Monitoring compliance with Senegal's tobacco products packaging and labelling requirements 6 months after implementation of the law.

INTRODUCTION: As of December 2021, 22 countries and one jurisdiction in WHO African Region (AFRO) have adopted pictorial health warning labels on tobacco packaging, but only 13 have implemented them. In 2014, Senegal enacted a comprehensive tobacco control law, which requires strong provisions on tobacco packaging and labelling. The objective of this study was to assess the level of compliance with these provisions in Senegal 6 months after implementation. METHODS: Data collection took place in Senegal's capital city of Dakar across 12 districts in February 2018, following the Tobacco Pack Surveillance System Field Protocol developed by the Institute for Global Tobacco Control at Johns Hopkins Bloomberg School of Public Health. Unique tobacco packs were purchased from a total of 48 tobacco vendors, and compliance with new packaging and labelling provisions was assessed. RESULTS: In total, seven unique cigarette packs were confirmed to be legally available for sale in Dakar, Senegal. All packs complied with all health warning provisions (type, size, location, language and quitline information) as well as bans on quantitative emissions yields. However, no pack complied with the descriptive constituents and emissions statement required on the lateral side, and four of the seven packs violated the ban on misleading brand descriptors. CONCLUSIONS: AFRO countries have made substantial progress in adopting comprehensive tobacco control laws that bring them closer into alignment with the Framework Convention on Tobacco Control. This study found areas of effective implementation of FCTC recommended packaging and labelling requirements, as well as areas in need of stronger enforcement.

Time-Resolved cw Thermal Z-scan for Nanoparticles Scattering Evaluation in Liquid Suspension.

The thermal lens effect is analyzed as a time-resolved Z-scan measurement using cw-single Gaussian beam configuration. The main characteristics of the measurement method are determined. We focus on the evaluation of the measurement error from statistical calculations to also check the linearity of the response and the way to extract the thermo-optical characteristics of absorbing liquids. The results are also applied to demonstrate the feasibility of absorption and scattering efficiencies determination on gold nanoparticles of 5 and 50 nm diameters.

Palliative Care Need and Availability in Four Referral Hospitals in Senegal: Results from a Multicomponent Assessment.

CONTEXT: With prevalence of noncommunicable diseases and life expectancy rising in Senegal, the need for palliative care is likely growing. No national palliative care needs assessments have been carried out. OBJECTIVES: To assess the capacity and need for palliative care in Senegal. METHODS: A multicomponent assessment of availability and demand for palliative care was conducted in two tertiary and two regional hospitals in Senegal in 2015 with approval from Senegal's National Ethics Committee for Health Research. The assessment consisted of (1) an inpatient hospital census; (2, 3) surveys of inpatients and outpatients with life-limiting illness; (4) a knowledge, attitudes, and practices survey among health care workers; and (5) a facility survey to assess availability of palliative care medications. RESULTS: Nearly half (44.4%) of all inpatients (n = 167) had an active life-limiting illness. Among them, 56.6% reported moderate-to-severe pain in the past three days, 2.3% of whom received morphine, and 76.7% received weak or no pain medication. Inpatients also experienced moderate-to-severe dyspnea (42.1%), fatigue (66.5%), nausea (16.5%), and drowsiness (42.1%). About 39.2% of all outpatients (n = 395) reported moderate-to-severe pain, and 52.8% reported that the treatment they had received relieved their pain only partially or not at all. Two-thirds of all doctors reported feeling comfortable prescribing pain medicines; however, 83.0% rarely or never prescribed morphine. Two of four hospitals reported no use of morphine in 2014. CONCLUSION: There is significant need for palliative care in Senegal. Training of health care workers and ensuring availability of relevant medications should be prioritized.

[Costal metastasis revealing esophageal squamous cell carcinoma]. / Métastase costale révélant un carcinome épidermoïde de l'œsophage.

Esophageal cancer is associated with poor prognosis. Its severity is linked to delayed diagnosis which is most often made once a cancer has metastasized, in Africa. Costal metastases are rare. We report a case of a 38-year old Senegalese patient with squamous cell carcinoma of the lower esophagus with lytic metastases to the ribs. Mrs. TD, aged 38, was admitted with painful swelling in right hemithorax associated with weight loss. The patient also reported mechanical dysphagia evolving during 4 months which had not motivated consultation. Clinical examination showed a poor general condition, a hard, sensitive swelling measuring 3 cm along its longer axis, located on the anterolateral surface of the right hemithorax at the level of the 5thrib. Biological examinations showed normocytic normochromic anemia with hemoglobin level of 9.4 g/dl, non-specific biological inflammatory syndrome, and hypercalcemia (corrected calcium = 107 mg/l. Oesogastroduodenal endoscopy showed a ulcerative, budding, stenotic lesion 32 cm from the dental arches. Anatomopathological examination of the biopsies revealed moderately differentiated squamous cell carcinoma. In addition to oesophageal tumor, thoracoabdominal-pelvic computed tomography showed bone lysis involving the anterior arch of the 5th rib, carcinomatous pulmonary nodules and bilateral pleural effusion. Pleural fluid aspiration through an exploratory needle showed serohematic fluid and the cytological examination of this fluid objectified carcinomatous cells. The diagnosis of squamous cell carcinoma of the lower esophagus with rib, pleural and pulmonary metastases was retained and palliative treatment was initiated. The evolution was marked by the death of the patient 3 months after gastrostomy, within a context of respiratory distress. The originality of this observation is related to the atypical seat of metastases of this cancer of the esophagus as well as the risk factors of this tumor. Cancer of the esophagus in young adults is a major problem in Africa. The challenge is to determine its risk factors in order to prevent its occurrence.

HIV/AIDS in African militaries: an ecological analysis.

The HIV/AIDS pandemic is considered a security threat. Policy-makers have warned of destabilization of militaries due to massive troop deaths. Estimates of the rate of HIV within African militaries have been as high as 90 per cent. We aimed to determine if HIV prevalence within African militaries is higher than their host nation prevalence rates. Using systematic searching and access to United States Department of Defense data, we abstracted data on prevalence within militaries and their host communities. We conducted a random effects pooled analysis to determine differences in HIV prevalence rates in the military versus the host population. We obtained data on 21 African militaries. In general, HIV prevalence within the military is elevated compared to the general population. The differences were significant (odds ratio 1.97, 95% confidence interval: 1.58-2.45, P < 0.001). Further, inflated rates of HIV in militaries compared to non-military males of similar age were also significant (6.09, 4.47-8.30, P < or = 0.0001). States with recent conflicts and wars had elevated military rates, but these were also not significant (P = 0.4). Population levels predicted military prevalence rates (P < or = 0.001). HIV/AIDS prevalence rates in most African militaries are significantly elevated compared to their host communities.