[Factors associated with the practice of exclusive breastfeeding among mothers of children aged 6 to 12 months in Kaolack (Senegal)]. / Facteurs associés à la pratique de l´allaitement maternel exclusif chez les mères d´enfants âgés de 6 à 12 mois dans la commune de Kaolack (Sénégal).

Introduction: the World Health Organization (WHO) recommends immediate and exclusive breastfeeding in order to reduce malnutrition and neonatal mortality. The purpose of this study was to determine the prevalence of exclusive breastfeeding (EBF) and to identify its associated factors among mothers of children aged 6 to 12 months in Kaolack. Method: we conducted a cross-sectional descriptive and analytical study. The study was conducted from July 8th, 2020 to February 8th, 2021. Multivariate analysis was performed using the logistic regression model. The target population consisted of mothers of children aged 6 to 12 months residing in the city of Kaolack and met during vaccination sessions. Results: a total of 400 women were enrolled in the study. Among them, 51.8% practiced EBF according to the WHO recommendations. The average age of mothers was 27.42 years; 56.3% were housewives and 82.7% have done at least 4 antenatal care (ANC). Logistic regression showed an association between EBF and the following factors: age < 25 years (OR=2.03 CI 95% [1.23-3.36]), receiving advice on EBF during ANCs (OR=2.92 CI 95% [1.70-5.01]), receiving advice on EBF during postnatal care (PNC) (OR=4.33 CI 95% [2.51-7.45]), the permanent presence of mother with her baby (OR=3.97 CI 95% [1.99-7.91]), and a good knowledge of EBF (OR=4.54 CI 95% [1.96-10.51]). Conclusion: these modifiable factors can help improve the practice of EBF in the city of Kaolack.

Assessment of potentially preventable hospitalizations in the regional hospital of Saint-Louis, Senegal.

INTRODUCTION: The "potentially preventable hospitalizations (PPH)'' are hospital admissions that could have been avoided through effective primary care given at the appropriate time. Non-communicable diseases (NCDs), causes of PPH, are the leading cause of death worldwide with significant socioeconomic consequences especially in developing countries. This study aimed to assess the burden of potentially preventable hospitalizations in the St. Louis regional hospital. METHODS: This was a descriptive cross-sectional study. The surveyed population consisted of all patients older than one year, admitted to St. Louis hospital for more than four (04) hours time between January 20 and April 30, 2015. Patients hospitalized in surgery (general surgery, ENT, ophthalmology), maternity and neonatology, as well as those who refused or were unable to participate in the study were excluded. RESULTS: The study included one hundred forty four (144) individuals with an average age of 54.68±15 years (17-88 years) and sex ratio woman/man of 1.21. The PPH represented 54% of all hospitalizations. The main causes of hospitalizations were diabetes with 22.1%, chronic kidney disease 12%, hypertension 10.9%, Stroke 6.4% and finally broncho-pulmonary diseases 2.6%. The average length of stay was 6.68±5.51 days. The average distance between the residence and the hospital was 26.51±60KM with a median of 3.5KM. The average cost of care was Euros 104.583 ±83.51. For 61.10%, it was a first hospitalization and for 30.60%, a second one. The Knowledge about signs of disease severity had changed significantly at the end of hospitalization, from 29% at the beginning to 98% at the end of stay in hospital. As for the means of prevention, 30.55% reported knowing them before their hospitalization and 68% after hospitalization. CONCLUSION: Potentially preventable hospitalizations are a heavy burden for the population of St. Louis. Their negative social and economic impacts may hinder health policies initiated to relieve vulnerable groups. Their prevention should be a national priority.

An Alternative Strategy of Preventive Control of Tick-Borne Relapsing Fever in Rural Areas of Sine-Saloum, Senegal.

In Senegal, tick-borne relapsing fever (TBRF) is a major cause of morbidity and a neglected public health problem. Borreliosis cases commonly detected in two villages led us to implement a borreliosis preventive control including cementing of floors in bedrooms and outbuildings attended by inhabitants to avoid human contacts with tick vectors. Epidemiological and medical monitoring of the TBRF incidence was carried out at Dielmo and Ndiop by testing the blood of febrile patients since 1990 and 1993, respectively. Intra-domiciliary habitat conditions were improved by cementing, coupled with accompanying measures, from March 2013 to September 2015. Application of this strategy was associated with a significant reduction of borreliosis incidence. This was more evident in Dielmo, dropping from 10.55 to 2.63 cases per 100 person-years (P < 0.001), than in Ndiop where it changed from 3.79 to 1.39 cases per 100 person-years (P < 0.001). Thirty-six cases of TBRF were estimated to be prevented at a cost of €526 per infection. The preventive control strategy was successful in Dielmo and Ndiop, being associated with decreased incidence by 89.8% and 81.5%, respectively, suggesting that TBRF may be widely decreased when the population is involved. Public health authorities or any development stakeholders should adopt this effective tool for promoting rural health through national prevention programs.

[Sesame Health Programme at Senegal: Limitations of this free healthcare model]. / Plan Sésame au Sénégal : limites de ce modèle de gratuité.

INTRODUCTION: Up until now, elderly people have experienced medical management difficulties despite the free care provided by the Sesame Health Programme. The objective of this study was to determine the costs borne by beneficiaries and/or their families and to evaluate these costs in relation to overall management. This comprehensive, cross-sectional, quantitative study was conducted from 21 February to 21 March 2011 in the Ouakam gerontology centre. METHODS: Epi Info Version 6 software was used for data analysis. The study population was composed of 203 patients with a mean age of 68 years, with 59% of women and 63% of retired subjects. The most common diseases were hypertension (52%), cataract (16%), and osteoarthritis (12%). RESULTS: The beneficiaries healthcare costs were covered by the Sesame Health Programme, apart from most of the drugs used to treat chronic diseases, which remained at the charge of patients and/or their families. The overall mean cost of monthly management of the diseases detected in elderly people was estimated to be CFA 37,700, a large share of which (65%) was supported by the patient and/or the family corresponding to the purchase of these drugs. Other dysfunctions were also observed, particularly the difficulty of targeting beneficiaries, generic stock shortages, absence of generics for the treatment of chronic diseases. CONCLUSION: Recommendations are formulated to improve implementation of the Sesame Health Programme.

Influence of ultrasonic frequency on Swan band sonoluminescence and sonochemical activity in aqueous tert-butyl alcohol solutions.

The multibubble sonoluminescence (MBSL) spectra of t-BuOH aqueous solutions submitted to power ultrasound at 20, 204, 362, and 613 kHz show emissions for the Δυ = -1 to Δυ = +2 vibrational sequences of C2* Swan system (d(3)Πg → a(3)Πu). The Δυ=+2 emission overlaps with the CH(A-X) emission band. The maximal Swan band emission is observed when the MBSL of water itself is almost completely quenched. In general, MBSL is more intense at high-frequency compared to 20 kHz ultrasound. However, in the presence of Xe, the MBSL of C2* at 20 kHz is so bright that it can be seen by the unaided eye as a blue glow in the close vicinity of the ultrasonic tip. The intensity of the C2* band emission exhibits a maximum vs t-BuOH concentration: 0.1-0.2 M at 20 kHz and (1-8) × 10(-3) M at high-frequency ultrasound. Such a huge difference is attributed to a much smaller bubble size at high ultrasonic frequency or, in other words, to a much higher bubble surface/volume ratio providing more efficient saturation of the bubble interior with t-BuOH vapors and to the fact that high frequency bubbles remain active for many more cycles than 20 kHz ones, thus accumulating more hydrocarbon decomposition products. Simulation of the emission spectra using Specair software demonstrated the absence of thermal equilibrium for C2* radicals (Tv > Tr), where Tv and Tr are the vibrational and the rotational temperature, respectively. In Ar, Tv decreases with increasing t-BuOH concentration reaching a steady value in the concentration domain that corresponds to C2* emission maximum intensity. In the presence of Xe an extremely high Tv is obtained, which is explained by the relatively low ionization potential of Xe providing a higher electron temperature of nonequilibrium plasma generated during bubble collapse. Analysis of the gaseous products of t-BuOH sonolysis reveals a significant sonochemical activity even at high t-BuOH concentration when MBSL is totally quenched, indicating that drastic conditions could be produced also within nonsonoluminescing cavitation bubbles.

The origin of isotope effects in sonoluminescence spectra of heavy and light water.

Bubble and peak: The isotope effects in the sonoluminescence spectra of light and heavy water under ultrasound indicate the formation of a non-equilibrium plasma inside the collapsing cavitation bubbles. The picture demonstrates the active cavitation zones in water at 204 kHz.

Nonequilibrium vibrational excitation of OH radicals generated during multibubble cavitation in water.

The sonoluminescence (SL) spectra of OH(A(2)Σ(+)) excited state produced during the sonolysis of water sparged with argon were measured and analyzed at various ultrasonic frequencies (20, 204, 362, 609, and 1057 kHz) in order to determine the intrabubble conditions created by multibubble cavitation. The relative populations of the OH(A(2)Σ(+)) v' = 1-4 vibrational states as well as the vibronic temperatures (T(v), T(e)) have been calculated after deconvolution of the SL spectra. The results of this study provide evidence for nonequilibrium plasma formation during sonolysis of water in the presence of argon. At low ultrasonic frequency (20 kHz), a weakly excited plasma with Brau vibrational distribution is formed (T(e) ~ 0.7 eV and T(v) ~ 5000 K). By contrast, at high-frequency ultrasound, the plasma inside the collapsing bubbles exhibits Treanor behavior typical for strong vibrational excitation. The T(e) and T(v) values increase with ultrasonic frequency, reaching T(e) ~ 1 eV and T(v) ~ 9800 K at 1057 kHz.

Impact of a mass immunization campaign to control an outbreak of severe respiratory infections in Nunavik, northern Canada.

OBJECTIVES: In spring 2002, a mass immunization campaign using a 23-valent pneumococcal polysaccharide vaccine (23-PPV) was launched in order to control an outbreak of severe pneumonia caused by a virulent clone of serotype 1 Streptococcus pneumoniae in Nunavik, Quebec, Canada. The objective of the study was to evaluate the impact of this campaign on the incidence of invasive pneumococcal disease (IPD) and hospitalizations possibly associated with pneumococcal infections (HPAPI) in the mostly Inuit population aged 10 to 64 years. STUDY DESIGN: Retrospective analysis of surveillance and administrative data. METHODS: Multivariate Poisson model comparing the frequency rates of selected outcomes before the outbreak, during the outbreak, and after implementation of the mass immunization program. RESULTS: The reported incidence of serotype 1 IPD decreased markedly after the implementation of the vaccination campaign (rate ratio = 0.16; p < 0.002). The frequency of HPAPI and the mean duration of hospital stay also decreased. However, vaccine failures were documented and the HPAPI rate remained higher than in the period prior to the outbreak. CONCLUSIONS: Although 23-PPV contributed to control the outbreak, better vaccines are needed for the prevention of infections caused by serotype 1 S. pneumoniae.