[General situation, stalemate and future].
Explore the source record for details and available documents.
Forecasting↗
Biomedical subjects
B Floury
Publications and source records attributed to B Floury.
[What determines the choice of health care treatment in the town of Contonou (Benin)?].
Households in Contonou show a clear preference for modern medicine. Self-medication is the first choice, followed by use of private practices, which are growing in importance in Benin as treatment options. This preference for private medicine seems to meet a demand that is not covered by the public services, which occupy the third place among treatment options. The hospital and the practitioner of traditional medicine are the last resort where the other choices have not produced the expected outcome. The choice of self-medication is determined by the patient's assessment that the illness is not serious, by the habit of using a certain treatment in response to a familiar symptomatology, and by the desire to avoid the expense of a consultation. The recourse to other options is connected with the geographical accessibility of the places of consultation, the cost of care and treatment, the reception accorded to patients at the place of consultation, the seriousness of the illness and, to a lesser degree, the relations of kinship with the health personnel in the services visited. The choice between the available health services lies principally between private clinics and public health centres. There is therefore a need to consider the operation of public health centres and the quality of the care they provide since this would enable those responsible for health service organization and planning to make better informed choices. At the same time, the state should encourage its research bodies to study the operation of the private sector in the light of the importance of this type of care in the treatment chosen by households.
Benin↗
Serological evaluation of a simplified immunization schedule using quadruple DPT-polio vaccine in Burkina Faso.
The immunogenicity of quadruple DPT-polio vaccine used in a two-dose regimen was investigated in a cross-sectional serological survey involving 355 children under 5 years of age. This schedule is currently applied in the EPI programme in three provinces in Burkina Faso, West Africa. It was found that two doses of quadruple DPT-polio vaccine induced antibodies at protective levels to diphtheria and tetanus toxin, and to the three types of polioviruses in over 90% of 179 children. The persistence of antibodies to tetanus and polioviruses is good, since over 90% of the children studied still had antibodies more than 2 years after their last vaccination. The antibodies to diphtheria toxin tend to decline in the first 6 months after vaccination, which is not uncommon. However, our data indicate clearly that a very high percentage (98%) of children have been primed to diphtheria toxin. Of 176 non-vaccinated children, up to 25% of the older ones had antibodies to polioviruses, most of them only to one type. This appears to be a sensitive parameter for the circulation of wild polioviruses in the environment. As the vaccination coverage in the study area was low (< 60%), it was to be expected that the circulation of polioviruses in the community could not be interrupted. The present study demonstrates the applicability of a two-dose strategy for primary immunization with a quadruple DPT-polio vaccine especially for poliovirus components and the toxoids. To induce pertussis immunity, however, a third vaccination is recommended.
Antibodies, Bacterial↗
Glucose-6-phosphate dehydrogenase and hemoglobin variants in Kel Kummer Tuareg and related groups. Indirect evidence for alpha-thalassemia trait.
A field study of glucose-6-phosphate dehydrogenase (G6PD) and hemoglobin polymorphisms was performed in 327 subjects belonging to the Kel Kummer, a highly inbred Tuareg tribe of North-East Mali, and to the contact populations. In the Kel Kummer group 11% of the investigated subjects carried the nondeficient G6PD A+ variant. No other G6PD variant was found. Hemoglobin D Ouled-Rabah was found in 21% of the subjects of this group. The presence of an alpha-thalassemic trait was also inferred from indirect evidence. The contact groups (Inedän, Iklan, Kel es Suq and Dausahaq) exhibited different polymorphisms at the G6PD and globin loci, substantiating their belonging to different ethnic stock.
Black People↗
[The Bamako initiative: hope or illusion? Observations on the Benin experience].
In various countries in Africa, community financing has become the main source of finance for health services. In Benin, the "Bamako Initiative" experiment started in 1988 for many health structures and has subsequently been greatly expanded. After three years experience, the authors try to answer some important questions about community financing: To what extent does payment of fees have an influence on the use of health services? How are the funds collected and used and is embezzlement a serious problem? The question of equity is also considered as well as cost recovery, allowing an economics-based assessment of the Bamako Initiative which suggests that it has a promising future in Benin.
Benin↗