Ibrahima Seck

Improving malaria control in West Africa: interruption of transmission as a paradigm shift.

With the paradigm shift from the reduction of morbidity and mortality to the interruption of transmission, the focus of malaria control broadens from symptomatic infections in children ≤5 years of age to include asymptomatic infections in older children and adults. In addition, as control efforts intensify and the number of interventions increases, there will be decreases in prevalence, incidence and transmission with additional decreases in morbidity and mortality. Expected secondary consequences of these changes include upward shifts in the peak ages for infection (parasitemia) and disease, increases in the ages for acquisition of antiparasite humoral and cellular immune responses and increases in false-negative blood smears and rapid diagnostic tests. Strategies to monitor these changes must include: (1) studies of the entire population (that are not restricted to children ≤5 or ≤10 years of age), (2) study sites in both cities and rural areas (because of increasing urbanization across sub-Saharan Africa) and (3) innovative strategies for surveillance as the prevalence of infection decreases and the frequency of false-negative smears and rapid diagnostic tests increases.

[Access to intermittent preventive treatment (IPt) in a situation of abolition of user's fee: role of economic welfare].

In Senegal, the free distribution of sulfadoxine pyrimethamine during antenatal care is recommended to remove the disparity in the context of intermittent preventive treatment against malaria. The objective of this study was thus to identify factors influencing access to treatment in a situation of abolition of user fees. It was a cross-sectional and analytical study. It covered a sample of 1906 women aged 15-49 years randomly selected during the national survey on malaria in Senegal. Data were collected during a personal interview. The economic well-being was measured from the characteristics of housing and durable goods. The multivariate analysis was performed using logistic regression. The average age was 27.94 ± 5.34, 64.27% resided in rural area and 71.8% had received no schooling. Among the surveyed women, 23% were in the poorest quintile, while 16.3% were in the richest. Intermittent preventive treatment was performed in 49.3%. IPt were made more in urban areas (OR 1.45 95% [1.17 to 1.72]). It increased with the level of education with an OR of 1.5 and 1.68 in primary and secondary. The completion of the IPt increased with economic welfare. The OR ranged from 1.44 to 2.95 in the second quintile to the richest. Free medication does not necessarily benefit poor people. Other accompanying measures must be developed to facilitate the distribution of drugs particularly at community level with the involvement of people.

Accès au traitement préventif intermittent (TPI) dans une situation de gratuité : rôle du bien-être économique

In Senegal, the free distribution of sulfadoxine pyrimethamine during antenatal care is recommended to remove the disparity in the context of intermittent preventive treatment against malaria. The objective of this study was thus to identify factors influencing access to treatment in a situation of abolition of user fees. It was a cross-sectional and analytical study. It covered a sample of 1906 women aged 15-49 years randomly selected during the national survey on malaria in Senegal. Data were collected during a personal interview. The economic well-being was measured from the characteristics of housing and durable goods. The multivariate analysis was performed using logistic regression. The average age was 27.94 ± 5.34, 64.27% resided in rural area and 71.8% had received no schooling. Among the surveyed women, 23% were in the poorest quintile, while 16.3% were in the richest. Intermittent preventive treatment was performed in 49.3%. IPt were made more in urban areas (OR 1.45 95% [1.17 to 1.72]). It increased with the level of education with an OR of 1.5 and 1.68 in primary and secondary. The completion of the IPt increased with economic welfare. The OR ranged from 1.44 to 2.95 in the second quintile to the richest. Free medication does not necessarily benefit poor people. Other accompanying measures must be developed to facilitate the distribution of drugs particularly at community level with the involvement of people.

Assessment of General Public’s Knowledge and Opinions towards Antibiotic Use and Bacterial Resistance: A Cross-Sectional Study in an Urban Setting, Rufisque, Senegal

Background: Bacterial resistance is a major public health problem worldwide. One solution to this scourge is to sensitize the general public on rational use of antibiotics. Our goal was to assess people’s knowledge and opinions about antibiotic use and bacterial resistance in an urban setting. Method: We performed a cross-sectional study. A convenience sampling was done. A questionnaire was administered to 400 persons during face-to-face interviews. Results: Most respondents thought that antibiotics are effective against colds/flu (69.8%), cough (72.3%) and sore throat (64.4%). At the same time, 42.8% stated that antibiotic therapy can be stopped as soon as the symptoms disappear. Only 8.8% and 41.8% of people knew that handwashing and vaccination prevented bacterial resistance. Globally, 7% of people had a good knowledge. Socio-demographic variables were not associated with the level of knowledge. The main sources of information were entourage and pharmacy staff. Regarding the opinions, 78.3% of surveyed participants the people thought that that people overuse antibiotics. Additionally, 28% said that they have no role to play against bacterial resistance. Conclusion: People living in an urban setting had a low knowledge about antibiotic use and bacterial resistance. There is a need to implement awareness campaigns. Further studies on population practices toward antibiotic use are necessary.

Study of risk factors in patients hospitalized for psychotic disorders in the Dalal Xel mental health center in Fatick (Senegal)

Psychotic pathologies have the particularity of being often chronic and costly. According to Charrier, the direct costs associated with schizophrenia range from US

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

16billion in the United States to US

Self-Medication Among Children Under 5 Years Living in Rural Area, Ferlo Senegal

204billion in the United Kingdom and

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

79billion in Canada.1 Developing countries, particularly those in Africa, are no exception. Those who are already struggling with their inadequate health systems and on a small budget do not have the means to cope with the growing mental health problems.2 Since 1956, Senegal has set up psychiatric structures to provide a sanitary environment for the mentally ill with the creation of the neuropsychiatry department of the Fann hospital. In 1994, the first private non-profit psychiatric structure was created as the mental health center “Dalal Xel” in Thiès. Then in 2003, another health center “Dalal Xel” was opened in Fatick. This partnership between the Order of “Saint-Jean de Dieu” and the State of Senegal has increased the coverage and quality of mental health services. Dalal Xel’s mental health care providers offer a range of preventive and curative services to the population.3 The aim of this study was to study the risk factors of psychotic pathologies hospitalized in Dalal Xel of Fatick to allow a better understanding of the psychopathological processes of these diseases.

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

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.

[Study of the Consumers' preference on the universal health coverage development strategy through health mutual in Ziguinchor Region, Southwest of Senegal].

In African rural area, self-treatment has its place in the devices of therapeutic choices. The aim of this study was to determine the extent and pattern of self-treatment among children living in Senegal rural area. A cross-sectional study was carried out to examine the place of self-treatment in the stages of the therapeutic itinerary among children living in Senegal rural area in March 2017. Using Schwartz formula for sampling, we had included in this study 173 children aged 6 to 59 months living in the area of Widou Thiengoly. Mothers were interviewed on the therapeutic itinerary chosen in case of children disease. Bivariate and multivariate analyses were made. Most of children (82.3%) lived on more than 1 hour drive from health facility. For the first instance of therapeutic choice, most of mothers (61.2%) used self –medication in case of children disease, 35.3% of mothers used health facilities and 2.6% choosed traditional healers. For second instance, only 2.4% of mothers were used self-medication. For third instance, there was no self-treatment. Therapy organizing group were led by mothers at 56.5% and fathers in 45.6%. At 77.6% of cases, there were discussions to decide on the treatment of the child. In most cases, fathers were interviewed (90.9%) to give their opinion on the therapeutic choice. Fathers paid for children care in 87.6% of cases. 30.6% of mothers said that self-medication was cheaper compared to health facilities and traditional healers. 95.3% said that they believed that it was most efficiency to use a lot of type of therapeutic in same moment. Multilogistic regression found that living away from health facility (more than 30 minutes) was positively correlate with self-treatment p<0.01, ORaj=5.39 IC= [1.42-24.26]. This study contributes to the knowledge of self-treatment choices regarding children disease management in Senegal rural area. This study shows that geographical inaccessibility of health facilities impact on self-medication practices in rural area.