A comparison of 2 capture methods for sampling the population of Anopheles funestus Giles in a Sudanese savannah village (Dielmo,Senegal)

We conducted a comparative study of two collection methods for sampling An. funestus populations--human bait catch and indoor pyrethrum spray--in the Sudanese savannah area of Senegal from April 1996 to March 1997. An. funestus females were captured every month during the study period. The resting density per dwelling was 1.9 times higher than those obtained with human landing catch. The population dynamics were similar with two peaks situated respectively at the beginning of the rainy season between May-July and during the dry season January-March. A significant correlation of population densities between collection methods was detected.     

Combined eco-epidemiological and molecular biology approaches to assess Echinococcus granulosus transmission to humans in Mauritania: occurrence of the 'camel' strain and human cystic echinococcosis

Mauritania lies between West-Central Africa where human cystic echinococcosis (CE) is considered extremely rare and West Maghreb where CE accounts for a real public health problem. Until 1992, Mauritania was considered as human CE-free even through CE seemed well known in livestock. In 1992, the introduction of ultrasonography led to the diagnosis of the first human CE cases. In 1997, a veterinary study revealed that dogs living around Nouakchott were commonly infected by Echinococcus granulosus. To assess E. granulosus transmission and to identify the most relevant animal reservoir responsible for human CE emerging in Mauritania, a simultaneous eco-epidemiological and molecular biology approach was performed. The fieldwork included sample collection and investigation of relationship between intermediate hosts, definitive hosts and humans. Typing of E. granulosus strains was performed using comparison of polymerase chain reaction (PCR)-amplified DNA sequences with one nuclear (BG 1/3) and 2 mitochondrial (COI, NDI) targets. Results show that the 'camel' strain is actually infectious to humans and circulates between intermediate hosts including camels and cattle. It is suggested that preventive measures at slaughtering places could reduce human contamination.     

Laugh away,he is gay! Heteronormativity and children’s television in Denmark

This article examines the representation of sexuality on Danish public service children’s television. Previous research demonstrates that the worldview presented to children on television is extremely heteronormative, but no existing research has examined the issue in a Danish context. The analysis is conducted on two levels: a content analysis of 545 television programs, and interviews with stakeholders in Danish society on the issue “children and sexuality” to examine what the dominant ideas about children and childhood are in today’s society, and how those influence what is considered appropriate for children. We found that representations of sexuality in the programs served to enforce heteronormativity, and failure to behave in a heteronormative way often served as comic relief. None of the stakeholders had considered LGBT children in their work, and it is proposed that the association of homosexuality with sexual activity constructs non-heterosexuality as incompatible with “innocent” childhood, rendering non-heterosexual childhood invisible.     

Anatomic basis for conservative surgery of the spleen

Summary 100 pancreatico-splenic blocks obtained at autopsy were treated by the injection-corrosion method. The splenic artery ended in the lienorenal ligament in 64% of cases, in the pancreatic segment in 32% and in the hilar segment in 4%. In 84% of cases, the artery divided into two lobar arteries, upper and lower. In 16% the artery trifurcated. The pedicle was 20 to 60 mm long (mean 35 mm). The branches of the splenic artery were in three successive stages: the primary or lobar arteries were each associated with a lobe; the secondary or segmental arteries each supplied one of the constituent segments of a lobe; the tertiary or subsegmental arteries supplied the various areas which made up a splenic segment. Nine cases of extraparenchymal anastomoses were found. There were 32 intraparenchymal anastomoses, being either interlobar or intersegmental. There were a few interlobar anastomoses. The findings support the notion of upper and lower intersegmental and interlobar planes. The latter is almost avascular, while the former has limited vascularity. These planes make conservative surgery of the spleen possible.

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Bases anatomiques de la chirurgie conservatrice de la rate

Résumé 100 pièces pancréatico-spléniques, prélevées par autopsie, ont été traitées par la méthode d'injection-corrosion. L'artère splénique se terminait le plus souvent dans l'épiploon pancréatico-splénique dans 64 % des cas, contre 32 % dans le segment pancréatique et 4 % dans le segment hilaire. Dans 84 %, l'artère se bifurquait en deux artères lobaires, supérieure et inférieure, dans 16 % des cas, elle se trifurquait. La longueur du pédicule s'échelonnait entre 20 et 60 mm avec une moyenne de 35 mm. Les ramifications de l'artère splénique constituaient trois étages successifs : les artères primaires ou artères lobaires destinées chacune à un lobe; les artères secondaires ou artères segmentaires se distribuant chacune à un des segments constitutifs d'un lobe splénique; les artères tertiaires ou sous-segmentaires se rendant aux différents territoires qui s'empilent les uns sur les autres à l'intérieur d'un segment splénique. Nous avons noté au total 9 cas d'anastomoses extraparenchymateuses et 32 anastomoses intraparenchymateuses réalisant soit des anastomoses interramaires, soit des anastomoses intersegmentaires, soit des anastomoses interlobaires beaucoup plus rarement. Ces constatations permettent d'introduire la notion de plans intersegmentaires supérieur et inférieur et de plan interlobaire. Ce dernier plan est quasi « exsangue » alors que les plans intersegmentaires restent paucivasculaires. Ces différents plans autorisent actuellement une chirurgie conservatrice de la rate.

     

Topographic anatomy of the tibial nerve in the medial malleolus: application to the effect of nerve block anesthesia

To better understand the anatomical variations and pathogeny of tarsal tunnel syndrome, the tibial nerve were dissected in 20 ankles of fresh black African cadavers. The tibial nerve located to 1.75 cm on average from the posterior side of the malleolus and to 2 cm from medial side of the calcaneus tendon. The nerve always ended according to dichotomic method. 90% cases of bifurcation were noted under the flexor retinaculum at 1 cm from the malléolo_calcaneus line; in 10% of dissections, we found proximal bifurcation at 5 cm from this line. The medal calcaneus branch which is a collateral branch of tibial nerve was constant, unique in 80% of cases and double in 20% of cases. The anatomical constatations allow a more precise anesthesia of tibial nerve block. We use constant anatomical marks formed by calcaneus tendon and internal malleolus tip. Olso we more understand the possibility of lesion of tibial nerve at the ankle during the synovites, or ossifications of flexor rétinaculum.     

Étude de la préférence des usagers sur les stratégies de développement de la couverture sanitaire universelle à travers les mutuelles de santé dans la région de Ziguinchor au sud-ouest du Sénégal

In Senegal, the informal and rural sector that accounts for over 80% of the population is covered only up to 7% by a health insurance system. That is why, for the implementation of development strategy of the universal health coverage (UHC) through mutual health insurance providers, the Government of Senegal has focused on this sector. The objective of this study was to assess the consumer’s preference on the UHC development strategies through mutual health insurance providers. This was a qualitative and exploratory study based on a literature review, and indepth interview with the heads of households. It was also based on focus groups of people with and without health mutual membership, and the Expert Committee meetings. The results showed that the most critical attributes in the decision-making of consumers to join the health mutual in Ziguinchor were the membership units; the content of the benefit package, the payment modalities of the premium, the premium amount, the availability of transportation, the co-payment level, convention arrangement with health facilities, and health mutual governance. For a successful implementation of the UHC development strategy through health mutual organizations, policymakers should explore the possibility of introducing the modality of payment in kind, the revision of the co-payment amount, and the promotion of equity through the introduction of a differentiated premium contribution by income. They should also establish a crossborder strategy with The Gambia and Guinea-Bissau to improve health care access to people living in the borders. The promotion of innovative funding and risk equalization between health insurance schemes is also recommended. In areas where the microfinance institutions are well organized and structured their substitution to health mutuals should be an option the decision-makers have to explore.     

Identification des gîtes larvaires d’anophèles dans les foyers résiduels de faible transmission du paludisme « hotspots » au centre-ouest du Sénégal

Malaria incidence has markedly declined in the Mbour, Fatick, Niakhar and Bambey districts (central and western Senegal) thanks to a scaling up of effective control measures namely LLINs (Long Lasting Insecticide Treated Net), ACTs (Artesunate Combination Therapy) and promoting care seeking. However malaria cases are now maintained by foci of transmission called hotspots. We evaluate the role of anopheles breeding sites in the identification of malaria hotspots in the health districts of Mbour, Fatick, Niakhar and Bambey. Surveys of breeding sites were made in 6 hotspot villages and 4 non-hotspot villages. A sample was taken in each water point with mosquito larvae by dipping method and the collected specimens were identified to the genus level. Additional parameters as name of the village and breeding sites, type of collection, original water turbidity, presence of vegetation, proximity to dwellings, geographic coordinates, sizes were also collected. Sixty-two water collections were surveyed and monitored between 2013 and 2014. Temporary natural breeding sites were predominant regardless of the epidemiological status of the village. Among the 31 breeding sites located within 500 meters of dwellings in hotspots villages, 70% carried Anopheles larvae during the rainy season while 43% of the 21 breeding sites located at similar distances in non-hotspot villages carried Anopheles larvae during the same period (P = 0.042). At the end of the rainy season, the trend is the same with 27% of positive breeding sites in hotspots and 14% in non-hotspots villages. The breeding sites encountered in hotspots villages are mostly small to medium size and are more productive by Anopheles larvae than those found in non-hotspot area. This study showed that the high frequency of smallest and productive breeding sites around and inside the villages can create conditions of residual transmission.     

Surveillance of Viral Encephalitis in the Context of COVID-19: A One-Year Observational Study among Hospitalized Patients in Dakar,Senegal

The burden of encephalitis and its associated viral etiology is poorly described in Africa. Moreover, neurological manifestations of COVID-19 are increasingly reported in many countries, but less so in Africa. Our prospective study aimed to characterize the main viral etiologies of patients hospitalized for encephalitis in two hospitals in Dakar. From January to December 2021, all adult patients that met the inclusion criteria for clinical infectious encephalitis were enrolled. Cerebrospinal fluids, blood, and nasopharyngeal swabs were taken and tested for 27 viruses. During the study period, 122 patients were enrolled. Viral etiology was confirmed or probable in 27 patients (22.1%), with SARS-CoV-2 (n = 8), HSV-1 (n = 7), HHV-7 (n = 5), and EBV (n = 4) being the most detected viruses. Age groups 40–49 was more likely to be positive for at least one virus with an odds ratio of 7.7. The mortality was high among infected patients, with 11 (41%) deaths notified during hospitalization. Interestingly, SARS-CoV-2 was the most prevalent virus in hospitalized patients presenting with encephalitis. Our results reveal the crucial need to establish a country-wide surveillance of encephalitis in Senegal to estimate the burden of this disease in our population and implement strategies to improve care and reduce mortality.