[Epidemiological, clinical and forensic physical violence against women in Tambacounda (Senegal)]. / Aspects épidémiologiques, cliniques et judiciaires des violences physiques faites aux femmes dans la région de Tambacounda (Sénégal).

INTRODUCTION: To contribute to the fight against physical violence against women, this work aimed to make a 10-year review of cases treated at the Regional Court of Tambacounda. METHODOLOGY: This observational, retrospective, descriptive and analytical study was conducted from 15 October 2014 to 15 April 2015. It covered all the court records of victims of intentional injury from 2006 to 2015. The data was entered and analyzed using Epi info 3.3.2 software. RESULTS: In all, 113 cases were treated. The mean age was 26.5±10.08 years for victims versus 32.5±13.8 years for the aggressors. The victims were all female, and 77.9% of offenders were male. The assaults took place mostly during the day (57.5%), and especially in the homes of victims (61.0%), in the street (16.8%) in the bush (12.4%). The consultation period was less than 24hours for 54.9% of the victims. Clinical examination differentiated: fractures (15%); contusions (13.5%); penetrating wounds (10.6%); bruises (9.7%); eye injuries (7.9%); broken teeth (7.9%); diffuse pains (7.1%), 6.2% polytrauma (6.2%), and 5.3% of trauma on pregnancies. Among the violence, 33.6% were domestic; 11.5% were associated with rape (7.1%); psychological violence (3.6%); rape and death threat (1.8%). Rape was statistically more common among child victims [OR=10.7 (3.2-35.5)] and/or educated victims [OR=5.8 (1.7-19.9)] and aggression in the bush [OR=7.5 (2.2 to 14.2)]. The attackers were lonely and imprisoned in 94.7% and 73.5% of cases respectively. The sentence was firm imprisonment for 89.2% of cases. CONCLUSION: In Tambacounda, health and judicial authorities should enhance public awareness concerning the risk of violence. The extension of this type of study to the national level would have enabled better orientation of control strategies against this scourge.

Spermatological characteristics of Elstia stossichianum (Digenea, Mesometridae) from the intestine of the cow bream (Sarpa salpa) off Dakar, Senegal.

The current study was designed to increase the spermatological ultrastructural database on Digenea, thus contributing to the future establishment of phylogenetic relationships within this group based on ultrastructural characteristics of both spermiogenesis and spermatozoa. Spermiogenesis in Elstia stossichianum begins with the formation of a differentiation zone containing two centrioles, two striated rootlets, a nucleus, several mitochondria and an intercentriolar body constituted by seven electron-dense layers. Each centriole develops into a free flagellum growing orthogonally to the median cytoplasmic process. Proximo-distal fusion of the flagella with the median cytoplasmic process occurs after flagellar rotation. Both nucleus and mitochondria migrate before the complete proximo-distal fusion of both flagella with the median cytoplasmic process. Finally, the constriction of the ring of arched membranes gives rise to the young spermatozoon. The mature spermatozoon of E. stossichianum exhibits two axonemes of different length of the 9+'1' trepaxonematan pattern, a nucleus, a mitochondrion, two bundles of parallel cortical microtubules, external ornamentation of the plasma membrane, a lateral expansion, spine-like bodies, cytoplasmic ornamented buttons and granules of glycogen. The formation of cytoplasmic ornamented buttons during the final stages of spermiogenesis is reported here for the first time.

[Relationships between the dental arches measurements and the peak nasal inspiratory flow (PNIF): a cross sectional study on 78 Senegalese teenagers]. / Relations entre les mensurations des arcades dentaires et le débit nasal inspiratoire de pointe: etude transversale sur 78 adolescents Senegalais.

INTRODUCTION: Upper airways obstruction can result in the reduction of the transversal dimensions of the maxillary arch which affect the vertical and the sagittal dimensions. The PNIF measure is an objec- tive and cheap way to assess the upper airways permeability. The aim of this study was to determine the relationship between PNIF and dental arch sizes. MATERIALS AND METHODS: Seventy eight patients (40 girls and 38 boys) age ranged 10-15 years were included in this cross sectional study. The PNIF was measured with a Youlten peak flow meter (Clement Clarke International, London, United Kingdom). The sagittal, vertical and transversal dimensions of the dental arches were evaluated on dental casts with a digital caliper (Mitutoyo Corporation, Tokyo, Japan). T test was used to assess differences in PNIF and dental arches variables between subjects grouped according to sex (male and female). The Pearson's correlation coefficient was used to analyze the relationship between the dental arches sizes and the PNIF. The significance was set at p < 0.05. RESULTS: PNIF rate was higher in girls than in boys but the difference was not significant. There were sexual dimorphism regarding the anterior and total lengths of the upper arch, the total length of the lower arch and the maxillary intermolar width which are significantly more important for boys (p respectively equal to 0.05; 0.03; 0.04 and 0.04). The PNIF was significantly and negatively correlated with the total length of the upper arch (r = -0.25). The others measurements did not show significant correlation with PNIF. CONCLUSION: Others parameters are needed to complement the peak nasal inspiratory flow rate for the respiratory disorders related dental arches sizes abnormalities diagnosis.

[Access to intermittent preventive treatment (IPt) in a situation of abolition of user's fee: role of economic welfare]. / Accès au traitement préventif intermittent (TPI) dans une situation de gratuité : rôle du bien-être économique.

In Senegal, the free distribution of sulfadoxine pyrimethamine during antenatal care is recommended to remove the disparity in the context of intermittent preventive treatment against malaria. The objective of this study was thus to identify factors influencing access to treatment in a situation of abolition of user fees. It was a cross-sectional and analytical study. It covered a sample of 1906 women aged 15-49 years randomly selected during the national survey on malaria in Senegal. Data were collected during a personal interview. The economic well-being was measured from the characteristics of housing and durable goods. The multivariate analysis was performed using logistic regression. The average age was 27.94 ± 5.34, 64.27% resided in rural area and 71.8% had received no schooling. Among the surveyed women, 23% were in the poorest quintile, while 16.3% were in the richest. Intermittent preventive treatment was performed in 49.3%. IPt were made more in urban areas (OR 1.45 95% [1.17 to 1.72]). It increased with the level of education with an OR of 1.5 and 1.68 in primary and secondary. The completion of the IPt increased with economic welfare. The OR ranged from 1.44 to 2.95 in the second quintile to the richest. Free medication does not necessarily benefit poor people. Other accompanying measures must be developed to facilitate the distribution of drugs particularly at community level with the involvement of people.

[Knowledge, attitudes and practices related to STD and HIV/AIDS: men having sex with men in Senegal]. / Connaissances, attitudes et pratiques relatives aux IST/VIH/sida: cas des hommes ayant des rapports sexuels avec d'autres hommes au Sénégal.

BACKGROUND: This study aimed to review knowledge, attitudes and practices related to sexual transmitted diseases (STD) and HIV/AIDS among men who have sex with men (MSM) in Senegal. METHOD: The study was undertaken from February 1st to June 30th 2007, in three capitals cities in Senegal (one national, and two regional). It concerned the MSM that benefited from at least one of services of an MSM association. Studied variables included socio demographic characteristics, sexual practices, as well as knowledge and attitudes related to STDs and VIH/AIDS. Interviews took place during appointments obtained by direct phone call or by two MSM leaders intermediary. Data were seized and analyzed with Epi2000 Software. RESULTS: Among 245 registered MSM, 63 had a precise contact (address and/or phone number), and 49 aged in average of 25 years were investigated. Among them, one was illiterate, five studied Koran, seven Arab and 36 French. The socio-professional categories differentiated two officials, two merchants, one mechanic, one fighter, five artists, five restorers, seven tailors, 11 students, and 15 unemployed. The associations, to which 35 HSH belonged, were related to sexuality (66%), religion (20%), social matters (8%) and economy (6%). Sexual habits, according to anal intercourse, differentiated the "Ubbi" or receptive/passive (57%), the "Yoos" or incertif/active (25%), the "Ubbi/Yoos" who play the two roles (14%) and the "neitherUbbi/norYoos" who had other practices than anal (4%). Practices between men, concerned mutual strokes (100%), fellatio (61%) and anal intercourse (49%), counted 45% for remuneration, 35% of multi-unprotected partnership, and 12% of breaking condom. Practices with women were reported by 15 MSM (31%). Concerning STDs, at least one sign was reported by 43 MSM, one transmission way by 42, one mean of protection by 47; and the first recourse was a health system for 36 MSM. The test of HIV/AIDS screening was done by 38 HSH among which 30 withdrew the results. The "Ubby" adhered much more to associations, and practiced less unprotected vaginal intercourses and multi partnerships. CONCLUSION: Sexual relations between men, in Senegal, constitute a factor of propagation for STDs and HIV/AIDS. Beliefs, values, and popular reactions still limit the big principles (liberty, equality, solidarity, and participation) of preventive and curative care. Therefore, ethics and effectiveness must be conciliated to face more MSM needs, for a better health of the populations.

[Acceptability of implementation of mutual health in a Senegalese rural area]. / Acceptabilité de la mise en place de mutuelle de santé en milieu rural sénégalais.

UNLABELLED: Funding for healthcare poses a major problem in developing countries. The purpose of this study was to assess public perceptions toward the implementation of mutual healthcare coverage in rural Senegal. METHODS: A descriptive transversal study was conducted from 24/09/07 to 05/10/07 in a randomly selected sample of 208 heads of households living in the rural communities of Ngogom and Réfane. Data were collected by means of individual interviews and focus group discussions. Topics included population health, community solidarity, health insurance and implementation of mutual healthcare insurance. RESULTS: The sample population was 94% male, 91% married, 36% uneducated and 11% unemployed. Household income was irregular in 36% and 84% had no savings. In case of medical emergency, 43% relied on family for assistance, 36% had no recourse and 21% would have to contract, a loan. Nearly half the sample population, i.e., 46%, were familiar with the principle of mutual healthcare insurance and 98% wanted to join. The main reasons for wanting to join were to reduce medical costs (57%), improve access to care (25%) and build community solidarity (11%). In focus groups, people expressed the need for micro health insurance. Findings also showed good community dynamics and a tradition of pooling resources to implement collective activities. CONCLUSION: The public perception of mutual healthcare insurance is favorable. However, due to economic difficulties, support from political and health authorities will be needed.

[Factors determining the place of delivery in women who attended at least one antenatal consultation in a health facility (Senegal)]. / Facteurs déterminant le lieu d'accouchement chez des femmes ayant bénéficié au moins d'une consultation prénatale dans une structure sanitaire (Sénégal).

BACKGROUND: Home birth remains a major cause of maternal and neonatal deaths in Senegal. The objective of this study was to identify the determinants of home birth in women who attended at least one antenatal consultation during their last pregnancy. METHOD: The study was cross-sectional and analytical. It covered a sample of 380 women selected at random among those who have given birth in the last 12 months in the health district Gossas. Data were collected at home using a questionnaire during an interview after informed consent. Multiple logistic regression was used to explore the determinants of childbirth at home using the Andersen model. RESULTS: The mean age was 26.2 ± 6.1 years. Women were married (97.3%), illiterate (81.8%) and lived in rural areas (78.4%). Available means of transportation at home were car (7.6%), cart (62.9%) or none 29.5%. In addition, 52.2% of the women lived more than 5 km from a health facility. For 59.0% of the women, the prenatal exam was considered satisfactory. The prevalence of home birth was 24%. Factors related to birth at home are polygamous marriage (OR=2.04 [1.13-3.70]), lack of transportation (OR=2.11 [1.13-5.01]) and residence more than 5 km from a health facility (OR=2.68 [1.56-4.16]). Late (3.90 [2.30-6.65]) or low quality (4.27 [2.25-8.10]) prenatal exams were also risk factors. CONCLUSION: Home birth is linked to access to health facilities but also to the prenatal consultation. Particular emphasis should be placed on training health care providers to improve the quality of the patients in the structures.

[Traditional healers in the fight against HIV/AIDS infection in the health district of Fada N'Gourma (Burkina Faso)]. / Enquête sur le rôle des tradipraticiens de santé dans la lutte contre l'infection VIH/sida au Burkina Faso.

The purpose of this study was to evaluate collaboration between traditional healers (TH) and registered nurses (RN) in the care of people living with HIV (PLHIV) in the health district N'Gourma Fada, Burkina Faso. A survey was conducted among 26 RN, 33 TH working in the health district and 96 PLHIV under treatment at the Fada N'Gourma Regional Hospital. Survey data showed that only 9.1% had sound knowledge about HIV/AIDS and 18.2% about prevention methods. Conversely 84.8% had a good knowledge about clinical manifestations. Among TH, 84.8% claimed to refer patients to health facilities that provided no support for HIV/AIDS, 51.1% called for establishment of a framework of cooperation and 21.2% asked for reciprocity. Among nurses, 85.2% did not consider TH as part of the health community fighting against HIV/AIDS. Proposals focused on association of TH, frameworks of cooperation, and coordination of TH activities in the fight against HIV/AIDS.

[Care for elderly patients in Africa: Analysis of the financial implications of the SESAME plan on the budget of the regional hospital center in Thies, Senegal]. / Prise en charge des patients du 3e âge en Afrique: étude des implications financières du plan SESAME sur le budget du centre hospitalier régional de Thiès (Sénégal).

PURPOSE: The SESAME plan has been implemented at the Thies Regional Hospital Center (TRHC) for one year. The purpose of this study was to analyze the financial implications of the plan on the hospital budget for the sustainability of care for persons aged 60 and over. METHODS: This descriptive study included analysis of budget data from October 2006 to September 2007 plus information obtained by interviewing the accountant and head of SESAME plan. The number of patients managed, sources of CHRT funding, grants from various SESAME plan partners, and expenditures for each partner were determined. The weight of the SESAME plan in the CHRT operating budget was determined by calculating the ratio of the overall cost of care for elderly persons in relation to the hospital's revenues and SESAME grants. RESULTS: During the study period, the CHRT received a total of 17375 elderly persons including 89% with no pension or social security. The institute pension scheme (IPRES) covered 21% of the plan as compared to 79% for the state. Utilization plan grants in relation to funding source was 41% for IPRES and 124% for the State. The total cost of services provided to beneficiaries of the SESAME plan exceeded the aggregate amount by 26 083 847 CFA francs. The weight of the SESAME plan in the operating cost of the CHRT was 17%. CONCLUSION: Prefinancing a plan to cover elderly care in hospitals should be sufficient to prevent deficits from impacting negatively on the operating budget of the hospital.

[Rhegmatogenous retinal detachment: Topography of breaks and agreement with lincoff's rules]. / Décollement de rétine rhegmatogène : topographie des déhiscences et conformité aux lois de Lincoff.

PURPOSE: To study the topography of retinal breaks and their agreement with Lincoff's rules. MATERIALS AND METHODS: We performed a retrospective descriptive study of patients with recent rhegmatogenous retinal detachments followed on the ophthalmology service of Abass Ndao Hospital from January 2006 through December 2016. Patients with no prior retinal treatment were included. RESULTS: Over 11 years, we reviewed 97 patients with 107 eyes with retinal detachments. The mean age of our patients was 51.7 years, range 23-79 years. There were 69 male patients, for a male:female ratio of 2.46. Refraction revealed that 38.1% of patients were myopes. Fourteen percent (14%) of patients had experienced trauma to the eye with the detachment. The right eye was involved in 54.6% of patients. The onset was insidious in 54.6% of cases and sudden in 23.7% of cases. All patients had decreased visual acuity, associated with a scotoma in 26.8% of cases. Visual acuity was decreased to light perception through 7/10. In 64.9% of cases, Lincoff's rules were observed. DISCUSSION: Lincoff's rules are still relevant for localization of the breaks in retinal detachments. CONCLUSION: Diagnosis of a retinal detachment is an essential step, since it determines the treatment. Lincoff's rules still have a role in finding the retinal break in retinal detachments.

[Obstetric urogenital fistula (OUGF): cost analysis at the Niamey National Hospital (Niger)]. / Fistule urogénitale d'origine obstétricale (Fugo) : coût de la prise en charge à l'hôpital national de Niamey (Niger).

BACKGROUND: A program to eliminate obstetric urogenital fistula (OUGF) was set up on February 19, 2004 in Niger. Though the consultations were free of charge, there was a cost involved, which constitutes the objective of this study. METHOD: The data were obtained from a documentary study completed by discussions with the principal management participants and interviews targeting the women suffering from OUGF attending the national hospital of Niamey during the surgery sessions of April and November 2006. Cost assessment included all resources devoted to activities involved in the program: hospital stay, hygiene education, medical and surgical treatment, social rehabilitation interventions (preparation for revenue generating activities and return to residence). Data analysis was performed with Excel and Epi2000 software. Average cost per item and patient was determined. RESULTS: The cost of the stay at the National hospital of Niamey was 96,445 francs CFA divided between transportation (4,688), room and board (21,572), assistance bonus (3,708) and indirect costs (66,477). The hygiene education cost 194,140 francs CFA: 30,150 for human resources, 143,965 for material resources and 20,025 for operational costs. The medical and surgery treatment had a cost of 144,009 francs CFA divided between consultations (15,000), complementary explorations (44,900), surgical operation (50,000) and consumables (34,109). The preparation for revenue generating activities had a cost of 118,244 francs CFA including training for clothes dying (22,084), soap manufacture (46,160) and the financial supportive grant (50,000). The return to the community cost 295,000 francs CFA, included room and board (2,500), human resources (65,000) and material resources (227,500). Altogether, the cost of the OUGF program came up to 742,018 francs CFA for our sample (76% of women with revenue generating activity), and was assessed at a maximum of 781,362 francs CFA if none of the woman had a revenue generating activity, and a minimum of 729,594 francs CFA if all of them did. CONCLUSION: Without the free consultations, the high cost of the OUGF program at the national hospital of Niamey would be inaccessible to Nigerian women owing to poverty and ignorance. Because of this observation, a long-term program is warranted for the treatment of overt cases and the reduction of prevalence, to enable Nigerian women to contribute to the development activities of their country.

[Epidemiology of women suffering from obstetric fistula in Niger]. / Parcours de la femme souffrant de fistule obstétricale au Niger.

OBJECTIVE: The purpose of this epidemiological study was to determine factors influencing management of obstetrical fistula (OF) by attempting to understand the itinerary followed by women suffering from OF in Niger. Study was carried out during the surgery session that took place at the Niamey National Hospital from April 18 to 29, 2006. Study variables were socioeconomic profile, obstetric/surgical history, support resources, and level of education. Four trained investigators using a specially designed questionnaire carried out patient interviews. Data were analyzed using the Epi Info 3.3.1 software package. A total of 91 patients with average age of 27.30 years (+/- 8.94) were interviewed. Most patients had no schooling (95%), came from the southwest region of the country (85%), and belonged to the Djerma ethnic group (52%). Most were married (76%) or divorced (19%). In the majority of cases the age at the time of marriage and first childbirth was under 18 years (76% and 55% respectively). The delivery that resulted in OF was the first in 59%, took place in a health care facility in 88%, lasted more than 24 hours in 97%, and took place by the vaginal route in 71%. The delay for the first medical visit was at least 3 months in most cases (66%) usually due to a lack of awareness of treatment availability, or to unavailability of transportation. Most patients had a history of surgery (63%) and were unaware of the probable date of the treatment (99%) with many waiting more than 3 months (44%). Prevention of gainful activity was 4.79 times more frequent after occurrence of OF. Management of OF requires not only qualified personnel but also and especially access to the quality obstetric care and greater awareness among the population. Education for girls is a crucial factor for a better health in Niger.

[Ametropia among senegalese children in a hospital setting]. / Amétropie de l'enfant sénégalais en milieu hospitalier.

INTRODUCTION: Ametropia is common in children and cause strabismus and amblyopia. The goal was to establish its prevalence in a hospital setting among Senegalese children. PATIENTS AND METHODS: This was a retrospective study of patients under 15 years of age with clear ocular media. The marital status, circumstances of discovery, and results of cycloplegic refraction were recorded. RESULTS: Of 1506 children, 175 demonstrated ametropia. The mean age was 8 years, and the male : female ratio was 0.68. Family history of ametropia was present in 8.5 %. Decreased VA was present in 39.66 %, headache 10.06 %, and strabismus 4.47 %. Automated refraction in 109 patients and skiascopy in one patient showed 58.18 % cases of myopia, 18.18 % of hyperopia and 36.57 % of astigmatism. DISCUSSION: The most common ametropia was myopia. Patients were referred for symptomatic ametropia. CONCLUSION: Screening for ametropia might occur earlier if it is associated with pediatric monitoring in our regions.

[Role of CT in diagnosis and monitoring of retinoblastoma in Senegal]. / Apport de la TDM dans le diagnostic et le suivi du retinoblastome au Sénégal.

INTRODUCTION: Retinoblastoma is a malignant tumor of neuroepithelial origin, developed from young retinal cells, occurring in infants and young children. The goal of the study was to assess the role of CT in the diagnosis of retinoblastoma at the Aristide le Dantec Hospital in Dakar. PATIENTS AND METHODS: This is an 11-year retrospective study of 160 patient records in the ophthalmology department and pediatric oncology unit of the same hospital. RESULTS: One hundred and sixty (160) patients were recruited. The male:female ratio was 1.05. The mean age was 32.19 months. Leukocoria was the most common clinical sign, occurring in 105 cases (65.62 %). The retinoblastoma was intraocular in 97 cases (60.62 %). We saw 122 (76.25 %) unilateral and 3 (1.87 %) trilateral presentations. CT was performed in 150 children with 110 cases (73.33 %) of calcifications ; 62 cases (41.33 %) of optic nerve invasion ; 24 cases (16 %) of extraocular muscle invasion and 18 cases (12 %) endocranial extension. Associated tumors were found on CT: 2 cases of suprasellar mass and 1 case of pineoblastoma. In patients whose specimens were analyzed, histology showed 48.15 % optic nerve invasion, consistent with the CT findings. DISCUSSION: CT has an important role in the diagnosis of retinoblastoma, despite its recent contraindication in bilateral and unilateral multinodular forms. CONCLUSION: CT is a good alternative to MRI in the diagnosis of retinoblastoma in developing countries with limited technological resources.

[Evaluation of mean macular thickness by optical coherence tomography (SD OCT) in black Senegalese subjects]. / Évaluation de l'épaisseur maculaire moyenne par la tomographie en cohérence optique (SD OCT) chez le sujet mélanoderme sénégalais.

INTRODUCTION: Our goal was to evaluate the normal macular thickness in Blacks by OCT and to determine socio-demographic and clinical parameters which may influence it. MATERIALS AND METHODS: This was a multicenter, prospective, descriptive study over 6 months. It included Black adults followed in the ophthalmology departments of Abass Ndao and Aristide-Le-Dantec hospitals in Dakar. Included subjects had corrected visual acuity of 10/10 (0 logMAR) and P2 (+0.1 logMAR), clear ocular media, and no retinal abnormalities. We used the Topcon 3D 2000 OCT to measure the central thicknesses of the cornea (CT) and of the macula (MT), and cup to disc ratio (C/D) in each eye. Socio-demographic, clinical and tomographic data were collected on a survey form and correlated to the MT. The analysis was carried out by the Epi info 7 software. We used the Chi2 comparison test with a P value˂0.05. RESULTS: One hundred and nine patients were included. The mean age was 27.39 years with a male/female ratio of 0.65. The subjects were emmetropic in 54.13% of cases. The mean CT was 519.97µm, the mean C/D was 0.23, and the mean MT was 264.35µm. The P-value (P) was greater than or equal to 0.1 for all the factors studied. CONCLUSION: MT in our study was lower than that of Whites, and the various parameters studied did not demonstrate a statistically significant influence on MT.

[Giant retinal tears: Senegalese experience]. / Aspect thérapeutique des déchirures géantes de la rétine : expérience sénégalaise.

PURPOSE: To appreciate the epidemiological characteristics and to show the therapeutic aspects of the giant retinal tears. PATIENTS AND METHODS: We conducted a retrospective study from January 2014 to June 2017 on subjects with giant retinal tears. Patients with media opacities limiting examination were excluded. RESULTS: We identified 17 cases of giant retinal tears. The frequency of detachments related to a giant retinal tear was 17% compared to all retinal tears. The mean age was 50.75 years with a sex ratio (M/F) of 6.5. We found three cases of high myopia, one case of hyperopia and four trauma cases. All patients had a decrease in visual acuity. The average time to consultation was four weeks. The mean intraocular pressure was 8mmHg. The tear was found in the left eye in eight cases and in the right eye in five cases; two cases were bilateral. We performed intraocular surgery in five eyes and laser in four eyes. We achieved anatomical reattachment and functional improvement in all operated patients. COMMENTS AND CONCLUSION: The prognosis of a giant retinal tear remains guarded, especially if patients are seen and treated late. Laser photocoagulation of giant tears remains effective, especially in cases of early diagnosis.

[HIV/AIDS prevalence among the attendees at the Center for Voluntary Anonymous Detection and Support in Pikine/Guediawaye, Senegal]. / Prévalence du VIH/sida chez les clients du Centre de Dépistage Volontaire Anonyme et d'Accompagnement de Pikine/Guédiawaye, au Sénégal.

Within the framework of HIV/AIDS epidemic control, a Center for Voluntary Anonymous Detection and Support (CDVAA) was opened in March 2003 in Pikine/Guediawaye, Senegal. The purpose of this study was to analyze the prevalence of the HIV infection among attendees at the center over a one-year period as a basis for targeting the services of the CDVAA towards improving public health. This retrospective epidemiological study based on analysis of CDVAA attendee records was carried out from April 8, 2003 to April 7, 2004. The CDVAA in Pikine/Guediawaye shares premises with the Departmental Center for Popular and Sports Education. Sampling was exhaustive with inclusion of all people that attended the CDVAA during the study period. Study variables were age, sex, family status, educational level, ethnic group, religion, reason for detection, knowledge about HIV/AIDS prevention methods, results of the test, and, in case of infection, acceptance/refusal of referral to an appropriate management facility. Data were computed and analyzed using EpiInfo 6.04d software. The most common reason for detection was curiosity to know serologic status (69%). Test results were positive in 3% of cases. Infection was due to HIV1 in 65% of cases, HIV2 in 24%, and both (HIV1-HIV2 co-infection) in 11%. Ninety-one percent of attendees that underwent testing returned to pick-up their results. Sixty-eight percent of attendees that tested positive accepted referral to an appropriate management facility. HIV infection was significantly more frequent in attendees who were 24 years old, married, or illiterate and in attendees reporting risky behavior. To further encouraging progress already achieved, the CDVAA must improve the quality of its services and promote its activities as a means of familiarizing the target population on prevention of sexual transmitted diseases and HIV/AIDS, with a particular focus on safe behavior.

[Clinical and angiographical findings of age-related macular degeneration in Senegal. Preliminary results]. / Aspects cliniques et angiofluorographiques de la degenerescence maculaire liee a l'age au Senegal. Résultats préliminaires.

INTRODUCTION: Principal cause of legal blindness in industrialized countries, age-related macular degeneration (ARMD) have never been studied in West Africa. We report and analyse the clinical and angiographical characteristics of macular degeneration in our patients older than 50 years. MATERIAL AND METHODS: In this prospective study, we recruited during 13 months all patients presenting ARMD signs from our consultation department. Various clinic and angiography parameters were collected. The follow up varied between 6 and 20 months. RESULTS: The prevalence of this pathology was of 6.5 per 1000. Sex ratio was 0.36 and mean age 61.6 years (53 to 80 years). No familial history of ARMD was found. Three patients were more exposed to sun because of their profession, 9 had high blood pressure, 6 were hyperopes and 1 was smoking. A drop of visual acuity was noted in all cases but no metamorphopsies. Signs founded were miliar drusen (20 eyes), serous drusen (4 eyes), association of those two kinds (4 eyes) and retinal pigmented epithelium abnormalities (PE) (8 eyes) alone or associated with drusen. These signs were significant of age-related maculopathy (ARM). The fluorescein angiography confirmed the type of lesions and showed no signs of neovascularization. An aggravation of the pigment migration was noted in one case after 20 months. CONCLUSION: Age related macular degeneration doesn't seem frequent in our population of patients and shows essentially under its initial form of ARM even though facilitating factors seemed identical, excepted tobacco addiction, sun exposition and systemic hypertension. This study which short terms results we are presenting would need to be continue to give more precisions on those data.

Savanna chimpanzee (Pan troglodytes verus) nesting ecology at Bagnomba (Kedougou, Senegal).

We studied the nesting behavior of the critically endangered West African chimpanzee (Pan troglodytes verus). We assumed that the nesting data stemmed from a single, unhabituated community at the Bagnomba hill site in the savanna-woodlands of southeastern Senegal. The aim of this study was to examine chimpanzees' nesting habits in terms of the tree species utilized and sleeping nest heights. We recorded a total of 550 chimpanzee nests at Bagnomba between January 2015 and December 2015. The chimpanzees here made nests in particular tree species more often than others. The majority of nests (63%) were in two tree species: Diospyros mespiliformis and Pterocarpus erinaceus. The average height of nesting trees was 10.54 m (SD 3.91, range, 0.0-29.0 m) and average nest height was 7.90 m (SD 3.62, range, 0.0-25.0 m). The result of a linear regression analysis (r = 0.7874; n = 550; p < 0.05) is consistent with a preference for nesting at a particular height. Bagnomba chimpanzees rarely made ground nests (0.36% of nests), but the presence of any ground nesting was unexpected, given that at least one leopard (Panthera pardus) also occupied the hill. This knowledge will enable stakeholders involved in the protection of chimpanzees specifically and of biodiversity in general to better understand chimpanzee ecology and inform a conservation action plan in Senegal where the survival of this species is threatened.

[Perception of ocular blinding manifestations of sickle cell disease by practitioners in Dakar university hospital]. / Perception des lésions oculaires cécitantes de la drépanocytose par les praticiens hospitalo-universitaire de Dakar.

INTRODUCTION: In Senegal, 10% of the population are said to be carriers of hemoglobin S, the most widespread hemoglobinopathy in the world. It is responsible for potentially blinding ophthalmological manifestations. Few practitioners refer patients for ophthalmologic screening. The goal of our study was to assess the level of knowledge of practitioners of the blinding ocular lesions of sickle cell disease. MATERIALS AND METHODS: A cross-sectional prospective study was carried out over five months. It included Dakar university hospital practitioners aside from ophthalmologists. On the survey form, each practitioner specified his or her specialty and responded to eight questions regarding sickle cell patients seen in consultation, knowledge of the blinding lesions related to the disease, and ocular monitoring for blinding systemic diseases. The practitioners were divided into three groups: department of medicine and medical specialties (group I), surgery and surgical specialties (group II), and biology and functional testing (group III). The descriptive analysis was done with the EPI-INFO software version 6.04. RESULTS: The participation rate was 45.88%. Group I represented 45.29% of the sample, Group II 35.85% and Group III 18.86%. In all, 87.73% of practitioners saw sickle cell patients in consultation, 75.47% were aware of ocular involvement related to sickle cell disease, and 58.49% were aware of blinding lesions. 94.62% of practitioners saw sickle cell disease patients without systematically recommending ophthalmological consultation. CONCLUSION: Practitioners' level of knowledge of the blinding ocular lesions of sickle cell disease is considered to be low.