Fatick Region Research Articles

Improving screening for malnourished children at high risk of death: a study of children aged 6-59 months in rural Senegal.

To investigate whether children with concurrent wasting and stunting require therapeutic feeding and to better understand whether multiple diagnostic criteria are needed to identify children with a high risk of death and in need of treatment. Community-based cohort study, following 5751 children through time. Each child was visited up to four times at 6-month intervals. Anthropometric measurements were taken at each visit. Survival was monitored using a demographic surveillance system operating in the study villages. Niakhar, a rural area of the Fatick region of central Senegal.ParticipantsChildren aged 6-59 months living in thirty villages in the study area. Weight-for-age Z-score (WAZ) and mid-upper arm circumference (MUAC) were independently associated with near-term mortality. The lowest WAZ threshold that, in combination with MUAC, detected all deaths associated with severe wasting or concurrent wasting and stunting was WAZ <-2·8. Performance for detecting deaths was best when only WAZ and MUAC were used. Additional criteria did not improve performance. Risk ratios for near-term death in children identified using WAZ and MUAC suggest that children identified by WAZ <-2·8 but with MUAC≥115 mm may require lower-intensity treatment than children identified using MUAC <115 mm. A combination of MUAC and WAZ detected all near-term deaths associated with severe anthropometric deficits including concurrent wasting and stunting. Therapeutic feeding programmes may achieve higher impact if WAZ and MUAC admission criteria are used.

Chemical Characteristics and Microbial Quality of Guedj a Traditional Fermented Fish from Senegal

The present study aimed to estimate the chemical characteristics and microbial quality of traditional Senegalese fermented fish produced locally and known as Guedj which was prepared by using three types of fish: fatty fish (Machoiron or catfish or Arius latisculatus), medium fat fish (Capitaine or Pseudotolithus brachygnatus) and lean fish (Sompatte or Pomadasys jubelini). Samples were collected from three production areas located in Dakar, Thies and Fatick regions. The other samples were from Institute of Food Technology (ITA). Samples from ITA were used as controls. Results of test samples have shown significant differences in most chemical and microbial parameters when compared with those of the controls. Mean values of moisture contents, pH, TVB-N and NaCl of Guedj samples from the three production areas were significantly higher than those of the control (collected at ITA). Specifically: 1) moisture contents from Machoiron, Capitaine and Sompatte were 58, 42.60 and 26.90%, compared to controls 42.48, 35.60 and 24.40 %, respectively. 2) pH values were 6.56, 6.38 and 6.35 compared to controls 6.42, 6.28 and 6.28 respectively. 3) TVB-N values were 228.3, 308, and 334.8 compared to controls 155.4, 236.5, and 204.8 respectively. 4) NaCl contents were 10.75, 10.78 and 7.77 compared to controls 8.20, 7.80 and 6.56 respectively. Microbiological analyses showed that all test samples displayed higher microbial loads when compared to the control groups. We noted the presence of yeasts and molds, coliforms, pathogenic staphylococci, clostridia and lactic acid bacteria (LAB) in some of Guedj samples, but salmonella and Vibrio parahaemolyticus were absent. In conclusion the poor quality of the fermented fish, Guedj were mainly due to use of low quality spoiled fish as raw material, unhygienic procedures, the lack of standard operating procedures and adequate equipment, combined to improper salting and drying.

Study of the snail intermediate hosts of urogenital schistosomiasis in Niakhar, region of Fatick, West central Senegal.

BackgroundSchistosoma haematobium is the most widespread schistosome species in Senegal and occurs in several regions of the country especially in the Sudan-Sahelian zone. The aims of the study were i) to determine the freshwater species ii) to ascertain the role of the identified snail species in the transmission of S. haematobium and iii) to study the impact of drought on the snails.MethodsSnails were sampled each year in 17 sites from July to November-December 2012 and 2013. At each snail survey, snails were grouped by village, counted, identified according to shell morphology and the rates of schistosome cercarial shedding recorded. The shell height of the snails collected in July was measured and classified into four groups according to their size in order to determine those that are open to aestivation.ResultsB. senegalensis and B. umbilicatus were the only snails intermediate hosts collected in the Niakhar study area. B. senegalensis is found in all the 17 sampling sites while B. umbilicatus was only found in one site out of the many surveyed. The total number of B. senegalensis collected in 2012 and 2013 was 1032 and 8261 respectively. A total of 901 and 6432 B. senegalensis were tested for Schistosoma spp. infestation in 2012 and 2013 respectively. For B. umbilicatus, 58 snails were collected and tested in 2012. In 2013, 290 were collected and 281 tested. The overall rates of schistosome cercarial shedding were 0 % in 2012 and 0.12 % in 2013 for B. senegalensis and 13.79 and 4.98 % in 2012 and 2013 respectively for B. umbilicatus. For both species collected in July, size group 3 individuals (7–9.9 mm) were the most numerous, 63.6 and 57.8 % for B. senegalensis and B. umbilicatus respectively. B. umbilicatus was reported for the first time in the region of Fatick located in the old ecological zone of Sine-Saloum, is able to maintain Schistosoma spp. larvae during 7 months of drought and may transmit the disease in early July, increasing the period and the risk of transmission.ConclusionThis study recommends an adaptation of snail control strategies at pond cycles and ecology of the snails in these seasonal foci. Malacological control strategies must take into account these phenomena of drought resistance and the capacity of some snails to maintain parasite during aestivation. The treatment of ponds with Bayluscide at the end of the rainy season in November and upon onset of rains in July would be more advantageous to the control of snails thereby reducing transmission of urogenital schistosomiasis in the Niakhar area.

Assessment of the iron-folic acid supplement (IFAS) supply chain to improve distribution at community level in Dakar and Fatick regions, Senegal

Objectives: Ensuring adequate and timely availability of iron folic acid supplements at delivery points is a challenge for success of IFAS interventions. In Dakar and Fatick regions, the supply chain of IFAS was assessed to identify constraints and bottlenecks and to recommend solutions. Methods: Structured interviews with 84 health workers from 36 health facilities were carried out to determine the supply chain constraints in Dakar and Fatick regions. Transcriptions were analyzed using content analysis. Results: Health workers reported IFA stock-outs in 50% of included health districts. Although the needed quantities were reportedly available at regional drugs stores, the limited frequency of overall health commodity orders, applied by health districts to reduce costs, resulted in delayed IFA procurement when stocks were low. These delays were the primary cause of stock-outs reported by health workers. Conclusions: Adequate and consistent supply of IFA supplements could be ensured through allowing larger orders of IFA during regular commodity orders, reducing or subsidizing the cost of IFAS or shipment costs. © 2015 Gueye et al.; This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Conference Abstract

Prevalence of Anemia and Its Risk Factors among Pregnant Women in Dakar and Fatick Regions, Senegal

Prevalence of Anemia and Its Risk Factors among Pregnant Women in Dakar and Fatick Regions, Senegal

Morbidity, mortality, and health-seeking behaviour in rural Senegal: local understanding and representation of disease across method of treatment

<h2>Abstract</h2><h3>Background</h3> Ethnomedical nosologies in many parts of the world, including west Africa, encompass both naturalistic (related to mechanisms of contagion and pollution) and personalistic (related to spiritual and supernatural malevolence) causes that are at times fundamentally at odds with the biomedical model. We explored cultural models in a rural population in the Fatick region of Senegal related to the use of ethnomedical and biomedical therapies and examine dimensionality of schemas and associated behaviours motivating and affected by the choice of therapeutic model. <h3>Methods</h3> We collected innovative disease-narrative histories as part of the Niakhar Social Networks and Health Project (NSNHP) from more than 100 in-depth semistructured interviews held with a random sample of area residents aged 16–91 years. These interviews, transcribed and extensively coded for computer-assisted analysis, contain information about the use of interpersonal resources and helping around illnesses, symptomology, perceived causes of illness, and treatment options pursued, their costs, respondents' understanding of them, and their perceived efficacy. We compared schemas and behaviours surrounding treatment in biomedical institutions (pharmacies, health centres, and hospitals) with those in ethnomedical intuitional settings (traditional spiritual healers, ethnobotanical practitioners, oracles, and religious healers). <h3>Findings</h3> Health seeking behaviour in this population is not restricted exclusively to biomedical or ethnomedical treatment. Rather, individuals and families seek efficacious solutions to illness and medical crises from both sequentially or simultaneously, with indigenous cultural schemas concerning nosology supportive of both ethnomedical and to a lesser extent (particularly in the case of infectious disease) biomedical treatment. At the same time, we noted a near universal duality of cause and treatment; certain illnesses are perceived to be treatable only by ethnomedical, others only by biomedical therapy. We report that although perceived cause can affect choice of therapeutic venue, perceived efficacy of previous treatment (both proximal and within respondents' social networks) could be equally responsible for shaping schemas invoked by respondents when discussing their illness and choice of therapeutic venue. <h3>Interpretation</h3> Insights such as those gained here could be used to develop measures of cultural and ideational context for use in survey-based demographic and health research projects, using the example of the instrument developed for the NSNHP. <h3>Funding</h3> National Institute of General Medical Sciences.

Prevalence and intensity of urinary schistosomiasis among school children in the district of Niakhar, region of Fatick, Senegal.

BackgroundUrinary schistosomiasis is a parasitic disease that exists in all regions of Senegal. It is a major public health issue in this country. This study was carried out to determine the prevalence and intensity of this parasitosis in 12 villages of Niakhar (Fatick, Senegal).MethodsA total of 210 schoolchildren, aged 7 to 15 years, were enrolled in this study, and urine samples were examined for Schistosoma haematobium eggs using a standard urine filtration technique.ResultsOf these children, 121 (57.6%) were found to be infected with a mean geometric count of 185 eggs per 10 ml of urine. The disease was present in all surveyed villages, and the prevalence ranged from 14.3% to 92.8%. The prevalence of infection was significantly correlated with increasing age and was higher in boys. Infection intensity was significantly higher in boys but did not significantly differ with age. Significant relationships between i) water contact or access to running water and ii) the prevalence or intensity of urinary schistosomiasis were also noted.ConclusionsThe district of Niakhar is endemic for urinary schistosomiasis, with a high intensity of infection. A control program to decrease the prevalence and intensity should be implemented in this area to improve community health.

HEALTH-SEEKING BEHAVIOUR FOR CHILDHOOD MALARIA: HOUSEHOLD DYNAMICS IN RURAL SENEGAL

Research on health care behaviour in sub-Saharan Africa usually considers the mother as the reference in the household when a child is sick. The study of health care management within the family is a key issue for understanding therapeutic rationales. This study was conducted in the region of Fatick in Senegal among 902 children with malaria-related fever. The data were taken from a retrospective quantitative survey conducted in all compounds of the DSS (Demographic Surveillance Site) of Niakhar. The results show that child care-taking is fundamentally a collective process: in 70.9% of out-of-home resorts, the treatment decision was collective. The health care process of 68.1% of morbid episodes involved several individuals. The involvement of the mother, the father and other relatives in the collective management of health care followed different logics. Each care-giver had a specific and complementary function depending on gender norms, intergenerational relations and characteristics of the family unit. Family management of illness aims at optimizing financial and human resources given the economic, logistical and social constraints on health care. Nevertheless, collective management also favoured home-based care, prevented good treatment compliance and delayed the resort to health facilities. These results suggest that health education campaigns should focus on an early involvement of fathers in health care-giving and also on the strengthening of the autonomy of mothers. Mothers' empowerment should give women more autonomy in their child's treatment choice. Lastly, there is a need to develop community health facilities and establish shared funding at the community level.

Village context and health-seeking behaviour in the Fatick region of Senegal

<titre>R&#233;sum&#233;</titre>Au sein de la dense litt&#233;rature sur les comportements de recours aux soins en milieu rural africain, les composantes contextuelles, et notamment les diff&#233;rences entre les villages, sont rarement &#233;tudi&#233;es. Face &#224; ce constat, cet article consid&#232;re le village, ou le groupe de villages, comme niveau agr&#233;g&#233; d&#8217;analyse, &#224; partir d&#8217;une &#233;tude men&#233;e dans la r&#233;gion de Fatick, au S&#233;n&#233;gal. Les r&#233;sultats descriptifs mettent en &#233;vidence de fortes variations des pratiques th&#233;rapeutiques, des modalit&#233;s de prise en charge de la maladie et des strat&#233;gies de planification des soins d&#8217;un village &#224; l&#8217;autre. &#192; diff&#233;rents niveaux, les comportements de recours aux soins individuels apparaissent conditionn&#233;s par un ensemble de normes collectives g&#233;n&#233;r&#233;es par la communaut&#233; villageoise. L&#8217;analyse spatiale montre que ces variations comportementales d&#233;crivent deux ensembles g&#233;ographiques, distingu&#233;s par un niveau d&#8217;&#233;quipement sanitaire, des caract&#233;ristiques historiques, sociales et culturelles diff&#233;rentes. Ces r&#233;sultats questionnent l&#8217;approche unifi&#233;e du milieu rural africain et appellent d&#8217;autres recherches, approfondissant l&#8217;analyse de l&#8217;impact de nombreux facteurs contextuels, quantitatifs et qualitatifs, sur les comportements de recours aux soins.