Épidémiologie des accidents domestiques chez l'enfant à Dakar (Sénégal)

Introduction. Ce travail avait pour but de rapporter les aspects épidémiologiques des accidents domestiques (AD) au niveau du service de chirurgie pédiatrique de l'Hôpital d'Enfants Albert Royer (HEAR) de Dakar. Matériels et méthodes. Les dossiers d'enfants victimes de traumatismes non intentionnels survenus à domicile ou dans ses abords immédiats étaient inclus. Nous avons noté l'âge et le sexe de l'enfant, le jour et l'heure de l'accident, le mécanisme de l'accident et le lieu de survenue. Nous avons aussi étudié les types de lésions occasionnées et leur siège. Résultats. On notait une prédominance masculine avec un sexe ratio de 2,21. L'âge moyen était de de 4,2 ans et les enfants âgés de moins de 5 ans étaient les plus touchés (63,4 %). Les familles avec plus de deux enfants étaient les plus concernées (67 %). L'AD survenait le plus souvent les jours ouvrables avec un pic les mercredis (18,4 %). Près de la moitié des AD (42,2 %) étaient survenues le soir entre 17 heures et 20 heures. Les alentours de la maison étaient l'endroit le plus accidentogène (18,2 %). Les types d'accidents rencontrés ont été les suivants: les traumatismes (77,6 %), les intoxications (20,4 %) et les ingestions de corps étrangers (2 %). Les lésions les plus rencontrées étaient les fractures (46 %), suivies des traumatismes cranio-encéphaliques (22,9 %), des contusions (21,3 %) et des plaies (9,8 %). Les membres pelviens étaient la partie du corps la plus touchée (51,5 %) suivis de la tête (10,6 %). Aucun cas de décès n'avait été enregistré. Conclusion. Les AD chez l'enfant sont fréquents dans notre service et surviennent essentiellement dans les abords immédiats de la maison. Les victimes sont essentiellement les garçons de moins de 5 ans. Les fractures prédominent et siègent aux membres

[Characteristics of work-related injuries and the fate of the victims: about 133 cases reported to the Social Security Fund in Dakar, Senegal]. / Caractéristiques des accidents du travail et devenir des victimes: à propos de 133 cas déclarés auprès de la Caisse de Sécurité Sociale de Dakar (Sénégal).

INTRODUCTION: Work-related injuries have an impact on social security system of the country, on the victims as well as on their relatives. The objective is the aim of our study was to describe the different characteristics of work-related injuries reported to the Social Security Fund (CSS) in Dakar as well as the socioprofessional course of the victims. METHODS: We conducted a retrospective cross-sectional study over a period of 5 years, from 2002 to 2006. Data were collected from 133 cases out of 9 308 reported to the CSS. Various parameters were studied: the socioprofessional characteristics of victims and the lesional features of the injuries. The victims were interviewed to gather informations about their socioprofessional history and their professional situation. RESULTS: The average age of patients was 37,55 years, with a male predominance (99,22 %). BPW (22.6%) and fishing (15%) sectors were most affected. Almost two thirds of injuries happened in the workplace (77.4%). These injuries resulted in fractures in 51.7% of cases and affected the hand in 30.1% of cases. Nearly two thirds of injured subjects (60.9%) had resumed their profession. Thirty one subjects were fired and 12 were redeployed. The average period of temporary total incapacity was 236.7 days. The median annual pension was 1 640 329 CFA Francs (2 504,31 Euros). CONCLUSION: In Senegal, work-related injuries don't have specific characteristics, as described elsewhere. The low resources allocated to the victims and the lack of supporting social-policy measures explain the different types of suffering of the victims and their families.

Évaluation du stress chez le personnel au service des refugiés et demandeurs d'asile à Dakar

Introduction. Dans les pays émergents, les conséquences du stress demeurent sous-évaluées. Le stress cumulatif est associé au travail humanitaire. Une lourde charge de travail est souvent associée à un manque de reconnaissance du travail accompli et à des difficultés de communication. S'ajoutent la nécessité de faire face à des situations devant lesquelles on se sent désarmé (souffrance des bénéficiaires, guerre) ou au contraire des situations d'attente avec impossibilité d'agir pour des raisons de sécurité. L'objectif de notre travail était d'évaluer la prévalence du stress chez le personnel de l'UNHCR et de l'OFADEC à Dakar au Sénégal et de déterminer les facteurs caractéristiques du stress. Patients et méthodes. Nous avons mené une étude transversale descriptive et analytique du 30 mai au 30 décembre 2012. Soixante individus ont été sélectionnés grâce à un échantillonnage aléatoire. A l'aide d'un questionnaire auto-administré, nous avons enregistré les caractéristiques sociodémographiques, l'hygiène de vie, les conditions de travail, le plan de carrière et les propositions d'amélioration, l'appréciation du stress et les problèmes relationnels. La saisie et exploitation des données ont été effectuées par les logiciels Epi-Info 3.5.4 et Microsoft Excel 2010. Résultats. Cinquante-deux salariés ont participé à l'étude, 30 exerçant à l'OFADEC et 22 à l'UNHCR avec une prédominance masculine (sexe ratio = 1,73). Il s'agissait d'une population jeune, entre 20 et 39 ans dans 53,84 % des cas, tabagique dans 11,53 % des cas et présentant des troubles du sommeil dans 15,38 % des cas. 78.8% des enquêtés avaient un contrat à durée déterminé. La prévalence du stress était de 40,38 % (n = 21) avec une prédominance masculine (sexe ratio = 2). La quasi-totalité des stressés (92,9 %) travaillait en équipe et 66,7 % avaient travaillé sans arrêt durant les 12 derniers mois. 25 agents (42,9 %) se sentaient épuisés, 12 (23,8 %) inquiets ; 10 (19 %) avaient un mal être et 7(14,3 %) avaient plusieurs sentiments à la fois. 37 (71,4 %) stressés adoptaient une attitude agressive face au stress et 29(56,7 %) des agents déclaraient être victimes d'agression verbale. Conclusion. Une bonne gestion du stress au travail passe par la mise en place de modes d'organisation favorables à la santé physique et mentale des travailleurs

[Accidents of the everyday life (AcVC) in children in Dakar: about 201 cases]. / Les accidents de la vie courante chez l'enfant à Dakar: à propos de 201 cas.

Accidents of everyday life (AcVC) are common in children and can led to disabling injuries and death. This study aimed to analyze the epidemiological aspects of AcVC and the related injury mechanisms in Dakar. We conducted a descriptive, cross-sectional study conducted from 1 January 2013 to 30 June 2013. All the children victims of domestic accidents, sport and leisure accidents or school accidents were included. We studied some general parameters and some parameters related to each type of AcVC. Two hundred and one children were included, accounting for 27% of emergency consultations. There were 148 boys and 53 girls. Children less than 5 years of age were most affected (37.8%). Football and wrestling game were the main causes of AcVC. AcVC occur mainly at home (58.2%) and in the areas of sport and recreation (31.8%). The fractures predominated in the different types of AcVC: 54.9% of domestic accidents, 68.8% of sport and recreation accidents and 40% of school accidents. From an epidemiological perspective, our results are superimposable to literature. Fractures predominated contrary to literature where bruises were preponderant. Wrestling game is the main cause of these fractures, after football. The acquisition of knowledge about the epidemiological aspects of AcVC and the related injury mechanisms will allow for prevention campaigns in Dakar.

Wrestling game injuries among children in Dakar: a report on 172 cases.

INTRODUCTION: The objective was to report epidemiological and lesional features among children practicing wrestling as a game in Dakar, Senegal. METHODS: It was a retrospective study including all patients under 16, victims of wrestling game injuries. We studied epidemiological and lesional aspects in children: frequency of wrestling game injuries among all games, age, sex, geographic origin, place of injury, parent's socioeconomic status, nature of the injury and location. RESULTS: Wrestling game injuries represented 19.9% injuries in all games. Sex-ratio was 33.4. The most affected age group was the 6-10 years old age group. The majority of children are from suburban Dakar (64%). Injuries occurred most often at home and in the street. Most children are from low socioeconomic status (64%). Fractures predominated and were localized almost exclusively on the elbow. CONCLUSION: Wrestling game injuries in Dakar occur among older children from the suburbs, living in the neighborhood of great wrestling champions' districts of residence. Wrestling game cause injuries, consisting mostly of elbow fractures.

Pyloric atresia: a challenge in an underdeveloped country.

Pyloric atresia is a rare congenital malformation. We report a case in a 5-day newborn with pyloric atresia type C. Authors emphasize the diagnostic difficulties and therapeutic challenges in a resource-limited country.

[Scooter accidents in children at Aristide Le Dantec, Unversity Hospital of Dakar: a study of 74 cases]. / Les accidents de scooter chez l'enfant au CHU Aristide Le Dantec de Dakar: à propos de 74 cas.

INTRODUCTION: Scooter accidents are becoming more frequent in Dakar. The purpose of this study is to report the epidemiological and lesional aspects of these accidents on children in Dakar. MATERIALS AND METHODS: A retrospective and descriptive study was conducted in Pediatric Surgery Unit of the Aristide Le Dantec Hospital in Dakar from January 1st, 2009 to December 31, 2011. Various parameters were studied. These parameters include: frequency, sociodemographic and lesional aspects. RESULTS: Scooter accidents represent 12% of highway accidents. They were more frequent in the day, from 12 am to 2 pm (27%) and in the night, from 6 pm to 8 pm (28.4%). They might occur every day but were more frequent during April (17.6%) and June (13.5%). They occurred mainly in the suburban district of Dakar (78%). The age group most affected was the one from 3 to 8 years (60.8%). Male gender was predominant (sex ratio 1.5). Pedestrians are the most vulnerable (93.2%). The fall was the dominant mechanism (98.7%). Lesions affected mainly the lower limb (51.1%) and were essentially constituted by fracture. CONCLUSION: The frequency of scooter accidents in children is related to the galloping urbanization and to the increase of the number of cars on the roads in the peninsula. Victims are essentially pedestrians and present most of the time fractures.

Traumatic posterior sternoclavicular joint dislocation in a child: a case report.

Sternoclavicular joint dislocation is a rare event. It occurs most often in a violent trauma. The authors report the case of a10 years old child, received at emergencies for right shoulder blunt trauma after been punched by another child. He presented with right shoulder pain, right upper limb functional impairment and right sternoclavicular joint depression. Standard chest radiographs were normal. Chest CT scan showed posterior dislocation and allowed us to determine its variety. Twelve hours after the trauma, a closed reduction has been done under general anesthesia. A control CT scan showed a restoration of normal joint anatomy. After 18 months, the shoulder was painless and mobile in all directions. It is an isolated recent posterior sternoclavicular joint dislocation in a child. With this observation the authors emphasizeon the unusual mechanism of such a dislocation occurrence, the primary role of CT scan in the diagnosis and early closed reduction.