Etude qualitative de suivi d’indicateurs dans la prise en charge communautaire du VIH/SIDA, et facteurs de survie après 12 mois de traitement dans les villes de Bouaké, Korhogo et Man.
Care/Fonds Mondial de lutte contre le sida, le paludisme et la tuberculose, 57 p.
Bovine tuberculosis: an old disease but a new threat to Africa
Wuhib Y. Ayele, S.D. Neill, I. Pavlik, Mitchell G. Weiss, Jakob Zinsstag, 2004
"Bovine tuberculosis (TB) is a disease characterised by progressive development of specific granulomatous le-sions or tubercles in lung tissue, lymph nodes or other organs. Mycobacterium bovis is the causative agent of the disease. Bovine species, including bison and buffaloes, are susceptible to the disease, but nearly all warm-blooded animals can be affected. All species are not equally susceptible to the disease; some are spill-over (end) hosts and others maintenance hosts. In Africa, bovine TB primarily affects cattle; however, infection in other farm and domestic animals, such as sheep, goats, pigs, dogs and cats, is not uncommon. Wild ruminants and carnivores are also affected and are the natural reservoirs of the infectious agent in the wild. Man is also susceptible to the disease, the highest risk groups being individuals with concomitant HIV/AIDS infection. In Africa, human TB is widely known to be caused by M. tuberculosis; however, an unknown proportion of cases are due to M. bovis. This infection in humans is underreported as a result of the diagnostic limitations of many laboratories in distinguishing M. bovis from M. tuberculosis. None of the national reports submitted to the OIE and WHO by African member states mention the importance of M. bovis in human TB cases. Consumption of unpasteurised milk and poorly heat-treated meat and close contact with infected animals represent the main sources of infection for humans. This review attempts to examine the impact of bovine TB on the health of animals and humans."
This report describes a network of public health care workers, veterinarians and nomadic pastoralists that was set up in Chad to increase vaccination coverage to nomadic children and women who had rarely been vaccinated before. The objectives of the project were to provide human vaccination in conjunction with existing veterinary services, to evaluate the feasibility and limitations of such campaigns, to determine what other services could be provided concurrently, and to estimate the savings for public health care cases in comparison with carrying out vaccination separately. The joint vaccination campaign approach is innovative, appreciated by nomadic pastoralists and less expensive than separate vaccination. By using the mobility of veterinarians in remote zones far from health care facilities, vaccination can be provided to nomadic children and women in countries with limited resources.
Médecine Tropicale 2004, Vol. 64, No. 5, pp. 497-502
"In September 2002, an armed conflict erupted in Côte d'Ivoire which has since divided the country in the government-held south and the remaining territory controlled by the 'Forces Armées des Forces Nouvelles' (FAFN). There is concern that conflict-related population movements, breakdown of health systems and food insecurity could significantly increase the incidence of HIV infections and other sexually-transmitted infections, and hence jeopardize the country's ability to cope with the HIV/AIDS epidemic. Our objective was to assess and quantify the effect this conflict had on human resources and health systems that provide the backbone for prevention, treatment and care associated with HIV/AIDS. We obtained data through a questionnaire survey targeted at key informants in 24 urban settings in central, north and west Côte d'Ivoire and reviewed relevant Ministry of Health (MoH) records. We found significant reductions of health staff in the public and private sector along with a collapse of the health system and other public infrastructures, interruption of condom distribution and lack of antiretrovirals. On the other hand, there was a significant increase of non-governmental organizations (NGOs), some of which claim a partial involvement in the combat with HIV/AIDS. The analysis shows the need that these NGOs, in concert with regional and international organizations and United Nations agencies, carry forward HIV/AIDS prevention and care efforts, which ought to be continued through the post-conflict stage and then expanded to comprehensive preventive care, particularly antiretroviral treatment."
Effect of washing and disinfecting containers on the microbiological quality of fresh milk sold in Bamako (Mali)
Bassirou Bonfoh, Idriss O. Alfaroukh, A. Fané, Zakaria Farah, J. Nicolet, C. Roth, Cheikh F. Simbé, A.N. Traoré, Jakob Zinsstag, 2006
"The present study aimed to improve the microbiological quality of the milk, from the cow’s udder to the selling point by container washing and disinfecting. The total counts (TC), Enterobacteriaceae counts (EBC) were used as quality indicators. [...] The study suggests that in milk production area, besides udder infection and water quality, hygiene behaviour with respect to hand washing, container’s cleaning and disinfection are the key areas that remain of relevance to milk hygiene intervention."
Operational plan for small scale milk producers in peri-urban of Bamako (Mali)
Bassirou Bonfoh, Idriss O. Alfaroukh, P. Ankers, M. Diabaté, Zakaria Farah, A. Sall, S. Tembely, 2006
Journal of Sahelian Studies and Research (12): 7-25.
Raw milk composition of Malian Zebu cows (Bos indicus) raised under traditional system
Bassirou Bonfoh, Riccardo Aebi, Idriss O. Alfaroukh, René Badertscher, Marius Collomb, Zakaria Farah, Jacques Meyer, Brita Rehberger, Cheikh F. Simbé, Jakob Zinsstag, 2005
Milk from Malian Zebu cows was analysed during the dry and hot season (March–June) in order to assess its composition and the components variation according to the presence of subclinical mastitis and supplementary feeding. The Zebu cow milk (n=30) was composed of 8 g/kg ash, 43 g/kg fat, 48 g/kg lactosemonohydrate, 37 g/kg proteins and 134 g/kg total solids. One-third of the cows tested positive to subclinical mastitis (white blood cell count >350,000/mL). Milk components were significantly affected by the somatic cell count (decrease of lactosemonohydrate, increase of fat and total solids P<0.01). Supplementation of the diet of Zebu cows with low quantity of pasture straw significantly and positively affected milk composition. The fatty acids were composed of a high proportion of polyunsaturated, long-chain fatty acids (oleic acid). This indicates that Zebu cows at this period of the year mobilize body fat for milk production because of the energy deficit in their diet. Lack of supplementary feeding of the Zebu cows and subclinical mastitis appeared to be main constraints in the extensive livestock system in Mali.
"Various studies on African solidarity, survival strategies and the 'therapy man agement group' [J. M. Janzen (1978) The Quest for Therapy in Lower Zaire, Berkeley, Los Angeles & London: University of California Press] have suggested that institutionalized relationships in the form of networks or groups afford an individual access to resources, also in case of illness. My study reconsiders these arguments in ethnographic research about everyday illness management. It focuses on a heterogeneous urban neighbourhood in Abidjan and analyses who offers help to whom, and what kind of help people offer to one another. The findings show that social networks play an important but at the same time restricted role in illness management. The main source of assistance in response to affliction is household members. Apart from emotional and moral support, relatives living outside the household and non-kin play only a minor role. The social network offers help only sporadically, and very often the sick person has to ask friends and family several times before she or he receives financial or practical support. The emphasis given to social networks in the existing literature is often overestimated, at least in the case of illness. These findings implicate the importance of strengthening informal and formal security systems, especially in an urban context of economic hardship and political insecurity."
In: Chenal J, Pedrazzini Y, Cissé G, Kaufmann V, éditeurs. Quelques rues d’Afrique. Observation et gestion de l’espace public à Abidjan, Dakar et Nouakchott. Lausanne : Les éditions du Lasur, pp 65-80.
In: Chenal J, Pedrazzini Y, Cissé G, Kaufmann V, éditeurs. Quelques rues d’Afrique. Observation et gestion de l’espace public à Abidjan, Dakar et Nouakchott. Lausanne : Les éditions du Lasur, pp 33-48.
This study investigated the possibility of recycling nutrients in human excreta and municipal solid waste for use in agriculture. It reports on the use of drying beds in separating solid and liquid fractions of faecal sludge (FS) so that the solids can be co-composted and the organic matter and part of the nutrients captured for urban agriculture...
Access to Health Care among Transhumant Fulani Pastoralists in Mauritania: Using the Health Access Livelihood Approach
Corinne Corradi, 2009
The focus of this study was set on pastoralist's livelihood capitals as well as qualitative dimensions of access. Available resources were identified and impeding factors when mobilising those were described. The financial means for health care were found to be limited by pastoralists themselves, despite the possession of cattle and a milk selling contract to a dairy plant. Further, insufficient and unreliable transport possibilities, as well as certain shortcomings in the quality of health services were pointed out by pastoralists. Mutual understanding and communication between Fulani pastoralist and health care personnel was also found to be insufficient and impeding for accessing health care. Limited access was also related to economic structures on the market, social norms within Fulani society and individual strategies, depending for example on pulaaku, the Fulani code of conduct. The lack of infrastructure and medical supplies further did not contribute to the utilisation of health services, either.
Within the framework of an multidisciplinary research and action program, morbidity patterns were assessed in three nomadic communities in Chad. A total of 1092 women, men and children were interviewed and examined in the course of three surveys carried out by a physician during the dry and rainy season. Nomads reporting no health problems were rare. Tuberculosis was suspected in 4,6 % of adults after clinical examination and bronchopulmonary disorders in children less than five years of age. Febrile diarrhea was more prevalent during the wet season when access to clean drinking water was more difficult. Simple malaria was rarely diagnosed in Arabs during the dry season. In contrast simple malaria was frequent in Fulani who stay in the vicinity of Lake Chad during the dry period. Protein-energy malnutrition was observed in only 3 of 328 children younger than 15 years of age.
Médecine Tropicale 2004, Vol. 64, No. 5, pp. 469-473
"The molecular characterizations of the first 40 Mycobacterium tuberculosis isolates from Chad revealed a high proportion of isolates of the Cameroon family (33%), of which one isolate showed a monodrug resistance. In total, 9/33 (27%) isolates were resistant to isoniazid. The implications of these findings are discussed."
"This slaughterhouse study in Chad shows higher proportions of Mycobacterium bovis isolates among Mbororo than Arabe zebu cattle. Spoligotyping shows a homogenetic population structure for M. bovis and lack of spacer 30, as were found in neighboring Cameroon and Nigeria. This finding suggests transborder and ongoing transmission between cattle."
"In Chad, during a study on tuberculosis in humans and cattle, 52 non-tuberculous mycobacteria (NTM) strains were isolated. By means of INNO-LiPA, PRA-hsp65 amplification and sequencing of 16S rDNA, NTM species of 25/52 isolates were identified. M. fortuitum complex (8) was the most frequent species, followed by M. nonchromogenicum (4) and M. avium complex (4). PRA method could identify M. fortuitum 3rd variant among isolates derived from cattle specimens. This finding could confirm the existence of farcy in the Chadian cattle population as M. fortuitum 3rd variant and putitative pathogen M. farcinogenes can't be distinguished by the methods used in this study. Half of the NTM isolates could not be specified and we considered them as contaminants from the environment."
The integration into a Geographical information system (GIS) of multi-source data from QUICKBIRD imagery, ancilliary data and the results from socio-environmental investigations alowed to analyse the sanitary environment of 6 precarious settlements located along an open and exposed drainage channel, in Yopougon (Abidjan, Côte d’Ivoire). The observatory of the sanitary environment of these deprivileged areas were conducted through analysis and mapping of main factors influencing the life quality of the populations. The spatial sharpness of QUICKBIRD imagery contributed to update the land use/land cover map. Analysis of various factors witch characterise the sanitary environment reveals many insufficiences as regards the management of the sanitation system of the settlements, thus exposing the populations to illness related to sanitation like malaria and diarrhoea. The findings will permit planing appropriate measurements to overcome sanitation problems in these précarious areas.
In: VertigO – La revue en sciences de l'environnement 8(3).
The purpose of this study was to contribute to syndrome mitigation related to deficiencies in the management of urban drainage and solid and liquid waste in Abidjan’s informal settlements in order to assist in improving living conditions of these populations. The study focuses on solid and liquid waste management in 6 informal settlements (Doukouré, Yaoséhi, Mami Faitai, Yamoussoukro, Gbinta and Niangon Continu) which are located along a main drainage channel.
Dongo K. 2006. Analysis of Deficiencies in the Management of Urban Drainage and Solid and Liquid Waste in the Slums of Yopougon (Abidjan, Ivory Coast): GIS Mapping, Modelling, and Social Anthropology Approaches [PhD thesis]. Abidjan, Cote d'Ivoire: Université de Cocody.
Tropical humid climates of sub-Saharan Africa with a high level of variability build a challenge for hygienic models used in urban drainage. Based on a probabilistic and stochastic approach,this work optimised and designed models which best simulate tropical downpours and improved calculations related to urban drainage in Abidjan and in other urban settings with similar climatic conditions.
In: African Journal of Science and Technology. Science and Engineering Series Vol. 8, No. 1, pp. 8 - 16.
In sub-Saharan Africa, the "hygienic" model used in urban drainage is faced with constraints in humid tropical environment, subjected to a high level of climatic variability. In Côte d’Ivoire adapting Montana's rain model is not satisfactory for certain time slots whereas this model includes the Caquot's rate-of-flow model used in urban
drainage. This work aims at optimizing and designing models which best simulate tropical downpours and help in calculations relating to urban drainage in Abidjan and elsewhere.
In: 10th International Conference on Urban Drainage, Copenhagen/Denmark, 21-26 August 2005.
A la recherche des déterminants institutionnels du bien-être des populations sédentaires et nomades dans la plaine du Waza-Logone de la frontière camerounaise et tchadienne
"Cette contribution présente les articulations d’une étude actuellement en cours dans la région du Logone et Chari au Cameroun et dont le but est d’oeuvrer pour l’élaboration des savoirs et des connaissances pour le développement pastoral. De nombreux groupes de populations sédentaires et nomades vivent dans cette localité et dépendent des plaines inondées du Sud du lac Tchad pour leur subsistance. Or, les ressources naturelles connaissent de grandes variations saisonnières et deviennent parfois la propriété des groupes sédentaires. De ce fait, les éleveurs nomades éprouvent de nombreuses difficultés pour accéder non seulement aux pâturages et à l’eau, mais aussi aux services de santé de qualité (centres hospitaliers, médicaments efficaces). L’ambition ici est de définir de nouvelles conditions institutionnelles d’accès aux soins de santé pour les populations sédentaires et nomades. En fait, la plupart des problèmes auxquels sont confrontés les nomades de nos jours seraient dus à l’inadaptation des règles formelles en vigueur aux stratégies de survie des populations rurales. Celles mises en place à l’époque pré-coloniale ne sont plus opérationnelles. L’on pourrait conclure, sous forme d’hypothèse à vérifier, que la définition de nouveaux cadres institutionnels de gestion des ressources naturelles pourrait contribuer à l’amélioration des conditions de santé des pasteurs nomades."
Focusing on pastoralism and access to land, this article aims to demonstrate that management institutions are eroded in a context of resource scarcity, and that certain groups build discourse and strategies on fuzzy notions of nationhood or identity in order to exclude other users. In this process, the notion of autochthony appears to be an ideological tool in the hands of native people to express their social malaise and difficulties in sustaining their livelihoods in a context of global development. The article concludes that in a context of ‘presence-absence’ of the state, negotiations between various stakeholders at different levels could foster sustainable development.
In: Hurni H, Wiesmann U, editors; with an international group of co-editors. Global Change and Sustainable Development: A Synthesis of Regional Experiences from Research Partnerships. Perspectives of the Swiss National Centre of Competence in Research (NCCR) North-South, University of Bern, Vol. 5. Bern, Switzerland: Geographica Bernensia, pp 61-76.
La vulnérabilité des citadins à Abidjan en relation avec le palu. Les risques environnementaux et la commoditization agissant à travers le palu sur la vulnérabilité urbaine
The article aims to better understand the relation between urban vulnerability, environmental risks, and commoditization in regard to palu in Abidjan (Côte d’Ivoire). This research in medical anthropology analyses the local illness palu (abbreviation of the paludisme, e.g. malaria), a bodily experience of non-specific symptoms.
Environmental risks are closely linked to palu. They are locally understood as a cause of palu, which, as the illness becomes a concrete bodily experience, offer a possibility of acting upon and addressing these risks. The patient does have the possibility of treating its palu with remedies. Therefore, commoditization of drugs not
only represents a source of vulnerability but also offers a possibility to face persisting environmental risks. Vulnerability and its attached meanings are a dynamic concept. Unfortunately, commoditization of drugs implies high risks of over- or mistreatment.
In French
VertigO - la revue électronique en sciences de l'environnement hors série 3
Most contemporary discussions on African development since independence forty years ago emphasize the notion that Africa is still “mal parti”. Many show discontent for what has been achieved in this time, despite that “Africa works” as is suggested by Chabal and Daloz in their widely discussed book (1999). I will focus on the issue of sustainable development in Africa. This will be illustrated by the presentation of a common property resource management research project (on fisheries, pastures, wildlife, water for irrigation, and forests). The question of why the overuse of natural resources and conflicts over resources are occurring in modern day Africa is addressed here. This research project is called “Common Property Institutions and Power Relations: Resource Management, Change and Conflicts in African Floodplain Wetlands”. It focuses on six African floodplain wetlands in semi-arid zones (Internal Niger Delta in Mali, Hadejia-Jama'ara in Northern Nigeria, Logone Floodplain in Northern Cameroon, Pangani Floodplain in Tanzania, Okavango Delta in Botswana and Kafue Flats in Zambia (Haller 2001)) [...].
The discriminatory power of variable number tandem repeat (VNTR) typing based on 16 known loci (12 MIRUs, 3 ETRs and VNTR 3232) was assessed for Mycobacterium bovis strains collected sequentially at the slaughterhouse of N’Djaména, Chad. Of 67 M. bovis strains analyzed, 67% were clustered. In this study, VNTR typing was highly discriminative with an overall allelic diversity (hoa) of 0.922. We defined five loci (ETR A, B, C and MIRU 26, 27) as highly (h > 0.25), two loci (MIRU 4, and VNTR 3232) as moderately (0.11 < h < 0.25) and three loci (MIRU 16, 20, 31) as poorly (0.01 < h < 0.11) discriminative. Six loci (MIRU 2, 10, 23, 24, 39, and 40) showed no polymorphism at all. VNTR typing of the five highly discriminative loci (h = 0.917) proved to be most appropriate for first line typing of M. bovis strains of Chad and superior than spoligotyping (hsp = 0.789). In contrast to Mycobacterium tuberculosis strains, a consensus on VNTR loci needs to be found for M. bovis strains. The selection of a generally agreed set of VNTR loci for molecular discrimination of M. bovis in different geographical settings is discussed.
Genetic Diversity in Mycobacterium ulcerans Isolates from Ghana Revealed by a Newly Identified Locus Containing a Variable Number of Tandem Repeats
Markus Hilty, Daniel Boakye, Ernestina Mensah-Quainoo, David Ofori-Adjei, Gerd Pluschke, Françoise Portaels, Simona Rondini, Esther Schelling, Dorothy Yeboah-Manu, Jakob Zinsstag, 2006
"The molecular typing methods used so far for Mycobacterium ulcerans isolates have not been able to identify genetic differences among isolates from Africa. This apparent lack of genetic diversity among M. ulcerans isolates is indicative of a clonal population structure. We analyzed the genetic diversity of 72 African isolates, including 57 strains from Ghana, by variable number of tandem repeat (VNTR) typing based on a newly identified polymorphic locus designated ST1 and the previously described locus MIRU 1. Three different genotypes were found in Ghana, demonstrating for the first time the genetic diversity of M. ulcerans in an African country. While the ST1/MIRU 1 allele combination BD/BAA seems to dominate in Africa, it was only rarely found in isolates from Ghana, where the combination BD/B was dominant and observed in all districts studied. A third variant genotype (C/BAA) was found only in the Amansie-West district. The results indicate that new genetic variants of M. ulcerans emerged and spread within Ghana and support the potential of VNTR-based typing for genotyping of M. ulcerans."
"One approach of molecular epidemiology of mycobacteria is the genotyping and comparison of DNA of infectious strains in order to monitor the transmission pathways of diseases. It is based on the assumption that patients infected with clustered strains are epidemiologically linked. Such results may help in understanding the modes of transmission and therefore in putting in place an adapted control strategy. [...] Therefore the overall aim of this study was to contribute to the development and refinement of innovative molecular typing tools in order to study Mycobacterium tuberculosis, bovis and ulcerans infections."
Humankind today is challenged by numerous threats brought about by the speed and scope of global change dynamics. A concerted and informed approach to solutions is needed to face the severity and magnitude of current development problems. Generating shared knowledge is a key to addressing global challenges. This requires developing the ability to cross multiple borders wherever radically different understandings of issues such as health and environmental sanitation, governance and conflict, livelihood options and globalisation, and natural resources and development exist.
Global Change and Sustainable Development presents 36 peer-reviewed articles written by interdisciplinary teams of authors who reflected on results of development-oriented research conducted from 2001 to 2008. Scientific activities were – and continue to be – carried out in partnerships involving people and institutions in the global North, South and East, guided by principles of sustainability. The articles seek to inform solutions for mitigating, or adapting to, the negative impacts of global dynamics in the social, political, ecological, institutional and economic spheres.
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In: Bearth, Barbara Becker, Rolf Kappel, Gesine Krüger, Roger Pfister, editors. 2007. Thomas Afrika im Wandel. vdf Hochschulverlag AG, ETH Zürich, pp. 123-136
"In Chad, as in most sub-Saharan Africa countries, HIV/AIDS poses a massive public health threat as well as an economic burden, with prevalence rates estimated at 9% of the adult population. In defining and readjusting the scope and content of the national HIV/AIDS control activities, policy makers sought to identify the most cost-effective options for HIV/AIDS control. The cost-effectiveness analysis reported in this paper uses a mixture of local and international information sources combined with appropriate assumptions to model the cost-effectiveness of feasible HIV prevention options in Chad, with estimates of the budget impact. The most cost-effective options at under US$100 per infection prevented were peer group education of sex workers and screening of blood donors to identify infected blood before transfusion. These options were followed by mass media and peer group education of high risk men and young people, at around US$500 per infection prevented. Anti-retroviral therapy for HIV infected pregnant women and voluntary counselling and testing were in the order of US$1000 per infection prevented. The paper concludes with recommendations for which activities should be given priority in the next phase of the national HIV/AIDS control programme in Chad."
Les associations de pré-collecte des déchets à Ouagadougou, les cas de Wogodogo et Nonssin
Analyse financière et devenir des associations dans ces associations
Raphael Jean Richard, 2005
Master's Thesis, Swiss Federal Institute of Technology Lausanne, Switzerland
"La gestion des ordures ménagères dans le contexte africain et burkinabé manque d'organisation et de coordination, car le secteur des déchets solides n'est pas considéré comme prioritaire. Pourtant, les déchets présentent un risque réel pour la santé et l'environnement. Le Centre Régional pour l'Eau Potable et l'Assainissement (CREPA) a appuyé avec un soutien financier, technique et formatif des associations de quartier qui souhaitaient améliorer leur cadre de vie. Cette étude s'est penchée sur les deux premières associations assistées par l'Institution à Ouagadougou en 1993 et 1994. [...]"
"L'une des préoccupations majeures qui apparaît lorsqu'on s'intéresse au VIH/sida dans les pays du sud, est celle de la vulnérabilité des femmes infectées. Face à cette vulnérabilité, quelles réponses une association de femmes vivant avec le VIH/sida peut-elle apporter ? Pour répondre à cette question, nous avons mené une enquête de terrain auprès d'une association de femmes vivant avec le VIH/sida à Abidjan. Cette enquête qui a combiné approche quantitative et approche qualitative visait à cerner les réponses de l'association face aux risques auxquels sont exposées ces femmes. Les résultats indiquent que face à la vulnérabilité des femmes qui se traduit soit par une rupture des liens sociaux soit par le silence imposé par le risque d'une telle rupture, les soutiens moral, matériel et financier constituent les principales actions menées par l'association."
Evaluation de la gestion communautaire des boues de vidange dans la Commune d’Arrondissement de Sahm-Notaire, Ville de Guédiawaye- Région de Dakar-Sénégal
Mvoubou Félicien Kassa, 2005
Master's Thesis, Ecole Inter-Etats d’Ingénieurs de l’Equipement Rural de Ouagadougou, Burkina Faso
Cost-description of a pilot parenteral vaccination campaign against rabies in dogs in N'Djaména, Chad
U. Kayali, G. Hutton, R. Mindekem, Guelmbaye Ndoutamia, Jakob Zinsstag, 2006
"In the discussion about policies and strategies for rabies prevention in developing countries, intervention costs arise as a major issue. In a pilot mass vaccination campaign against rabies in N'Djaména, Chad, 3000 dogs were vaccinated. We assessed vaccination coverage and cost, showing the cost per dog vaccinated for the public sector and for society. An extrapolation to city level calculated the approximate cost of vaccinating all 23 600 dogs in N'Djaména. In the pilot mass campaign with 3000 dogs the average cost per dog was 1.69 €. to the public and the full societal cost was 2.45 €. If all 23 600 dogs in N'Djaména were vaccinated, the average cost would fall to 1.16 € to the public and 1.93 € to society. Private sector costs account for 31% of the cost to vaccinate 3000 dogs, and 40% of the cost to vaccinate 23 600 dogs. Mass dog vaccination could be a comparatively cheap and ethical way to both control the disease in animals and prevent human cases and exposure, especially in developing countries. The cost-effectiveness of dog vaccination compared with treating victims of dog bites for prevention of human rabies should be further assessed and documented."
"Canine rabies, and thus human exposure to rabies, can be controlled through mass vaccination of the animal reservoir if dog owners are willing to cooperate. Inaccessible, ownerless dogs, however, reduce the vaccination coverage achieved in parenteral campaigns. This study aimed to estimate the vaccination coverage in dogs in three study zones of N’Djaména, Chad, after a pilot free parenteral mass vaccination campaign against rabies. We used a capture–mark–recapture approach for population estimates, with a Bayesian, Markov chain, Monte Carlo method to estimate the total number of owned dogs, and the ratio of ownerless to owned dogs to calculate vaccination coverage. When we took into account ownerless dogs, the vaccination coverage in the dog populations was 87% (95% confidence interval (CI), 84–89%) in study zone I, 71% (95% CI, 64–76%) in zone II, and 64% (95% CI, 58–71%) in zone III. The proportions of ownerless dogs to owned dogs were 1.1% (95% CI, 0–3.1%), 7.6% (95% CI, 0.7–16.5%), and 10.6% (95% CI, 1.6–19.1%) in the three study zones, respectively. Vaccination coverage in the three populations of owned dogs was 88% (95% CI, 84–92%) in zone I, 76% (95% CI, 71–81%) in zone II, and 70% (95% CI, 66–76%) in zone III. Participation of dog owners in the free campaign was high, and the number of inaccessible ownerless dogs was low. High levels of vaccination coverage could be achieved with parenteral mass vaccination. Regular parenteral vaccination campaigns to cover all of N’Djaména should be considered as an ethical way of preventing human rabies when post-exposure treatment is of limited availability and high in cost."
"This work describes for the first time the incidence risk of passively reported canine rabies, and quantifies reported human exposure in N’Djaména (the capital of Chad). To diagnose rabies, we used a direct immunofluorescent-antibody test (IFAT). From January 2001 to March 2002, we were brought 34 rabies cases in dogs and three cases in cats. Canine cases were geographically clustered. The annual incidence risk of canine rabies was 1.4 (95% CI: 1.2, 1.7) per 1000 unvaccinated dogs. Most of the rabid dogs were owned—although free-roaming and not vaccinated against rabies. Most showed increased aggressiveness and attacked people without being provoked. Eighty-one persons were exposed to rabid dogs and four persons to rabid cats (mostly children<15 years old). Most of the exposed persons were neighbours or family members of the animal owner. Most exposures were transdermal bites, but nearly half of all exposed persons did not apply any first wound care or only applied a traditional treatment. In N’Djaména, humans are often exposed to canine rabies but do not use the full-course post-exposure treatment and wound care is insufficient. Most rabid dogs would be accessible to parenteral vaccination. Pilot vaccination campaigns are needed to determine the success of dog mass vaccination in N’Djaména as a way to prevent animal and human rabies."
Re-evaluating the burden of rabies in Africa and Asia
Darryn L. Knobel, Sarah Cleaveland, Paul G. Coleman, Eric M. Fèvre, Martin I. Meltzer, François-Xavier Meslin, M. Elizabeth G. Miranda, Alexandra Shaw, Jakob Zinsstag, 2005
Rabies remains an important yet neglected disease in Africa and Asia. Disparities in the affordability and accessibility of post-exposure treatment and risks of exposure to rabid dogs result in a skewed distribution of the disease burden across society, with the major impact falling on those living in poor rural communities, in particular children.
Seasonal epidemiology of ticks and aspects of cowdriosis in N’Dama village cattle in the Central Guinea savannah of Côte d’Ivoire
Lea Knopf, B. Betschart, B. Gottstein, F. Jongejan, C. Komoin-Otaka, Jakob Zinsstag, 2002
In the Central Guinea savannah of Côte d’Ivoire, cattle breeding started only 30 years ago. The impact of parasitism on the overall health status and productivity of the trypanotolerant N’Dama cattle in this area is unknown. In close collaboration with national veterinary institutions and local farmers, we studied spectrum, burden and seasonal dynamics of ticks (including aspects of cowdriosis) on N’Dama village cattle.
PhD Thesis, Swiss Federal Institute of Technology Lausanne, Switzerland
The thesis developed tools for sustainable faecal sludge management: stakeholder analysis combined with stakeholder involvement as a planning model, sociopsychological model for understanding the population willingnesss to improve faecal sludge management, sustainable money fluxes based on sanitations taxes and emptying fees.
Etude de la morbidité palustre à l’Hôpital Général d’Adiaké, Côte d’Ivoire de 1998 à 2000
Atioumouna Kone, B. V. J. Benié, N. S. Dagnan, K. D. Ekra, B. Kakou, E. Konan, J. Tagliante-Saracino, I. Tiembré, P. Zengbé, 2005
Notre travail est une étude rétrospective de la morbidité palustre sur 3 ans (de 1998 à 2000) dans un hôpital général situé en zone lagunaire (Adiaké).
Il ressort de cette étude que le tiers (34,79 %) des patients ayant consulté présentait un paludisme et que plus de la moitié des hospitalisations étaient des cas de paludisme. Nous avons noté une légère prédominance féminine (52,11 %) en consultation. La population infanto-juvénile était la plus touchée tant en consultation qu’en hospitalisation avec respectivement 58,38 % et 54,97 % ; elle concerne surtout la tranche d’âge de 1 à 4 ans.
Le mois de Juillet pendant ces trois années a enregistré le plus de cas de paludisme. Nous avons constaté que le paludisme se transmet toute l’année avec une légère prédominance à la grande saison des pluies. La principale complication du paludisme qui a occasionné une hospitalisation était l’anémie (82,62 %) qui avait touché les enfants de 0 à 15 ans dans 88, 29 % des cas et les adultes dans 11,71 % des cas. Le paludisme représentait la principale cause de décès en hospitalisation. Ces décès étaient dus dans 81,84 % à l’anémie.
Impact de la démoustication sur les populations d’Aedes aegypti de deux communes de la ville d’Abidjan (Port-Bouët et Yopougon), Côte d'Ivoire
Atioumouna Kone, P. Carnevale, N. S. Dagnan, J. Tagliante-Saracino, I. Tiembré, 2005
Devant les résultats nous pouvons conclure que les pulvérisation aériennes spatiales d'insecticides permettent de réduire les densités de moustique en général et d'Aedes aegypti en particulier mais que cette réduction est de courte durée. Cette réduction est beaucoup plus marquée sur les populations exophagues que d'endophagues d'où la nécessité de tenir compte de la bio écologie des moustiques lors de l'application de cette technique.
Importance des pneus abandonnés dans la prolifération d’Aedes aegypti en milieu urbain
Cas de la ville de Sassandra
Atioumouna Kone, K. Adou, B. V. J. Benié, N. S. Dagnan, K. D. Ekra, L. Kouadio, K. P. Odéhouri, I. Tiembré, 2006
L’analyse montre que les pneus abandonnés représentent en moyenne 50% de l’ensemble des gîtes larvaires de la ville de Sassandra. Ils sont les plus productifs car 70% d’entre eux en moyenne contiennent des larves d’Aedes aegypti. Ainsi, ce travail met en évidence, le rôle prépondérant que jouent les pneus abandonnés dans la prolifération d’Aedes aegytpi dans la ville de Sassandra. Ainsi, la lutte antivectorielle prend une place de choix dans la lutte contre la fièvre jaune.
"La lagune d'Abidjan est polluée par les déchets urbains. Les populations périurbaines, riveraines de cette lagune sont exposées à la pollution. L'étude porte sur l'évaluation des aspects de vulnérabilité et de résilience des populations exposées. Neuf "focus groups" ou groupes de discussion ont été réalisés sur trois sites qui bordent la lagune. Les populations étudiées se disent victimes de "la ville". Les aspects de leur vulnérabilité rapportés par elles sont entre autres les mauvaises odeurs qui émanent des eaux lagunaires, les mouches et moustiques qui se multiplient en lagune et qui leur apportent des maladies comme le paludisme et les diarrhées, les démangeaisons de corps dont les pêcheurs se plaignent. En ce qui concerne les aspects de résilience, des actions individuelles d'entretien des berges lagunaires sont menées par endroit. Le capital financier, humain et social des malades ou de leur famille joue un rôle important dans leur résilience en cas de maladie."
Effect of agricultural activities on prevalence rates, and clinical and presumptive malaria episodes in central Côte d'Ivoire
Benjamin G. Koudou, Guéladio Cissé, O. Girardin, Jennifer Keiser, Kouassi Klero, Mamadou Kone, Eliézer K. N'Goran, Marcel Tanner, Yao Tano, Jürg Utzinger, Penelope Vounatsou, 2009
"L'objectif de la présente étude conduite dans des zones de production maraîchère d'Abidjan, Côte d'Ivoire, était d'analyser les problèmes principaux des cultivateurs; leur perceptions des maladies et des risques sanitaires et la corrélation entre les risques sanitaires et le statut socio-économique des ménages ainsi que la cohésion sociale dans les communautés maraîchères. Les problèmes principaux sont l'insécurité foncière et de difficultés de commercialisation. Les préoccupations sanitaires sont la fatigue et l'insalubrité. En l'absence d'une éducation sanitaire fondée et des interventions localement adaptées, les cultivateurs n'accordent pas une attention particulière à la prévention des risques sanitaires. Le support technique, en concordance avec l'éducation et la communication de la prévention des risques sanitaires, promettent une augmentation de la productivité et une amélioration des moyens de subsistance des ménages cultivateurs à Abidjan."
"Urban agriculture is common across Africa and contributes to the livelihoods of urban dwellers. Some crop systems create suitable mosquito breeding sites and thus might affect malaria transmission. The purpose of this study was to identify, map, and characterize potential mosquito breeding sites in agricultural land use zones in a medium-sized town of western Côte d’Ivoire and to assess risk factors for productive Anopheles breeding sites. Two surveys were carried out; one toward the end of the rainy season and the second one during the dry season. [...] The highest Anopheles larval productivity was observed in rice paddies, agricultural trenches between vegetable patches, and irrigation wells. An indirect link could be established between the occurrence of productive Anopheles breeding sites and agricultural land use through specific man-made habitats, in particular agricultural trenches, irrigation wells, and rice paddies. Our findings have important bearings for the epidemiology and control of urban malaria in sub-Saharan Africa."
Urban farming and malaria risk factors in a medium-sized town of Côte d’Ivoire
Barbara Matthys, Guéladio Cissé, Emmanuel Gbede Becket, Laura Gosoniu, Eliézer K. N'Goran, Giovanna Raso, Marcel Tanner, Andres Tschannen, Jürg Utzinger, Penelope Vounatsou, 2006
"Urbanization occurs at a rapid pace across Africa and Asia and affects people’s health and well-being. A typical feature in urban settings of Africa is the maintenance of traditional livelihoods, including agriculture. The purpose of this study was to investigate malaria risk factors in urban farming communities in a medium-sized town in Côte d’Ivoire. Two cross-sectional surveys were carried out among 112 households from six agricultural zones. [...] Our findings indicate that specific crop systems and specific agricultural practices may increase the risk of malaria in urban settings of tropical Africa."
Two groups of M. bovis were detected in cattle slaughtered at the Bamako abattoir. The spoligotype pattern of the first group has similarities to strains previously observed in Chad, Cameroon and Nigeria. The additional absence of spacer 6 in the majority of these strains suggests a Mali specific clone. The spoligotype patterns of the remaining strains suggest that they may have been of European origin.
In: Chenal J, Pedrazzini Y, Cissé G, Kaufmann V, éditeurs. Quelques rues d?Afrique. Observation et gestion de l?espace public à Abidjan, Dakar et Nouakchott. Lausanne : Les éditions du Lasur, pp 81-92.
Contribution à l’amélioration du système de gestion des ordures ménagères dans la commune de Fatick au Sénégal
Ndiogou Ndong, 2004
Master's Thesis, Ecole Inter-Etats d’Ingénieurs de l’Equipement Rural de Ouagadougou, Burkina Faso
"Cette étude a été faite dans le cadre du Projet d’Appui aux Collectivités Locales (PACOL) du Centre Régional pour l’Eau Potable et l’Assainissement (CREPA) dans la commune de Fatick au Sénégal. Elle propose des éléments d’ordre organisationnel et technique contribuant à la mise en place de stratégies pour une amélioration de la gestion des ordures ménagères dans la Commune. [...]"
Master's Thesis, Université Marc Bloch de Strasbourg II, Strasbourg, France
"Notre étude tente de comprendre les comportements, pratiques et attitudes des jeunes dans deux établissements scolaires au Tchad vis à vis de la sexualité et du VIH/SIDA et répond aux objectifs suivants :
• Analyser les perceptions, attitudes et pratiques que les jeunes en milieu scolaire ont de la sexualité et des facteurs de risques d’infection à VIH ;
• Identifier les comportements à risques chez les adolescents en milieu scolaire et les problèmes de santé sexuelle auxquels ils sont confrontés ;
• Déterminer leur dynamique relationnelle en matière d’engagement pour un changement de comportement."
Current debates about slums centre on the growing inequality brought about by economic globalisation. Within this context, slums are typically viewed as bounded units within the city emphasising differentiation with other neighbourhoods. This paper questions whether a focus exclusively on slums is useful for the examination of the provision of water, sanitation and health in African cities and suggests a complementary perspective emphasising urban interconnectedness. Using a comparative case study approach, it examines responses to environmental conditions in urban as well as rural contexts along drainage channels in Abidjan, West Africa. The paper traces linkages on various and partly interrelated analytical levels: spatial, material, social, political, local, national and international. Such an analysis of multi-level dynamics between stakeholders contributes to a better understanding of slums as a phenomenon of urbanisation.
The objective of this study was to assess malaria prevalence rates and seasonal patterns among clinically diagnosed malaria cases at the level of primary care facilities in an urban Sahelian setting.
Clinical diagnosis of malaria has a very low positive predicted value in this low endemicity urban setting, and its low specificity leads to inappropriate care for a large proportion of patients. This has a major impact on economic costs for health services and households. In the Sahel, systematic use of microscopy-based diagnosis and/or rapid diagnostic tests should be considered to appropriately manage malaria and non-malaria cases.
"Ce travail porte sur la perception des déterminants de la vulnérabilité à la maladie et la gestion des problèmes de santé qui surviennent dans les ménages au niveau des populations d'origine nomade en milieu urbain défavorisé à Nouakchott. La méthodologie utilisée est qualitative basée sur des entretiens approfondis et l'observation participante. La perception de la santé est largement rapportée à la mauvaise qualité de l'habitat et au manque de moyens financiers pour l'accès aux services de santé. Les maladies les plus citées sont le paludisme, les problèmes gastriques et les maladies pédiatriques. Les épisodes de maladie sont gérés grâce à l'appui du réseau familial ou tribal qui se manifeste à travers la ''loha'', la solidarité du groupe de parenté. Il y a un besoin de stratégies de développement adaptées pour assurer l'intégration de ces populations spécifiques dans le tissu urbain à travers (1) l'implantation de services sociaux d'éducation et de santé, (2) le financement de microprojets pour combattre le chômage et (3) l'appui en formation pour les coopératives."
Disparities in parasitic infections, perceived ill health and access to health care among poorer and less poor schoolchildren of rural Côte d'Ivoire
Giovanna Raso, Barbara Matthys, Eliézer K. N'Goran, Mamadou Ouattara, Kigbafori D. Silué, Marcel Tanner, Abale Toty, Jürg Utzinger, Penelope Vounatsou, Ahoua Yapi, 2005
"Differences in the state of health between rural and urban populations living in Africa have been described, yet only few studies analysed inequities within poor rural communities. We investigated disparities in parasitic infections, perceived ill health and access to formal health services among more than 4000 schoolchildren from 57 primary schools in a rural area of western Côte d'Ivoire, as measured by their socioeconomic status. [...] Our study provides evidence for inequities among schoolchildren's parasitic infection status, perceived ill health and access to health care in a large rural part of Côte d'Ivoire. These findings call for more equity-balanced parasitic disease control interventions, which in turn might be an important strategy for poverty alleviation."
Multiple parasite infections and their relationship to self-reported morbidity in a community of rural Côte d'Ivoire
Giovanna Raso, Cinthia A. Adjoua, Marc-Emmanuel Dumas, Elaine Holmes, Anne Luginbühl, Barbara Matthys, Eliézer K. N'Goran, Kigbafori D. Silué, Burton H. Singer, Marcel Tanner, Norbert T. Tian-Bi, Jürg Utzinger, Penelope Vounatsou, Yulan Wang, 2004
"Concomitant parasitic infections are common in the developing world, yet most studies focus on a single parasite in a narrow age group. We investigated the extent of polyparasitism and parasite associations, and related these findings to self-reported morbidity. [...] Our data confirm that polyparasitism is very common in rural Côte d'Ivoire and that people have clear perceptions about the morbidity caused by some of these parasitic infections. Our findings can be used for the design and implementation of sound intervention strategies to mitigate morbidity and co-morbidity."
"The objectives of this study were (1) to examine risk factors for Schistosoma mansoni infection among schoolchildren living in western Côte d'Ivoire, and (2) to carry forward spatial risk prediction and mapping at non-sampled locations [...]. Results showed that age, sex, the richest wealth quintile, elevation and rainfall explained the geographical variation of the school prevalences of S. mansoni infection. The goodness of fit of different spatial models revealed that age, sex and socio-economic status had a stronger influence on infection prevalence than environmental covariates. The generated risk map can be used by decision-makers for the design and implementation of schistosomiasis control in this setting. If successfully validated elsewhere, this approach can guide control programmes quite generally."
An Urban Monitor as support for a participative management of developing cities
Alexandre Repetti, R. Prélaz-Droux, 2003
"Urban management is a complex process, which requires a sizeable information base and a large coordination between the actors who are managing the city. In developing countries, this management is made even more difficult by a lack of financial means and technical skills. For this reason among others, the classical instruments for planning are inefficient. Starting from this fact, this paper proposes a participative planning and management tool, developed through a concrete case study: the city of Thiès, in Senegal.
Participation, individual capacities and coordination have been identified as key factors for improving the efficiency of the system of actors in charge of the urban management. Therefore, the proposed method focuses on information, communication and training. In parallel, an Urban Monitor (participative system of geographical information and indicators) has been developed and implemented, for an improvement of the information and communication structuring.
This original approach allows combining the concepts of Research Action Training with participative methods and the new information and communication technologies. Based on a dynamic and geographical view of the urban planning, it integrates tools adapted to the contextual specificities. Through these original aspects, it opens great perspectives in the fields of participative urban management and the implementation of good governance."
“It was hard to come to mutual understanding…” – The multidimensionality of social learning processes concerned with sustainable natural resource use in India, Africa and Latin America
Sustainable natural resource use requires that multiple actors reassess their situation in a systemic perspective. This can be conceptualised as a social learning process between actors from rural communities and the experts from outside organisations. A specifically designed workshop provided the background for evaluating the potentials and constraints of intensified social learning processes. Case studies in rural communities in India, Bolivia, Peru and Mali showed that changes in the narratives of the participants of the workshop followed a similar temporal sequence relatively independently from their specific contexts. Social learning processes were found to be more likely to be successful if they 1) opened new space for communicative action, allowing for an intersubjective re-definition of the present situation, 2) contributed to rebalance the relationships between social capital and social, emotional and cognitive competencies within and between local and external actors.
"The present paper discusses a conceptual, methodological and practical framework within which the limitations of the conventional notion of natural resource management (NRM) can be overcome. NRM is understood as the application of scientific ecological knowledge to resource management. By including a consideration of the normative imperatives that arise from scientific ecological knowledge and submitting them to public scrutiny, ‘sustainable management of natural resources’ can be recontextualised as ‘sustainable governance of natural resources’. This in turn makes it possible to place the politically neutralising discourse of ‘management’ in a space for wider societal debate, in which the different actors involved can deliberate and negotiate the norms, rules and power relations related to natural resource use and sustainable development. [...]"
"As a part of a research-and-action partnership between public health and veterinary medicine, the relationships between the seroprevalences of brucellosis and Q-fever in humans and livestock were evaluated in three nomadic communities of Chad (Fulani cattle breeders, and Arab camel and cattle breeders). Nomad camps were visited between April 1999 and April 2000. A total of 860 human and 1637 animal sera were tested for antibodies against Brucella spp., and 368 human and 613 animal sera for Coxiella burnetii. The same indirect ELISA was used for livestock and human sera, and the test characteristics for its use on human sera were evaluated. Twenty-eight people were seropositive for brucellosis (seroprevalence 3.8%). Brucella seroprevalence was higher in cattle (7%) than other livestock, and brucellosis seropositivity was a significant factor for abortion in cattle (OR=2.8). No correlation was found between human brucellosis serostatus and camp proportions of seropositive animals. [...]"
"The first laboratory to culture mycobacteria was established in Chad to confirm the presence of bovine tuberculosis and to describe the distribution of M. tuberculosis complex strains in livestock and humans. Specimens were collected on condemned animal carcasses due to tuberculosis. Spoligotyping and analysis of Variable Numbers Tandem Repeats (VNTRs) have been used on 67 M. bovis strains. The prevalence of tuberculosis-like lesions at the slaughterhouse was 7.3%. More M’bororo than Arab zebus were condemned (p = 0.04), M’bororo carcasses were more often entirely condemned in comparison to a partial condemnation (p ≤ 0.001) and M. bovis was more often isolated from Mbororo carcasses than from Arab zebu (p = 0.004). [...]"
"Le premier laboratoire de culture des mycobactéries a été établi au Tchad pour confirmer la présence de la tuberculose bovine chez le bétail et pour évaluer la répartition des souches du complexe Mycobacterium tuberculosis. Les prélèvements ont été réalisés sur des carcasses d’animaux saisis pour cause de tuberculose. Le typage moléculaie par spoligotypie et le typage des VNTR (séquences répétées en nombre variable) ont été réalisés avec 67 souches M. bovis du Tchad. La prévalence de lésions tuberculeuses à l’abattoir était de 7,3%. Davantage de carcasse de zébus M’bororos ont été saisies par rapport aux zébus Arabes (p = 0,04); une saisie totale en comparaison à une saisie partielle a été plus souvent effectuée chez les Mbororos (p ≤ 0,001) et M. bovis a été plus fréquemment isolé chez les zébus Mbororos que chez les Arabes (p = 0,004). [...]"
The health of nomadic pastoralists is influenced by factors specific to their way of life. Veterinary services provide vaccination against feared livestock diseases such as anthrax. Agents transmissible between livestock and humans (zoonotic agents) may have an important impact on the health status of pastoralists because they live in close contact to their animals. However, morbidity of nomadic pastoralists in Chad had not been documented and their everyday use of health services was virtually unknown. A research collaboration between veterinary and public health was implemented to evaluate morbidity of nomadic pastoralists and of their animals simultaneously and to test intersectoral pilot-interventions following the concept of “one medicine”.
"As a part of an interdisciplinary research and action programme, morbidity and nutritional patterns were assessed in three nomadic communities: Fulani and Arab cattle breeders and Arab camel breeders, of two prefectures in Chad. The predominant morbidity pattern of Chadian nomadic pastoralists (representing approximately 10% of the total population of the country) had not been documented so far. A total of 1092 women, men and children was examined by a physician and interviewed during two surveys in the dry season and one in the wet season (1999–2000). Participants with no complaint were rare. Pulmonary disorders (e.g. bronchitis) were most often diagnosed for children under 5 years of age. Of the adult participants, 4.6% were suspected of tuberculosis. Febrile diarrhoea occurred more often during the wet season when access to clean drinking water was precarious. Malaria was only rarely clinically diagnosed among Arabs during the dry season, whereas Fulani, who stayed in the vicinity of Lake Chad, were also affected during this period. A 24-h dietary recall showed that less Arab women than men consumed milk during the dry season (66% versus 92%). [...]"
This article argues that the collaboration between public health and veterinary services could increase coverage of essential health interventions for people and livestock in remote rural areas.
Sex and the City. Erzählungen alter Männer und Frauen über jugendliche Sexualität und AIDS in Ouagadougou (Burkina Faso)
Patricia Schwärzler, 2010
In: Dilger H, Hadolt B, editors. Medizin im Kontext: Krankheit und Gesundheit in einer vernetzten Welt. Frankfurt a. M.: Peter Lang Verlag, pp 389-409.
The objective of this study was to evaluate the importance and the geographical distribution of Buruli ulcer in Cameroon on the national level: using a rapid assessment procedure, areas at risk were identified and environmental characteristics of these areas analysed.
Les herpès génitaux au dispensaire anti-vénérien de l’institut national d’hygiène publique d’Abidjan
Aspects épidémiologiques et cliniques à propos de 250 cas recensés de janvier 1994 à juillet 2000
I. Tiembré, B. V. J. Benié, N. S. Dagnan, K. D. Ekra, N.M. Koffi, K. Koffi, Atioumouna Kone, K. O. N'guetta, J. Tagliante-Saracino, P. Zengbé, 2006
"Notre étude réalisée au dispensaire antivénérien (DAV) de l’Institut National d’Hygiène Publique d’Abidjan avait pour objectif d’étudier les cas d’herpès génital reçus et pris en charge dans ce service de janvier 1994 à juillet 2000. Nous avons retrouvé 250 cas d’herpès génital sur un total de 18 069 consultants soit une prévalence globale de 1,4 %. Les patients présentant l’herpès génital étaient en majorité des hommes (91 %); Célibataires dans (70 %) dont l’age était compris entre 20 et 39 ans (88 %) et exerçant un métier dans 63,70 % des cas. Les principaux sièges des lésions étaient le sillon balano-prépucial chez l’homme (64 %) et chez la femme au niveau des grandes lèvres (71 %). 62 % des patients avaient consulté pour primo-infection contre 38 % de récurrence (2 à 4 chez le même patient). L’association herpès génital avec les autres Infections Sexuellement Transmissibles a été retrouvée. Il ressort de cette étude que l’herpès génital occupe une place non négligeable dans les consultations au dispensaire antivénérien de l’Institut National d’Hygiène Publique, et l’évolution est marquée par plusieurs récurrences chez le même malade."
Condition d'Acclimatement d'Echinochoa pyramidalis (Lam.) Hitchc. & Chase et de Cyperus papyrus L. pour le Traitement de Bous de Vidange
Valérie Tsama Njitat, 2006
Master's Thesis, Université de Yaoundé, Cameroun
The main macrophytes that are used in constructed wetlands for treating faecal sludge or waste water in Europe and Asia are Typha spp. and Phragmites spp. Asia. These plants are absent in Cameroon. This study was designed to study the conditions of acclimatization of two indigenous species in Cameroon (Cyperus papyrus L. and Echinochoa pyramidalis (Lam.) Hitchc. & Chase cultivated in vertical flow constructed wetlands system fed with rough faecal sludge.
"This analysis of constraints to scaling-up health-related interventions in Chad shows that emphasis has to be put on systemic approaches which address absorptive capacity, on removal of structural constraints, and on efficient and equitable production of health services. In the production of services the development of infrastructure must not exceed the development of human resources. If the millennium development goals are to be achieved, major investments in basic and in-service training and in management skills are crucially needed. In addition, the study shows the importance of promoting health services which actively seek to fulfil community demands and those of disadvantaged groups."
"This paper assesses the economic costs of AIDS at the household level in Chad, one of the poorest countries in the world. One hundred and ninety-three AIDS patients living in four different regions were found by case identification at hospital level and through community based organizations providing psycho-social relief. They were matched by age, sex, professional category and zone of residence with controls. Costs were evaluated through a standard questionnaire. Costs at household level attributable to AIDS up to death were US$836 per case. Costs related to productivity losses made up 28% of total costs. More than half of total costs (56%) were health care related expenditures, and funeral costs contributed 16%. AIDS cases relied more often on borrowing and the selling of household assets than controls for treatment. Household expenditures of AIDS cases were much higher than control households mainly due to health related expenditure. The response of concerned families to HIV/AIDS implies high costs and for most households, especially in low-income settings, the consequences of AIDS are devastating. Innovative strategies on how best to assist households are thus requested and may include the strengthening of care and treatment services being offered to AIDS cases."
"To overcome barriers of access to health care of nomadic people and to alleviate inequities in health, a transdisciplinary team has initiated research and intervention activities among three nomadic groups of Chad: Foulbé, Arabes and Gouranes. A regular and consistent communication among all actors involved (nomadic groups, researchers, planners and administrators of health and veterinary services, etc.) through repetitive meetings and workshops showed to be a crucial element for success. Differences between ethnic nomadic groups made it necessary to develop specific communication strategies adapted to each group. As to interventions to improve the vaccination coverage, mixed teams combining health and veterinary specialists were able to vaccinate an important number of children and women and showed to have a high potential in terms of organisational and logistic feasibility, acceptability as well as good cost-effectiveness. With regard to improving access to health care, Information – Education and Communication approaches adapted to the intervention context and linked to the provision of essential services and generic drugs showed to be crucial."
Médecine Tropicale 2004, Vol. 64, No. 5, pp. 493-496
Les articles dans cet ouvrage collectif sont regroupés autour de trois piliers de la notion vulnérabilité : (1) la
monnayabilité/marchandisation (anglais «commoditization»), (2) les risques environnementaux («environmental hazards»), et (3) fragmentation sociale. À la suite de la présentation du cadre conceptuel emprunté par l’équipe de recherche, chacune des notions est reprise par une série d’articles. Enfin, le dernier chapitre établit une synthèse des différents chapitres précédents tout en élargissant la notion de vulnérabilité et son lien avec la
santé urbaine.
VertigO - la revue canadienne et électronique en sciences de l'environnement hors série 3: 1-2.
"The WHO ministerial summit held in Mexico City, Mexico, on Nov 16–20, 2004, recognised the pivotal role of strengthened health systems in achieving the Millennium Development Goals (MDGs) in an equity-effective manner. Its resolutions encourage health systems research to include broad societal dimensions. One extension involves closer interaction between human and animal health, for which the US epidemiologist Calvin Schwabe coined the term “one medicine”, to focus attention on the similarity between human and veterinary health interests. [...]"
The Lancet 2005, Vol. 366, Issue 9503, pp. 2142-2145
Human serum retinol and livestock milk retinol levels were assessed as part of a study on the health status of Chadian nomadic pastoralists and their livestock in close partnership between Chadian public health and livestock institutions. Our study supports the use of goat and cow milk as an important source of vitamin A in pastoral nomadic settings. However, the levels still require to be complemented further by promoting green leafy vegetables, fruits, and supplements.
Taux sérique de rétinol chez les femmes nomades pastoralistes tchadiennes en relation avec la teneur en rétinol et en carotène dans le lait de leur bétail
"Human serum retinol and livestock milk retinol levels were assessed as part of a study on the health status of Chadian nomadic pastoralists and their livestock in close partnership between Chadian public health and livestock institutions. Of the examined women (n = 99), 43% (95% CI 33 – 54 %) were retinol deficient (levels from 0.35 ?mol/L to 0.7 ?mol/L) and 17% (95% CI 10 - 26 %) severely deficient (<0.35 ?mol/L). None of the interviewed women (n=87) reported the consumption of fruit and only two of fresh vegetables in the past 24 hours. Thus, milk was the almost exclusive source of vitamin A for these populations. Goats (n=6) had the highest average milk retinol levels (329 ± 84 ?g/kg [mean ± SEM]), followed by cattle (n=25; 247 ± 32 ?g/kg), and camels (n=12; 120 ± 18 ?g/kg). Human serum retinol was significantly related to livestock milk retinol levels (partial slope 0.23; 95% confidence interval 0.008 – 0.47). Our study confirms that goat and cow milk are important sources of vitamin A in pastoral nomadic settings. However, the intake levels still require to be further complemented by promoting green leafy vegetables, fruits and vitamin supplements."
Médecine Tropicale 2004, Vol. 64, No. 5, pp. 478-481
This article discusses alternative sanitation systems enabling the reuse of human waste (organic solid waste, urine, faeces) in agriculture. Case studies in Mexico, China, and Ghana illustrate how the concept of closing nutrient cycles can be succesfully implemented.
The NCCR North-South is hosted by the University of Bern
and funded jointly by the Swiss National Science Foundation and the Swiss Agency for Development and Cooperation
