Refugee women's and providers' perceptions of person-centered maternity care: a qualitative study in two refugee camps in Chad.

BACKGROUND: Globally, mistreatment of women during labor and delivery is a common human rights violation. Person-centered maternity care (PCMC), a critical component of quality of care, is respectful and responsive to an individual's needs and preferences. Factors related to poor PCMC are often exacerbated in humanitarian settings. METHODS: We conducted a qualitative study to understand Sudanese refugee women's experiences, including their perceptions of quality of care, during labor and delivery at the maternities in two refugee camps in eastern Chad, as well as maternity health workers' perceptions of PCMC and how they could be better supported to provide this. In-depth interviews were conducted individually with 22 women who delivered in the camp maternities and five trained midwives working in the two maternities; and in six dyads with a total of 11 Sudanese refugee traditional birth attendants and one assistant midwife. In addition, facility assessments were conducted at each maternity to determine their capacity to provide PCMC. RESULTS: Overall, women reported positive experiences in the camp maternities during labor and delivery. Providers overwhelmingly defined respectful care as patient-centered and respect as being something fundamental to their role as health workers. While very few reported incidents of disrespect between providers and patients in the maternity, resource constraints, including overwork of the providers and overcrowding, resulted in some women feeling neglected. CONCLUSIONS: Despite providers' commitment to offering person-centered care and women's generally positive experiences in this study, one of few that explored PCMC in a refugee camp, conflict and displacement exacerbates the conditions that contribute to mistreatment during labor and delivery. Good PCMC requires organizational emphasis and support, including adequate working conditions and ensuring suitable resources so health workers can effectively perform.

Prevalence of hepatitis B virus infection and its associated factors among students in N'Djamena, Chad.

INTRODUCTION: Infection by hepatitis B virus (HBV) is a major issue in public health. The prevalence of HBV in Chad is 12.4%, all age groups considered. Here, we aimed to determine the prevalence of HBV and its associated factors among university students in N'Djamena, the country's capital. METHODS: A cross-sectional survey of students at either the University of N'djamena or Emi Koussi University was conducted from 3 to 23 July 2021. All participating students provided signed, informed consent and were included in the study consecutively. Blood samples were collected, and serum tested for hepatitis B surface antigen (HBsAg) using the Determine HBsAg rapid test kit, with confirmation of positive tests on an Abbott Architect i1000SR analyzer. Descriptive analysis and logistic regression were used to determine associations between the outcome variable and independent/covariate variables. RESULTS: A total of 457 students with a median age of 24 years were included across different faculties. The prevalence of HBV infection was 14.87% (68/457). Most students (75%) were aged 25 years or less. Unprotected sex was reported by 64.9% of the students and multiple sexual partners by 53.6%. Furthermore, 45.7% of them reported having no knowledge of hepatitis B. Having an HBsAg-positive mother (AOR: 2.11), having a history of transcutaneous medical procedures (AOR: 2.97) and living with a family (AOR: 4.63) were significantly associated with HBV status. Age ≥26 years appeared as a protective factor (AOR = 0.41). CONCLUSION: Our study detected a high, 14.87% prevalence of HBV infection among students in N'djamena, Chad, and shed light on its associated factors. HBV prevention strategies should include raising awareness among students, making full hepatitis vaccination mandatory before children begin school, promoting mass screening to identify and treat chronic HBV carriers and reduce transmission, and reducing the cost of vaccination.

Limited impact of vector control on the population genetic structure of Glossina fuscipes fuscipes from the sleeping sickness focus of Maro, Chad.

Tsetse flies (genus Glossina) transmit deadly trypanosomes to human populations and domestic animals in sub-Saharan Africa. Some foci of Human African Trypanosomiasis due to Trypanosoma brucei gambiense (g-HAT) persist in southern Chad, where a program of tsetse control was implemented against the local vector Glossina fuscipes fuscipes in 2018 in Maro. We analyzed the population genetics of G. f. fuscipes from the Maro focus before control (T0), one year (T1), and 18 months (T2) after the beginning of control efforts. Most flies captured displayed a local genetic profile (local survivors), but a few flies displayed outlier genotypes. Moreover, disturbance of isolation by distance signature (increase of genetic distance with geographic distance) and effective population size estimates, absence of any genetic signature of a bottleneck, and an increase of genetic diversity between T0 and T2 strongly suggest gene flows from various origins, and a limited impact of the vector control efforts on this tsetse population. Continuous control and surveillance of g-HAT transmission is thus recommended in Maro. Particular attention will need to be paid to the border with the Central African Republic, a country where the entomological and epidemiological status of g-HAT is unknown.

Title: Impact limité de la lutte antivectorielle sur la structure des populations de Glossina fuscipes fuscipes dans le foyer de la maladie du sommeil de Maro, Tchad. Abstract: Les mouches tsé-tsé (genre Glossina) transmettent des trypanosomes mortels aux populations humaines ainsi qu'aux animaux domestiques en Afrique sub-saharienne. Certains foyers de la trypanosomiase humaine Africaine due à Trypanosoma brucei gambiense (THA-g) persistent au sud du Tchad, où un programme de lutte antivectorielle a été mis en place contre le vecteur local de la maladie, Glossina fuscipes fuscipes, en particulier à Maro en 2018. Nous avons analysé la structure génétique des populations de G. f. fuscipes de ce foyer à T0 (avant lutte), une année après le début de la lutte (T1), et 18 mois après (T2). La plupart des mouches capturées après le début de la lutte ont montré un profil génétique local (survivants locaux), mais quelques-unes d'entre elles présentaient des génotypes d'individus atypiques. Par ailleurs, la présence de perturbations des signatures d'isolement par la distance (augmentation de la distance génétique avec la distance géographique), l'absence de signature génétique d'un goulot d'étranglement, et un accroissement de la diversité génétique entre T0 et T2 sont des arguments forts en faveur de la recolonisation de la zone par des mouches d'origines variées, tout en témoignant des effets limités de la campagne de lutte dans ce foyer. Ces résultats conduisent à recommander une lutte et une surveillance continues dans le foyer de Maro. Une attention particulière devra par ailleurs être prêtée à l'autre côté de la rive, située côté République Centre Africaine, dont le statut épidémiologique reste inconnu concernant les tsé-tsé et la THA-g.

Malaria infection and predictor factors among Chadian nomads' children.

BACKGROUND: In Chad, malaria remains a significant public health concern, particularly among nomadic populations. Geographical factors and the mobility of human populations have shown to be associated with the diversity of Plasmodium species. The study aims to describe the malaria prevalence among nomadic children and to investigate its associated factors. METHODS: A cross-sectional study was conducted in February and October 2021 among nomadic communities in Chad. Blood sample were collected and tested from 187 Arab, Fulani and Dazagada nomadic children aged 3-59 months using malaria rapid diagnostic test (RDT). A structured electronic questionnaire was administered to their parents to collect information about the socio­economic data. Malaria testing results were categorized according to the SD BIOLINE Malaria Ag Pf/Pan RDT procedures. Logistic regression analysis was used to determine key risk factors explaining the prevalence of malaria. STATA version IC 13 was used for statistical analysis. RESULTS: The overall malaria prevalence in nomadic children was 24.60%, with 65.20% being Plasmodium falciparum species and 34.8% mixed species. Boys were twice as likely (COR = 1.83; 95% CI, 0.92-3.62; p = 0.083) to have malaria than girls. Children whose parents used to seek traditional drugs were five times more likely (AOR = 5.59; 95% CI, 1.40-22.30, p = 0.015) to have malaria than children whose parents used to seek health facilities. Children whose parents reported spending the last night under a mosquito net were one-fifth as likely (AOR = 0.17; 95% CI, 0.03-0.90, p = 0.037) to have malaria compared to children whose parents did not used a mosquito net. Furthermore, Daza children were seventeen times (1/0.06) less likely (AOR = 0.06; 95% CI, 0.01-0.70, p = 0.024) to have malaria than Fulani children and children from households piped water as the main source were seven times more likely (AOR = 7.05; 95% CI, 1.69-29.45; p = 0.007) to have malaria than those using surface water. CONCLUSIONS: Malaria remains a significant public health issue in the nomadic communities of Chad. Community education and sensitization programs within nomad communities are recommended to raise awareness about malaria transmission and control methods, particularly among those living in remote rural areas. The National Malaria Control Program (NMCP) should increase both the coverage and use of long-lasting insecticidal nets (LLINs) and seasonal malaria chemoprevention (SMC) in addition to promoting treatment-seeking behaviors in nomadic communities.

Community-based symptom reporting among agro-pastoralists and their livestock in Chad in a One Health approach.

One Health Syndromic Surveillance has a high potential for detecting early epidemiological events in remote and hard-to-reach populations. Chadian pastoralists living close to their animals and being socio-economically unprivileged have an increased risk for zoonosis exposure. Engaging communities in disease surveillance could also strengthen preparedness capacities for outbreaks in rural Chad. This study describes a retrospective cross-sectional survey that collected data on clinical symptoms reported in people and livestock in Chadian agro-pastoral communities. In January-February 2018, interviews were conducted in rural households living in nomadic camps or settled villages in the Yao and Danamadji health districts. The questionnaire covered demographic data and symptoms reported in humans and animals for the hot, wet, and cold seasons over the last 12 months. Incidence rates of human and animal symptoms were comparatively analyzed at the household level. Ninety-two households with a homogeneous socio-demographic distribution were included. We observed cough and diarrhea as the most frequent symptoms reported simultaneously in humans and animals. In all species, the incidence rate of cough was significantly higher during the cold season, and diarrhea tended to occur more frequently during the wet season. However, the incidence rate of cough and diarrhea in animals did not predict the incidence rate of these symptoms in humans. Overall, the variations in reported symptoms were consistent with known seasonal, regional, and sociological influences on endemic diseases. Our retrospective study demonstrated the feasibility of collecting relevant health data in humans and animals in remote regions with low access to health services by actively involving community members. This encourages establishing real-time community-based syndromic surveillance in areas such as rural Chad.

Assessment of current water, sanitation, and hygiene (WASH) practices in the third and ninth districts of N'Djamena, Chad.

Access to safe drinking water, sanitation, and hygiene in Chad's cities, especially N'Djamena, is a persistent and significant challenge. This study aimed to assess current practices in water, sanitation, and hygiene in N'Djamena's third and ninth districts. We surveyed 395 households, conducted water source identification, and analyzed seven water samples at the National Water Laboratory. Temperature, ammonium, total coliforms, and aerobic flora values exceeded World Health Organization (WHO) guidelines. Ammonium and temperature averaged 0.7 mg/L and 30.1-31.93 °C, respectively. Bacterial contamination (>100 MPN/100 mL) exceeded the WHO's 0 MPN/100 mL guidelines, rendering the water unfit for consumption. Survey results indicate that 78.7% use hand pumps, 21.1% have tap water access, and 0.2% rely on rivers for water. Regarding toilets, 92.8% have traditional models, 2.9% have modern facilities, and 4.3% practice open defecation. 95% dispose of untreated wastewater into nature, with only 5% using septic tanks. For solid waste, 72% use illegal dumpsites, 18% rely on public services, and 10% burn waste. Finally, 95.5% of households wash their hands with clean water and soap after using the toilet. It is crucial to treat drinking water and implement proper hygiene and sanitation measures to safeguard the population's health in the studied area.

Contextual factors for understanding the heterogeneity of outcomes of a policy of exemption from payment for care in Chad / Les facteurs contextuels pour comprendre l'hétérogénéité des résultats d'une politique d'exemption du paiement des soins au Tchad

Chad has one of the highest maternal and infant mortality rates in the world. Efforts to reduce these rates have led to the introduction of fee exemption and community involvement initiatives to further encourage the use of health services. Despite the introduction of these initiatives, inequalities in access to and use of health facilities persist. The aim of this study is to understand why and how the same action, implemented in a quasi-homogeneous way, produced contrasting results in different health centers. A multiple, contrasting case study was used to analyze the outcomes of pediatrics consultations and deliveries in four health centers in the Bénoye and Beinamar districts. Data were collected through individual interviews (n=26) and focus groups (n=22) with women beneficiaries, community health workers, and health care providers. The qualitative software QDA Miner was used to process the data. The study revealed that the organizational and managerial capacities of the providers and community actors would explain the heterogeneity of the results observed. Contextual factors such as the remoteness of services or the impassability and dangerousness of roads accentuated the disparities in the results observed. The results of this study show that human and contextual factors would explain the heterogeneity of the observed effects.

Le Tchad a l'un des taux de mortalité maternelle et infantile les plus élevés au monde. Les efforts visant à réduire ces taux ont conduit à la mise en place d'une politique d'exemption du paiement des soins, associée à l'implication des communautés pour encourager l'utilisation des services. Malgré l'introduction de cette initiative, des inégalités dans l'accès et l'utilisation des établissements de santé persistent. L'objectif de cette étude est de comprendre pourquoi et comment cette politique d'exemption, mise en œuvre de manière quasi homogène, a donné des résultats contrastés dans plusieurs centres de santé. Une étude de cas multiples contrastés a été utilisée pour analyser les résultats des consultations pédiatriques et des accouchements dans quatre centres de santé des districts de Bénoye et Beinamar. Les données ont été recueillies lors des entretiens individuels (n=26) et des groupes de discussion (n=22) auprès des femmes bénéficiaires, des agents de santé communautaire et des prestataires de soins. Le logiciel QDA Miner a été utilisé pour traiter les données. L'étude a révélé que les capacités organisationnelles et managériales des prestataires et des acteurs communautaires expliqueraient l'hétérogénéité des résultats observés. Des facteurs contextuels tels que l'éloignement des services ou l'impraticabilité et la dangerosité des routes ont accentué les disparités des résultats observés. Dans la mise en place des politiques de santé, il est important de tenir compte des facteurs humains et contextuels, car ils participent à l'explication de l'hétérogénéité des effets observés et renforcent la pertinence de ce type d'études.

A Review on Medicinal and Ethnomedicinal Uses, Biological Features, and Phytochemical Constituents of Sesbania sesban L. Merr., A Nitrogen-Fixing Plant Native to the Republic of Chad.

This study reports on a literature review of the leguminous tree Sesbania sesban (L.) Merr which is found in the N'djamena region, the Republic of Chad. The study focused on S. sesban's medicinal and ethnomedicinal uses, biological features, and phytochemical constituents to assist in future evaluations. A literature review was conducted using academic websites, such as Science Direct and Springer, online international plant databases, and data from national herbaria. S. sesban is a perennial shrub or tree that measures 3-4 m in height. This species is becoming rare in N'djamena but can be found in the rainy season, while in winter, it occurs mainly in ponds (called the Chadian dialect "Bouta") and on the shores of the Chari and Logone rivers. The local inhabitants in Chad use the species as medicine, livestock feed, and fuelwood and for improving soil fertility and repelling desert encroachment. Traditional healers use its leaves to treat breast cancer and edema. S. sesban is an essential species native to the Republic of Chad that needs conservation and valorization. Viewing its importance and rarity in N'djamena , a strategy for replanting the species in gardens, homes, and fields around N'djamena and other regions of Chad is recommended.

Predicting the potential impact of scaling up four pneumonia interventions on under-five pneumonia mortality: A prospective Lives Saved Tool (LiST) analysis for Bangladesh, Chad, and Ethiopia.

Background: Pneumonia remains the leading cause of mortality in under-five children outside the neonatal period. Progress has slowed down in the last decade, necessitating increased efforts to scale up effective pneumonia interventions. Methods: We used the Lives Saved Tool (LiST), a modelling software for child mortality in low- and middle-income settings, to prospectively analyse the potential impact of upscaling pneumonia interventions in Bangladesh, Chad, and Ethiopia from 2023 to 2030. We included Haemophilus influenzae type B (Hib) vaccination, pneumococcal conjugate vaccine (PCV), oral antibiotics, pulse oximetry, and oxygen as pneumonia interventions in our analysis. Outcomes of interest were the number of pneumonia deaths averted, the proportion of deaths averted by intervention, and changes in the under-five mortality rate. Findings: We found that 19 775 lives of children under-five could be saved in Bangladesh, 76 470 in Chad, and 97 343 in Ethiopia by scaling intervention coverages to ≥90% by 2030. Our estimated reductions in pneumonia deaths among children under five range from 44.61% to 57.91% in the respective countries. Increased coverage of oral antibiotics, pulse oximetry, and oxygen show similar effects in all three countries, averting between 18.80% and 23.65% of expected pneumonia deaths. Scaling-up PCV has a prominent effect, especially in Chad, where it could avert 14.04% of expected pneumonia deaths. Under-five mortality could be reduced by 1.42 per 1000 live births in Bangladesh, 22.52 per 1000 live births in Chad, and 5.48 per 1000 live births in Ethiopia. Conclusions: This analysis shows the high impact of upscaling pneumonia interventions. The lack of data regarding coverage indicators is a barrier for further research, policy, and implementation, all requiring increased attention.

Epidemiology of group A rotavirus in children under five years of age with gastroenteritis in N'Djamena, Chad.

BACKGROUND: Group A Rotaviruses (RVA) is one of the most common causes of severe diarrhoea in infants and children under 5 years of age. Unlike many countries in the world where RVA surveillance/control is active, in Chad , there is currently no applied RVA immunization program and surveillance strategy. The present study aims to determine the prevalence and associated risk factors of RVA gastroenteritis among children under five years of age in N'Djamena. METHOD: This study comprised two parts: (1) A cross-sectional study carried in four hospitals in N'Djamena between August and November 2019, to determine infection risk factors and evidence of RVA infection among children aged five and below, consulted or hospitalized for diarrhea. An ELISA based RVA VP6 protein detection was used to determine RVA infection prevalence. Infection results and sociodemographic data were statistically analysed to determine RVA infection risk factors. (2) A retrospective study that consisted of analysing the records of stool examinations of the period from January 2016 to December 2018, to determine the prevalence of infectious gastroenteritis among the target population. RESULTS: For the cross-sectional study, RVA infection prevalence was 12.76% (18/141) with males (61.11%) being more affected (sex ratio: 1.57). Children below 12 months were the most affected age group (44.44%) and 44.4% were malnourished. The mean Vesikari score shows that 38.8% of children have a high severity level and 41.1% have a moderate level. For the retrospective study, 2,592 cases of gastroenteritis hospitalization were analysed; 980 out of 2,592 cases (37.81%) of hospitalization due to diarrhoea were due to diarrhoeagenic pathogens including Emtamoeba hystolitica, Gardia lamblia, Trichomonas hominis, Hymenolepis nana, Escherichia coli, Shigella spp, Proteus mirabilis, and Klebsiella oxytoca. Cases of diarrhoea with negative pathogen search were 1,612 cases (62.19%). The diarrhoea peak was observed during the dry seasons, and the age group under 11 months was the most affected was (57.3%). CONCLUSION: This study describes the evidence of RVA infection among diarrhoeic children below five years of age in N'Djamena, thus indicates a serious health burden. Malnourishment younger age was the higher risk factor. Further studies are needed to determine the circulating strains prior to considering introduction of RVA vaccine and setup a routine rotavirus surveillance in Chad.

Presence of neutralizing SARS-CoV-2 antibodies in asymptomatic population of N'Djamena, Chad.

INTRODUCTION: Neutralizing antibodies (NAbs) are an important specific defence against viral infections, as these antibodies bind to specific receptor(s) and block the viral entry. NAbs assessments are therefore useful in determining individual or herd immunity to SARS-CoV-2. This study aims to deepen the investigation by assessing the positivity rate of neutralizing anti-spike antibodies to understand the real protection of the studied population against SARS-CoV-2. METHODS: This study involved 260 plasma samples from a larger cohort of 2,700 asymptomatic volunteer donors, enrolled between August and October 2021 in health facilities of N'Djamena. In this study four different kits and techniques including the pseudotype assay have been used and compared with detect the SARS-CoV-2 antibodies. Pseudotyped vesicular stomatitis virus (VSV), was used both the identify and measure the NAbs that to evaluate the performance of two cheaper and easy to use commercial kits, specific for the detection of receptor-binding domain antibodies (anti-RBD) against the SARS-CoV-2 spike protein. RESULTS: The VSV spike neutralization assay showed that 59.0% (n = 59) samples were positive for NAbs with titers ranging from 1:10 to 1:4800. While 23 out the 41 negative NAbs samples were detected positive using anti-RBD (Abbott) test. Furthermore, a direct and significant strong correlation was found between NAbs and anti-RBD, specifically with Abbott kit. Taken together, the Roche and Abbott methods indicated agreement at the high concentrations of antibodies with the VSV-pseudovirus method. Abbott and Roche indicated a good sensitivity, but the Abbott system test appeared to have better specificity than the Roche test. CONCLUSION: Our findings indicated a high presence of NAbs against SARS-CoV-2 spike protein among asymptomatic individuals in N'Djamena. This could be one of the reasons for the low severity of Covid-19 observed in this area, given the key role of NAbs in blocking SARS-CoV-2 infection.

Assessing the Effects of One-Time Praziquantel Treatment on Urogenital Lesions Detected by Ultrasound in Schistosoma haematobium-Infected Individuals in Chad.

The objective was to determine the impact of a single dose of praziquantel on urogenital lesions caused by Schistosoma haematobium. Ultrasound (US) was performed on three age groups of subjects with a positive test for hematuria, with the first examination performed in November 2017 and a follow-up visit 7 months later. None of the subjects had previously received treatment. The participants were categorized into three distinct age groups: group 1 = 1-15 years, group 2 = 15-30 years, and group 3 = ≥ 30 years. A total of 250 people from these three groups underwent screening: 99 in group 1, 90 in group 2, and 61 in group 3, among whom 131 (52.4%) had at least one detectable lesion of the urogenital tract on US. Follow-up US after 7 months was possible in 60%, 67%, and 77% of the respective groups (with lesions). The anomalies disappeared in 80% of individuals in group 1, 76% of those in group 2, and 65% in group 3. With the exception of calcifications, most visible anomalies had been resolved. The total number of anomalies is low. Severe obstructive uropathy was not detected. We can conclude that single treatment with praziquantel is able to cure visible anomalies, with the exception of calcifications. The low rate of anomalies, compared with levels in the literature, is speculated to be due to undetected death by obstructive uropathy caused by S. haematobium. This requires further investigation.

Impact of COVID-19 Pandemic on the Clinical Follow-Up of Patients Living with HIV in Chad: A Retrospective Monocentric Investigation.

The impact of the coronavirus disease 2019 (COVID-19) pandemic on the clinical follow-up of people living with HIV (PLWH) remains poorly documented in Sahelian Africa. We conducted a monocentric retrospective investigation of the outcomes (loss to follow-up [LTFU], transferred, or dead) among a cohort of PLWH receiving antiretroviral treatment (ART) in N'djamena, Chad (December 2019-December 2022). The incidence of LTFU was found to be higher in 2020 than in 2022 (P > 10-4), with increases of incidence of LTFU in the first trimester of 2020 before identified severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection cases in Chad. The all-cause mortality was low and did not appear to be influenced by SARS-CoV-2 infection waves. Our data reveal a concerning trend of significantly increased LTFU among PLWH receiving ART during the COVID-19 pandemic. Our findings indicate that it is crucial to provide accurate information to ensure the continuity of care for PLWH during a sanitary crisis in Sahelian Africa.

Women's autonomy and fertility in Chad.

Chad's total fertility rate (TFR) is 6.4 children per woman, compared with no more than 5.5 in neighbouring countries: Cameroon and the Central African Republic. Scientific research on the determinants of fertility in Chad should therefore be carried out in order to show decision-makers how they can strengthen their actions in this area. This is the aim of this study, which focuses on the influence of women's autonomy on fertility in Chad. Analyses of data from the Multiple Indicator and Demographic and Health Survey (DHS/MICS) conducted in Chad in 2014/2015 and a qualitative survey conducted in the same country in 2020 show, among other things, that 1) in socio-cultural groups characterised by strong gender inequalities, women's autonomy is positively associated with their desired fertility; 2) in these and other groups characterised by less gender inequality, women's autonomy is negatively associated with their actual fertility, all things being equal; 3) the hypotheses explaining this relationship differ across sociocultural groups: In highly gender- inegalitarian groups, the frequent death of children leads couples in which women have either little or no autonomy to compensate with high fertility, whereas in less gender- inegalitarian groups, the negative association between women's autonomy and fertility is due to late union formation, union dissolution, the fertility-reducing effects of breastfeeding and modern contraception, and other intermediate fertility variables not considered here. These findings highlight both the importance of designing development programmes in Chad that focus on women's empowerment and the need for such programmes to take sufficient account of the socio-cultural contexts in which the populations concerned live.

Au Tchad, l'Indice Synthétique de Fécondité (ISF) est de 6,4 enfants par femme, alors que chez ses voisins, comme le Cameroun et la RCA, il ne dépasse pas 5,5. Il est alors très important de réaliser des recherches scientifiques sur les déterminants de la fécondité dans le premier pays, afin de montrer à ses décideurs comment ils devraient renforcer leurs actions dans ce domaine. La recherche réalisée ici en est un exemple et porte spécifiquement sur l'influence de l'autonomie de la femme sur sa fécondité dans ce pays. Les analyses des données de l'Enquête Démographique et de Santé et à Indicateurs Multiples (EDS/MICS) qui y a été menée en 2014/2015, et de celles de l'enquête qualitative, menée dans le même pays en 2020, ont, entre autres, révélé, ce qui suit : 1) dans les groupes socioculturels très inégalitaires en matière de genre, l'autonomie de la femme est positivement associée à sa fécondité désirée ; 2) dans ces groupes et dans ceux moins inégalitaires, toutes choses égales par ailleurs, l'autonomie de la femme est associée négativement à sa fécondité effective ; 3) les hypothèses d'explication de cette relation varie selon les groupes socioculturels : dans les premiers, les décès fréquents d'enfants entraînent les couples où les femmes ont une autonomie nulle ou faible à les compenser par une fécondité élevée ; dans les derniers, ce sont les entrées tardives en union, les ruptures d'unions, les effets réducteurs d'allaitement et de la contraception moderne et d'autres variables intermédiaires de la fécondité, non prises en compte, qui justifient pourquoi l'autonomie de la femme y est négativement associée à sa fécondité. Les résultats de cette étude témoignent non seulement de la pertinence des programmes de développement focalisés dans ce pays sur l'autonomisation de la femme, mais aussi du fait que pour être efficaces ces programmes devraient prendre suffisamment en compte les contextes dans lesquels vivent les populations concernées.

Investigation of optimized observation periods for estimating a representative home range of free-roaming domestic dogs.

Free-roaming domestic dogs (FRDD), as vectors of zoonotic diseases, are of high relevance for public health. Understanding roaming patterns of dogs can help to design disease control programs and disease transmission simulation models. Studies on GPS tracking of dogs report stark differences in recording periods. So far, there is no accepted number of days required to capture a representative home range (HR) of FRDD. The objective of this study was to evaluate changes in HR size and shape over time of FRDD living in Chad, Guatemala, Indonesia and Uganda and identify the period required to capture stable HR values. Dogs were collared with GPS units, leading to a total of 46 datasets with, at least, 19 recorded days. For each animal and recorded day, HR sizes were estimated using the Biased Random Bridge method and percentages of daily change in size and shape calculated and taken as metrics. The analysis revealed that the required number of days differed substantially between individuals, isopleths, and countries, with the extended HR (95% isopleth value) requiring a longer recording period. To reach a stable HR size and shape values for 75% of the dogs, 26 and 21 days, respectively, were sufficient. However, certain dogs required more extended observational periods.