Khadim Niang

[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.

Study of determinants of unprotected sex in sailors of the Senegalese merchant navy

Sailors are a mobile population travelling a lot and therefore being often exposed to casual sex. The aim of this study is to analyze the determinants of unprotected sex among sailors in Senegal. A descriptive and analytical study was conducted among sailors of the merchant navy. Data on knowledge, attitudes and practices were collected during a personal interview. A multivariate analysis was performed using a multiple logistic regression. A total of 400 sailors were interviewed, 57.9% had casual sex of whom 23.7% were not protected. Sexual intercourse without protection was more common among the uneducated (OR = 2.29 [1.23 to 5.99]) and married (OR = 2.29 [1.23-5.99]). Sailors who thought that using condom reduces pleasure during sexual intercourse (OR = 2.5 [1.2-5.1]) and those who consumed alcohol (OR = 5.4 [2.07-14.2]) were less protected during casual sex. Sexual contact is one of the main modes of transmission of HIV / AIDS. Sailors often have unprotected sex. Interventions using specific ways must be performed taking into account the mobility of these men who are often uneducated.

Social inequality and antenatal care: Impact of economic welfare on pregnancy monitoring in Senegal

AIM To explore the links between antenatal care (ANC) non-attendance and economic welfare. METHOD AND SUBJECT: This was a cross-sectional, descriptive and analytical study of women aged 15 to 49 years living in Senegal in 2005. Data were from the Demography and Health Survey using a two-stage random sampling procedure. Participants were classed by quintile using an economic well-being score based on housing characteristics and ownership of sustainable goods. The quality of ANC was determined from the number of visits, the qualification of the person delivering care, and content (counseling, weight, height and blood pressure measurements). Logistic regression was used for data analysis. RESULTS A total of 6927 women were surveyed. Mean age was 28.15 years (±2.6); 20.3% were primiparous; 61.2% resided in rural areas; 70.0% had received no education. Each of the first four economic quintiles included about 20% (19.2% to 21.5%) of the participants while 16.9% were in the fifth (richest) quintile. A total of 457 women (6.6%) did not undergo any ANC visit. ANC non-attendance increased with parity, decreased with education level and was higher in rural areas than in urban areas, OR=7.2 (95% CI [5.1-10.1]). It decreased with increasing economic well-being: OR=0.6 [0.47-0.75] 2nd quintile vs. 1st, OR=0.02 [0.01-0.05] 5th quintile vs. 1st, p<0.05 overall. CONCLUSION Economic welfare plays a major role in determining use of ANC. The only way to solve health problems is to reduce inequalities. The solution to this problem is beyond the scope of health but concerns an overall economic program involving the entire community, including policy-makers.

Delivering Vitamin A Supplements to Children Aged 6–59 Months: Comparing Delivery through Campaigns and through Routine Health Services in Senegal

Abstract Background Using twice-yearly campaigns such as Child Health Days to deliver vitamin A supplements has been a key strategy over the last 2 decades, and was an important component in helping reach the Millennium Development Goals in child health. As countries move to strengthen their routine health services under the Sustainable Development Goals, efforts are underway to shift supplementation from campaign to routine delivery. Objective The aim of this study was to compare cost, coverage, and user satisfaction between twice-yearly campaigns and routine delivery of vitamin A supplements in Senegal. Methods Information was collected on cost, coverage, and user satisfaction with both types of delivery, using administrative data, interviews at various levels in the health system, and focus group discussions with caregivers. Both qualitative and quantitative information were obtained, for 2 regions using routine delivery and 2 regions using campaign delivery. Results Routine delivery receives fewer dedicated resources. Coverage is lower, especially of children >12 mo of age. Districts undertake outreach (“mini-campaigns”) to try to improve coverage in regions using routine delivery, in effect using a hybrid approach. Some mothers prefer the administration of supplements at a health facility as it is perceived as more hygienic and involving professional health workers, but others, especially those living further away, prefer house-to-house delivery which was the norm for the campaign mode. Conclusions Advance planning for the shift to routine delivery is important in maintaining coverage, as is strengthening the primary health care system by having an appropriate ratio of salaried workers to population. When the system relies heavily on volunteers, and the small incentive payments to volunteers are discontinued, coverage suffers. Routine delivery also relies on good record-keeping and hence literacy. Community understanding of, and support for, supplementation are even more important for routine than for campaign delivery.

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

Evaluation of secondary school teachers’ knowledge on screening for breast cancer in Benin

16billion in the United States to US

Screening for cervical cancer in Senegal: Contributing factors

204billion in the United Kingdom and

Hypertension, Cardiovascular Risk Factors and Complications in Large Population Based Study in Senegal

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 des déterminants des rapports sexuels non protégés chez les marins de la marine marchande sénégalaise

Aims: breast cancer is a public health problem in Africa. the objective of this study is to assess the knowledge of secondary school teachers on screening for breast cancers and to determine the associated factors. Methods: this is a crosssectional, descriptive and analytical study. A stratified three-stage sampling allowed us to draw 405 secondary school teachers working in a public institution from the Atlantic to benin during the 2013–2014 school year. the data were collected on an individual interview in schools. the knowledge was considered good if the teacher knew about: mammography, its frequency of realization and its target. A logistic regression was performed. results: the mean age was 35.2 years (8.5). the male teachers accounted for 82.77%. Half of the teachers (49.90%) had good knowledge about breast cancer screening. Factors related to knowledge about breast cancer screening among high school teachers are: level of information (Or adjusted = 11.54 [6.62–20.11]), history of breast cancer in (adjusted Or = 4.75 [1.39–10.21]) and females (adjusted Or = 2.64 [1.29–5.42]). conclusion: the study shows insufficient information on breast cancer in benin. It is essential to raise this Adama Faye1, Sèlomè Julie Emma Azanman-Doumenou1, Khadim Niang1, Anta Tal-Tal1 Affiliation: 1Institute of Health and Development, BP16390 Dakar-Fann, UCAD, Dakar, Sénégal. Corresponding Author: Adama Faye, Institute of Health and Development, BP16390 Dakar-Fann, UCAD, Dakar, Sénégal; Email: adama.faye@ucad.edu.sn Received: 27 June 2017 Accepted: 06 July 2017 Published: 29 July 2017 level by establishing a national cancer control program.