cyst. Complete resection is recommended because of malignancy degeneration risk.

[Prevalence of child and teenage obesity in schools in Dakar]. / Prévalence de l'obésité de l'enfant et de l'adolescent en milieu scolaire à Dakar.

Obesity is currently viewed as a serious worldwide public health issue. In this survey, we aim to determine its prevalence among schoolchildren and teenagers in Dakar. The sample of our survey consisted of 2,356 students aged 11-17, including 1,110 boys and 1,246 girls. For each of them, we have calculated their body mass index. Based on the higher value of the norm of that index, referred to the 97th percentile of Rolland-Cachera MF's curves, we have identified obese students according to their age and sex. The prevalence of obesity within our sample is 9.34%, with 2.88% for boys and 6.46% for girls. It is at its peak in the age of 11, though there is no significance (p > 0.05) in its decrease (from age 12 to 17). There are significantly (p < 0.05) more obese students in "catholic private" schools than in "public" schools where schooling is free. Child and teenage obesity is a reality in Dakar schools. Consequently, it is advisable to determine its nationwide prevalence to take on its prevention as well as its cure.

[Prosthetic rehabilitation: needs in Senegalese dental offices]. / La réhabilitation prothétique: évaluation des besoins dans les cabinets dentaires du Sénégal.

Knowledge of dental prosthetic needs will develop strategies for prevention and treatment through a package of individual, community and professional policies. The aim of this study was to evaluate prosthetic needs in Senegalese dental offices. The survey was conducted among people aged 15 years and more attending Senegalese dental clinics. The mean number of missing teeth was 4.4. Only 55.3% of the sample expressed the need for dentures and 81.8% had a diagnosed need for prosthesis. A statistically significant difference was noticed between the needs diagnosed and the expressed needs (p < 0.0001). Finally, this study reveals that the need for prosthetic treatment is real in the Senegalese dental offices.

[Prevalence of halitosis in patients with dental prostheses in Senegal]. / Prevalence de l'halitose chez des patients sénégalais porteurs de prothèses dentaires.

INTRODUCTION: Bad breath is a disease affecting 25% of the world's population. Despite the widespread nature of this problem, people's knowledge about this condition is poor. OBJECTIVE: The purpose of this study was to determine the prevalence of halitosis in a cohort of 62 Senegalese subjects with dental prostheses. METHODS: Breath analysis was based on measurement of volatile sulfur compounds (VSC) using a halimeter. Halitosis was diagnosed ifVSC level was > or = 125 ppb. RESULTS: Mean VSC level was 157.7 +/- 152.6 ppb. The prevalence of halitosis was of 35.4% overall, 72.7% in persons with fixed dentures and of 27.3% in persons with removable prostheses. CONCLUSION: The relatively high prevalence of halitosis observed in this study indicates a need to enhance patient awareness of daily hygiene measures for dental prosthesis.

Physicochemical factors affecting the diversity and abundance of Afrotropical Culicoides species in larval habitats in Senegal.

Biting midges of the genus Culicoides (Diptera: Ceratopogonidae) are the biological vectors of arboviruses of global importance in animal health. We characterized the physicochemical parameters that determine the density and composition of the main Culicoides species of veterinary interest in larval habitats of the Niayes region of Senegal. For this purpose, we combined larval and substrate sampling in the field in different habitat types with adult emergence and physicochemical analyses in the laboratory. Three major habitat types were identified, conditioning the predominant species of Culicoides and pH and the amount of organic matter were positively correlated with the abundance of larvae and emerging Culicoides, as opposed to salinity. The diversity of emerging Culicoides was positively correlated with pH while it was negatively correlated with salinity. Culicoides distinctipennis was the predominant species in the larval habitat group of freshwater lake edges. In the larval habitat group of pond and puddle edges, C. oxystoma and C. nivosus were predominant; both species were again most abundant in the larval habitat group of saltwater lake edges. These variabilities in physicochemical parameters support the distribution of different Culicoides species in different habitat groups. These results make it possible to implement effective, selective and environmental-friendly control measures but also to improve current models for estimating the abundance of adult vector populations at a local scale.

The prevalence of African animal trypanosomoses and tsetse presence in Western Senegal.

In 2005, the Government of Senegal initiated a tsetse eradication campaign in the Niayes and La Petite Côte aiming at the removal of African Animal Trypanosomosis (AAT), which is one of the main constraints to the development of more effective cattle production systems. The target area has particular meteorological and ecological characteristics that provide great potential for animal production, but it is unfortunately still infested by the riverine tsetse species Glossina palpalis gambiensis Vanderplank (Diptera: Glossinidae). The tsetse project in Senegal has adopted an area-wide integrated pest management (AW-IPM) approach that targets the entire tsetse population within a delimited area. During the first phase of the programme, a feasibility study was conducted that included the collection of entomological, veterinary, population genetics, environmental and socioeconomic baseline data. This paper presents the parasitological and serological prevalence data of AAT in cattle residing inside and outside the tsetse-infested areas of the target zone prior to the control effort. At the herd level, a mean parasitological prevalence of 2.4% was observed, whereas a serological prevalence of 28.7%, 4.4%, and 0.3% was obtained for Trypanosoma vivax, T. congolense and T. brucei brucei, respectively. The observed infection risk was 3 times higher for T. congolense and T. vivax in the tsetse-infested than in the assumed tsetse-free areas. Moreover, AAT prevalence decreased significantly with distance from the nearest tsetse captured which indicated that cyclical transmission of the parasites by tsetse was predominant over mechanical transmission by numerous other biting flies present. The importance of these results for the development of a control strategy for the planned AW-IPM campaign is discussed.

[Spitting cobras: description of 2 cases in Djibouti]. / Cobras cracheurs: 2 observations à Djibouti.

The purpose of this report is to describe two cases involving ophthalmic exposure to venom from spitting cobras. Based on these cases, readers are reminded that eye injury can be prevented by low-cost treatment consisting of prompt, prolonged saline irrigation. This treatment also reduces pain.