Anta Tal Dia

Le nerf ischiatique à la fesse : Application à la « névrite » ischiatique post-injection

Resume L’injection intramusculaire est une pratique courante dans nos regions du fait de l’endemie palustre. Elle peut occasionner des accidents en particulier l’atteinte du nerf ischiatique a la fesse. Le but de notre travail est de determiner les bases anatomiques de la « nevrite » ischiatique post-injection. Vingt nerfs ischiatiques ont ete disseques a la region fessiere chez 10 cadavres frais adultes Africains melanodermes. Le nerf emergeait 18 fois du canal sub-piriforme et deux fois au-dessus chez un cadavre (bilateralite). Le trajet etait constant, avec une portion oblique et une portion verticale descendant dans la gouttiere ischio-trochanterienne. Le nerf croisait les muscles pelvi-trochanteriens sauf le piriforme. Par ailleurs, il etait croise entre ses deux portions par une arteriole venant de l’artere gluteale inferieure. Sa projection cutanee etait distante du quadrant supero-externe de la fesse. Une injection intramusculaire au niveau de ce quadrant evite l’atteinte directe du nerf. Les variations anatomiques du nerf etant quasi inexistantes, une autre hypothese causale de nevrite ischiatique post-injection devrait etre recherchee, en particulier la toxicite locale des sels de quinine. Leur diffusion dans l’espace sous cellulaire sous fessier (lieu de cheminement des vaisseaux et nerfs gluteaux) peut atteindre le nerf ischiatique vascularise par une branche de l’artere gluteale inferieure. Cette injection intramusculaire doit etre proscrite au profit de la voie intraveineuse ou de la voie intra-rectale chez l’enfant.

Radio-anatomie du côlon descendant dans l’espace pararénal gauche : à propos de 1084 sujets

AIMS Due to the severity of colonic injuries and their frequency on the left side, we study relationships between the left kidney and the descending colon to identify subjects at risk of colonic perforation during percutaneous surgery of the left kidney. MATERIAL AND METHODS Over a period of 3 years we exploited abdominal CT scans for 1084 patients in both sexes without any visceral or parietal lesions. We studied the situation and relationships of the lumbar part of the descending colon in the left pararenal space using a conventional grid technique. RESULTS The preferential site of the colon in both sexes was laterorenal in 55.8% of cases. We also found the descending colon in a posterolateral situation in 21.1% of cases, and in an anterolateral situation in 14.8% of cases. In women, the posterolateral situation was twice more common than in men, but we did not observe any post-renal situation. Laterorenal and posterolateral situations were the most frequent in patients less than 50 years; while beyond this age 70.1% of subjects had a laterorenal type. CONCLUSION Sex and age affect topographic variations of the lumbar part of the descending colon in the left pararenal space. Although they are rare or aberrant, some locations exist and should not be ignored by the operator. These locations are risk factors of colonic lesion during percutaneous approach of the left kidney.

Determinants of women’s satisfaction during their delivery in the health structures of Pikine in Dakar: A transversal study

Aims: This article presents the results of a study aimed at assessing the satisfaction of women during childbirth in the health structures of the department of Pikine in the region of Dakar Senegal and identifying the determinants of this satisfaction. Methods: This cross-sectional survey carried out in 2015 involved 318 women who gave birth. An adapted version of the Satisfaction Questionnaire for Obstetric Care and Postpartum Immediate Care (SSOPPI) was used. Factors on the quality of the system in the structures, the socio-demographic and psychological characteristics of the mothers Thierno Souleymane Ball Anne1, Ibrahima Seck2, Massamba Diouf3, Adama Faye4, Marie BA5, Anta Tal Dia4 Affiliations: 1M&E Technical Advisor, The Challenge Initiative, IntraHealth International, Senegal Office; 2First Technical Advisor of the Minister of Health and Social Action of Senegal; 3Department of Odontology, Faculty of Medicine, Pharmacy and Dentistry, Cheikh Anta Diop University of Dakar; 4Director of Studies at the Institute of Health and Development (ISED), Public Health Service, Institute of Health and Development, Faculty of Medicine, Pharmacy and Dentistry, Cheikh Anta Diop University Dakar; 5Head of Advocacy and External Relations, Coordination Unit for the Ouagadougou Partnership, IntraHealth International, Senegal Office. Corresponding Author: Thierno Souleymane Ball Anne, Dakar, Senegal, BP 5328 Dakar Fann; Email: tanne@intrahealth.org Received: 09 May 2017 Accepted: 06 July 2017 Published: 22 August 2017 were used as exposure variables. Results: The two-thirds of the sample having a satisfaction score greater than 7.92 for satisfaction scores ranging from 1 to 10. Childbirth in a Mbao structure as well as the lack of appropriate premises, human resources or equipment in the structures (quality of the system) are negatively associated with satisfaction with respectively adjusted odd ratio (OR) of 0.39 [0.22–0.67] and 0.46 [0.23–0.90]. Conversely, childbirth in a Pikine (district) health facility is positively associated with satisfaction with adjusted OR of 3.15 [1.76–5.70]. Similarly, childbirth in a health post is associated with satisfaction with adjusted OR of 1.70 [1.00–2.91]. Conclusion: The sociodemographic and psychological characteristics of the mothers were not associated with their satisfaction. Characteristics related to childbirth structure were significantly associated with the satisfaction of mothers.

Screening for cervical cancer in Senegal: Contributing factors

Context: Cervical cancer is first cancer in women in Africa. The disease is often diagnosed at a late stage. Aims: The purpose of this survey is to study the factors of cervical cancer screening. Settings and Design: This is a descriptive and analytical cross-sectional survey carried out in the health district of Thiès in Senegal. Subjects and Methods: Sampling was in two-stage clusters. The data were collected during an individual interview at home. The collection focused on knowledge, attitudes, and practices on cervical cancer. Statistical Analysis Used: Logistic regression was used for data analysis. Results: A total of 498 women were interviewed; 77% of them lived in urban areas, 38% have not been to school, and 82% were married. Nearly, 82.7% of them have already heard about the disease. Infection was the most reported risk factor (55.8%). The screening practice was 35.5% in our sample. Nonschooling reduced screening, while women living in urban areas were seven times more likely to be screened. Screening increased from the poorest quartile to the richest quartile. The knowledge of risk factors and the possibility of recovery increased by 4.80 and 2.34, respectively, the chance of being screened. Conclusions: Improved screening requires multiple strategies that target particularly poor uneducated people living in rural areas but also the strengthening of the capacity of health-care providers.

[Sesame Health Programme at Senegal: Limitations of this free healthcare model].

INTRODUCTION Up until now, elderly people have experienced medical management difficulties despite the free care provided by the Sesame Health Programme. The objective of this study was to determine the costs borne by beneficiaries and/or their families and to evaluate these costs in relation to overall management. This comprehensive, cross-sectional, quantitative study was conducted from 21 February to 21 March 2011 in the Ouakam gerontology centre. METHODS Epi Info Version 6 software was used for data analysis. The study population was composed of 203 patients with a mean age of 68 years, with 59% of women and 63% of retired subjects. The most common diseases were hypertension (52%), cataract (16%), and osteoarthritis (12%). RESULTS The beneficiaries healthcare costs were covered by the Sesame Health Programme, apart from most of the drugs used to treat chronic diseases, which remained at the charge of patients and/or their families. The overall mean cost of monthly management of the diseases detected in elderly people was estimated to be CFA 37,700, a large share of which (65%) was supported by the patient and/or the family corresponding to the purchase of these drugs. Other dysfunctions were also observed, particularly the difficulty of targeting beneficiaries, generic stock shortages, absence of generics for the treatment of chronic diseases. CONCLUSION Recommendations are formulated to improve implementation of the Sesame Health Programme.

Analyse des politiques publiques en faveur des personnes âgées au Sénégal : état des lieux de la protection juridique

Senegal will be spared by phenomenon of population ageing, which will surely have socioeconomic and cultural consequences that will not be easy to tackle, as all sectors will be affected. In regard to legal protection, there are not any special legal acts for the elderly as is the case for children and women. They are treated just as responsible adults whose legal status is the same as everyone else. As far as the framework of legal protection of elderly people is concerned, Senegal has ratified all international and regional means and mecanisms for the protection of the rights of the elderly. In addition, the authorities have adopted policies and programs that favor taking charge of old peoples interests. At the present, Senegal possesses a legal framework for the protection of its elderly people. So the matter is about creating new rights, because even the existing rights are not known to their beneficiaries. What is important is to ensure that the elderly fully enjoy their rights in the same way as the other members of society. It is wise, therefore, to put in place plan for information, public awareness and communication concerning the legal regulating framework. Thus, Senegal could be regarded as a pioneer in terms of the protection the elderly, and these leading programs can represent models for the countries of the region, whose social, sanitary and economic contexts are similar.

Determinants of modern contraceptive use in the Mbacké health district (Senegal)

INTRODUCTION Contraceptive prevalence is low in Senegal, particularly in the Mbacké health district. The objective of this study was to identify the determinants of use of modern contraception by women of reproductive age in this district. METHODOLOGY A quantitative and qualitative analytical study was conducted. The quantitative survey was conducted from 1st to 20 July 2011. The study population consisted of women of childbearing age living in the district. A two-stage survey was conducted. Data were entered and bivariate analysis was performed using Epi Info 3.3.5software. Multivariate analysiswas performed by R 2.2.9 software. The adjusted odds ratios were calculatedfor variables with significant p values. The qualitative study was conducted from 25 to 31 July2011. Grouped interviews were used to collect womens perceptions of modern contraception. Content analysis was performed. CONCLUSION Improving the socio-economic characteristics of women and raising public awareness about modern contraception would contribute to a better use of modern contraceptives in the Mbacké health district.

Étude anatomique par dissection des variations de la crosse de la veine saphène interne. Applications dans la chirurgie des varices du membre pelvien

Veritable carrefour veineux, la crosse de la veine saphene interne presente de nombreux affluents diversement disposes. La meconnaissance de leur distribution anatomique est une cause non negligeable de recidive apres cure de varices. Le but de ce travail est d’etudier les variations anatomiques des confluents veineux de la crosse de la veine saphene interne et de fixer des reperes anatomiques palpables pour son abord chirurgical. Pour ce faire, nous avons disseque 40 regions inguino-femorales de 20 cadavres frais de sujets melanodermes, dont un de sexe feminin. Nous avons note le mode d’abouchement des affluents veineux, les rapports avec les arteres honteuses externes ; nous avons aussi mesure la distance entre le sommet de la crosse de la veine saphene interne et l’epine iliaque ventro-crâniale d’une part, l’epine du pubis et le ligament inguinal d’autre part. Nos resultats etaient les suivants : disposition classique « en etoile » : 4 cas ; tronc commun abdominal (fusion veine epigastrique et veine circonflexe iliaque superficielle) : 5 cas ; tronc commun interne (fusion des veines honteuses) : 19 cas ; tronc externe et tronc interne : 8 cas. Un tronc saphene anterieur etait present dans 15 cas contre 5 pour la saphene posterieure. L’artere honteuse externe pre-croisait la veine saphene interne dans 43 % des cas et dans 57 % des cas, elle la sous-croisait. S’agissant des reperes anatomiques palpables, le sommet de la crosse se projetait en moyenne a 10,71 cm de l’epine iliaque ventro-crâniale ; a 3,9 cm de l’epine du pubis et a 4,15 cm du ligament inguinal. Au vu de nos resultats, les variations sont reelles. Leur connaissance et leur prise en compte sont indispensables pour prevenir les recidives lors de la chirurgie des varices des membres inferieurs.