Heat waves and health risks in the northern part of Senegal: analysing the distribution of temperature-related diseases and associated risk factors.

The Sahelian zone of Senegal experienced heat waves in the previous decades, such as 2013, 2016 and 2018 that were characterised by temperatures exceeding 45°C for up to 3 successive days. The health impacts of these heat waves are not yet analysed in Senegal although their negative effects have been shown in many countries. This study analyses the health impacts of observed extreme temperatures in the Sahelian zone of the country, focusing on morbidity and mortality by combining data from station observation, climate model projections, and household survey to investigate heat wave detection, occurrence of climate-sensitive diseases and risk factors for exposure. To do this, a set of climatic (temperatures) and health (morbidity, mortality) data were collected for the months of April, May and June from 2009 to 2019. These data have been completed with 1246 households' surveys on risk factor exposure. Statistical methods were used to carry out univariate and bivariate analyses while cartographic techniques allowed mapping of the main climatic and health indicators. The results show an increase in temperatures compared to seasonal normal for the 1971-2000 reference period with threshold exceedances of the 90th percentiles (42°C) for the maxima and (27°C) the minima and higher temperatures during the months of May and June. From health perspective, it was noted an increase in cases of consultation in health facilities as well as a rise in declared morbidity by households especially in the departments of Kanel (17.7%), Ranérou (16.1 %), Matam (13.7%) and Bakel (13.7%). The heat waves of May 2013 were also associated with cases of death with a reported mortality (observed by medical staff) of 12.4% unequally distributed according to the departments with a higher number of deaths in Matam (25, 2%) and in Bakel (23.5%) than in Podor (8.4%) and Kanel (0.8%). The morbidity and mortality distribution according to gender shows that women (57%) were more affected than men (43%). These health risks have been associated with a number of factors including age, access to drinkable water, type of fuel, type of housing and construction materials, existence of fan and an air conditioner, and health history.The heat wave recurrence has led to a frequency in certain diseases sensitive to rising temperatures, which is increasingly a public health issue in the Sahelian zone of Senegal.

Estimating herbaceous aboveground biomass in Sahelian rangelands using Structure from Motion data collected on the ground and by UAV.

Herbaceous aboveground biomass (HAB) is a key indicator of grassland vegetation and indirect estimation tools, such as remote sensing imagery, increase the potential for covering larger areas in a timely and cost-efficient way. Structure from Motion (SfM) is an image analysis process that can create a variety of 3D spatial models as well as 2D orthomosaics from a set of images. Computed from Unmanned Aerial Vehicle (UAV) and ground camera measurements, the SfM potential to estimate the herbaceous aboveground biomass in Sahelian rangelands was tested in this study. Both UAV and ground camera recordings were used at three different scales: temporal, landscape, and national (across Senegal). All images were processed using PIX4D software (photogrammetry software) and were used to extract vegetation indices and heights. A random forest algorithm was used to estimate the HAB and the average estimation errors were around 150 g m-² for fresh mass (20% relative error) and 60 g m-² for dry mass (around 25% error). A comparison between different datasets revealed that the estimates based on camera data were slightly more accurate than those from UAV data. It was also found that combining datasets across scales for the same type of tool (UAV or camera) could be a useful option for monitoring HAB in Sahelian rangelands or in other grassy ecosystems.

An unexpectedly large count of trees in the West African Sahara and Sahel.

A large proportion of dryland trees and shrubs (hereafter referred to collectively as trees) grow in isolation, without canopy closure. These non-forest trees have a crucial role in biodiversity, and provide ecosystem services such as carbon storage, food resources and shelter for humans and animals1,2. However, most public interest relating to trees is devoted to forests, and trees outside of forests are not well-documented3. Here we map the crown size of each tree more than 3 m2 in size over a land area that spans 1.3 million km2 in the West African Sahara, Sahel and sub-humid zone, using submetre-resolution satellite imagery and deep learning4. We detected over 1.8 billion individual trees (13.4 trees per hectare), with a median crown size of 12 m2, along a rainfall gradient from 0 to 1,000 mm per year. The canopy cover increases from 0.1% (0.7 trees per hectare) in hyper-arid areas, through 1.6% (9.9 trees per hectare) in arid and 5.6% (30.1 trees per hectare) in semi-arid zones, to 13.3% (47 trees per hectare) in sub-humid areas. Although the overall canopy cover is low, the relatively high density of isolated trees challenges prevailing narratives about dryland desertification5-7, and even the desert shows a surprisingly high tree density. Our assessment suggests a way to monitor trees outside of forests globally, and to explore their role in mitigating degradation, climate change and poverty.

Clinical characteristics and outcomes of COVID-19 infection in nine pregnant women: a report from a sub-Saharan African country, Senegal.

INTRODUCTION: To investigate the clinical characteristics of COVID-19 in pregnancy in Senegal. METHODS: This was a cross-sectional and descriptive study of all cases of COVID-19 including nine pregnant women who were admitted in COVID-19 treatment centers in Senegal from March 2 to May 15, 2020. SARS-COV-2 infection was confirmed by PCR. Patients' characteristics, clinical features, treatment and outcome were obtained with a customized data collection form. RESULTS: The frequency of the association COVID-19 and pregnancy was 0.5%. The age range of the patients was 18-42 years with an average 28 years, and the range of gestational weeks at admission was 7 weeks to 32 weeks. None of the patients had underlying diseases. All the patients presented with a headache and only four of them had fever. Other symptoms were also observed: two patients had a cough, two had rhinorrhea, and two patients reported poor appetite. The median time to recovery was 13.6 days, corresponding to the number of days in hospital. None of the nine pregnant women developed severe COVID-19 pneumonia or died. CONCLUSION: Pregnant women appear to have the same contamination predispositions and clinical features of SARS-COV-2 infection as the general population. This study shows no evidence that pregnant women are more susceptible to infection with coronavirus.

Clinical characteristics and outcomes of COVID-19 infection in nine pregnant women: a report from a sub-Saharan African country, Senegal

Introduction: to investigate the clinical characteristics of COVID-19 in pregnancy in Senegal. Methods: this was a cross-sectional and descriptive study of all cases of COVID-19 including nine pregnant women who were admitted in COVID-19 treatment centers in Senegal from March 2 to May 15, 2020. SARS-COV-2 infection was confirmed by PCR. Patients' characteristics, clinical features, treatment and outcome were obtained with a customized data collection form. Results: the frequency of the association COVID-19 and pregnancy was 0.5%. The age range of the patients was 18-42 years with an average 28 years, and the range of gestational weeks at admission was 7 weeks to 32 weeks. None of the patients had underlying diseases. All the patients presented with a headache and only four of them had fever. Other symptoms were also observed: two patients had a cough, two had rhinorrhea, and two patients reported poor appetite. The median time to recovery was 13.6 days, corresponding to the number of days in hospital. None of the nine pregnant women developed severe COVID-19 pneumonia or died. Conclusion: pregnant women appear to have the same contamination predispositions and clinical features of SARS-COV-2 infection as the general population. This study shows no evidence that pregnant women are more susceptible to infection with coronavirus

[Sexuality in postmenopausal women in sub-Saharan Africa: example from Senegal]. / Sexualité des femmes ménopausées en Afrique sub-saharienne: exemple du Sénégal.

INTRODUCTION: In Africa, sex life after menopause remains an under-explored topic due to the fact that it is a taboo. This study aims to evaluate the quality of couple's sex life during menopause. METHODS: We conducted a cross-sectional survey of a representative sample of 320 postmenopausal women. The inclusion criteria were natural menopause. Patients who had experienced early or iatrogenic menopause were excluded. Investigation form was divided into 4 sections: social and cultural characteristics, clinical data, psycho-sexual data and therapeutic data. Comparison of proportions and chi-squared test with a significance threshold of less than 0.05 were used. RESULTS: The average age of women was 60 years; the average age of onset of menopause was 48 years and the age of the menopause was 11.3 years. All woman suffered from climacteric syndrome. Hot flushes occured in 85.9% of women, vaginal dryness in 62.8% and urinary disorders in 52.5%. Only married women reported having sex with their partner (62.1%). Women had sex occasionally in 68.9% of cases, while 18.1% of women reported no sexual activity. Decreased sexual activity was due to partner's erectile dysfunction (62% of couples) and the lack of sexual desire (83.5% of women). Lack of sexual appetite and orgasm were also reported in 92% and 100% of cases. However, 93.5% of married women thought their life was bearable. CONCLUSION: Marital status, dyspareunia, vaginal dryness and partner's erectile dysfunction have a significant impact on sexuality of menopausal women in Senegal.

Changes in rainfall distribution promote woody foliage production in the Sahel.

Dryland ecosystems comprise a balance between woody and herbaceous vegetation. Climate change impacts rainfall timing, which may alter the respective contributions of woody and herbaceous plants on the total vegetation production. Here, we apply 30 years of field-measured woody foliage and herbaceous mass from Senegal and document a faster increase in woody foliage mass (+17 kg ha-1 yr-1) as compared to herbaceous mass (+3 kg ha-1 yr-1). Annual rainfall trends were partitioned into core wet-season rains (+0.7 mm yr-1), supporting a weak but periodic (5-year cycles) increase in herbaceous mass, and early/late rains (+2.1 mm yr-1), explaining the strongly increased woody foliage mass. Satellite observations confirm these findings for the majority of the Sahel, with total herbaceous/woody foliage mass increases by 6%/20%. We conclude that the rainfall recovery in the Sahel does not benefit herbaceous vegetation to the same extent as woody vegetation, presumably favoured by increased early/late rains.

[Pregnancy and delivery in patients with a personal history of cesarean section in Dakar: epidemiological, clinical, therapeutic and prognostic aspects]. / Grossesse et accouchement des patientes ayant un antécédent de césarienne à Dakar: aspects épidémio-cliniques thérapeutiques et pronostiques.

The aim of our study was to determine hospitalization rate for vaginal birth after cesarean section in Pikine, to evaluate the quality of the management of pregnant women with previous cesarean section and to determine prognostic factors of the outcome of a trial of scar. We conducted a retrospective study based on medical records and operational protocols of patients who underwent vaginal birth after cesarean section over the period 1 January 2010 - 31 December 2011. We analyzed socio-demographic data, pregnancy follow-up, therapeutic modalities and prognosis. Data were collected and analyzed using Microsoft Office Excel 2007 software and SPSS software 17.0. The frequency of vaginal births after cesarean section was 9.6%. The average age of our patients was 29.4 years. Primiparous women accounted for 54%. Short spacing interval between births was found in 52.6% of cases. Based on the number of cesarean sections, the breakdown was as follows: patients with a history of one previous cesarean section (79.8%), patients with a history of two previous caesarean sections (17.9%) and patients with a history of three previous caesarean sections (2.3%). The number of antenatal consultations performed was greater than or equal to 3 in 79.8% of cases. Patients undergoing evacuation accounted for 54.2% and they were already in labor at the time of admission in 81.7% of cases. Trial of scar was authorized in 177 patients (34.3%) and, at the end of this test, 147 patients (83%) had vaginal birth, of whom 21.7% by vacuum extraction. Cesarean section was performed in 71.4% of cases with 245 emergency cesarean sections and 93 scheduled cesarean sections. A history of vaginal birth was a determining factor in normal delivery (p = 0.0001). There was also a significant relationship between mode of admission and decision to perform a cesarean section (p = 0.0001). Maternal mortality was 0.4%. Perinatal mortality rate was 28.2‰ of live births. We are witnessing a dramatic increase of deliveries after cesarean section in our SONUC Health Centre. The quality of management should be enhanced through a better strategy in preparation for delivery. Trial of scar is a procedure to encourage in order to reduce the rate of iterative cesarean sections.

[Sexual abuse in Ziguinchor, Senegal: epidemiology and management]. / Abus sexuels dans une zone reculée du seud du Sénégal: épidemiologie et prise en charge.

AIMS: To determine the frequency of sexual abuse, establish the demographic profile and to evaluate the care of victims of sexual abuse in Ziguinchor. METHODS: That is a retrospective, descriptive study from February 1, 2008 to August 31, 2010, including all patients received in the Department of Gynecology and Obstetrics, Ziguinchor Regional hospital for sexual abuse. For each patient, data analyzed were sociodemographic data, characteristics of aggression, clinical implications and psychological support. The data were entered and analyzed using the Excel 2003 version. RESULTS: 50 cases of sexual abuse were collected on 4950 patients, a prevalence of 1%. The average age of victims was 13 years (range: 3 to 23 years). The abuse took place in the day in 60% of cases. The location was familiar to victims in 70% of cases. The notion of penetrative genital contact was reported in 74% of victims. Physical force or a weapon was used in 34% of cases. The offender was 30 years old in 86% and operated alone in 92% of cases. Half of the victims had consulted in the first 24 hours. Genital trauma was found in 82% of victims. Feelings of fear, shame, or anger was observed in 64% of patients. Antibiotic was prescribed in two-thirds of the victims as postexposure prophylaxis for HIV was performed in only five patients. Emergency contraception was prescribed in 34% of victims. Six pregnancies were recorded. Six patients had developed complications such as depressive syndrome, hysteria with severe epileptiform seizures, mood disorder and psychosis. A proportion of 26% of victims did not consider it necessary to have recourse to justice. CONCLUSION: The management of a victim of sexual abuse should not stop at a forensic evaluation. We must therefore endeavor to provide a solution to three important consultation which are medical care, legal and emotional.

[Impact of AQUASOU: a practice-based research program at the Rufisque Health Centre, Senegal]. / Impact d'AQUASOU: un programme de recherche-action au Centre de Santé de Rufisque, Sénégal.

INTRODUCTION: Due to the inadequacy of preventive strategies to reduce maternal and neonatal mortality, the current priority concerns emergency obstetric and neonatal care, as defined in the Improvement of the Quality and Access to Emergency Obstetric Healthcare programme (AQUASOU). The objective of this study was to assess the impact of the AQUASOU programme on improved availability and quality of healthcare in the Rufisque Health District in Senegal. METHODOLOGY: We conducted a qualitative and operational descriptive study evaluating the activities of the AQUASOU programme between May 2004 and December 2007: observation of Prenatal Consultations, supervision of emergency care, organization of "mirror meetings" and medical evacuation audits. The periods before and after setting-up of the programme were compared. RESULTS: These various activities had a real impact on indicators of accessibility and availability of healthcare. A consultation framework based on the principle of feedback control and a "practice review" approach allowed an improvement of the quality of care. The number of deliveries increased by 60%. The annual surgical activity was increased sevenfold and the number of evacuations to more specialised structures was decreased (0.4% versus 9.6%), while evacuations admitted to the local structure increased. The maternal mortality rate decreased from 656 to 435 per 100,000 live births. The stillbirth rate decreased from 51 to 56 per thousand. The leading causes of death were bleeding complications (mortality of 3.7%) and paroxysmal complications of hypertension (mortality of 2.7%).

Spontaneous Uterine Rupture of an Unscarred Uterus before Labour.

Uterine rupture is a public health problem in developing countries. When it is spontaneous, it occurs most often during labor in a context of scarred uterus. Uterine rupture during pregnancy is a rare situation. The diagnosis is not always obvious and morbidity and maternal and fetal mortality is still high. We report a case of spontaneous uterine rupture during pregnancy at 35 weeks of an unscarred uterus before labour. This is an exceptional case that we observe for the first time in our unit.