Biomedical subjects

E Lagarde

Publications and source records attributed to E Lagarde.

36 records · Page 2Linked to original sources

PubMed1997

[Results of a preliminary study on the various factors of HIV infection and sexually transmitted disease in rural west Africa].

A pilot study has been carried out in two Senegalese rural communities in January-February 1996 in order to evaluate the feasibility of a study that is being launched in several rural sites in West Africa. This study aims to shed light on the factors of HIV infection and other sexually transmitted diseases. A sample of 100 adults were asked to answer a questionnaire on at risk behaviors for these infections. Few of them have refused to answer the questionnaire: 9% (6/66) in a first site and 3% (1/34) in the other site. Interviewers', remarks made after this pilot study showed that sex and age of interviewer and interviewee must be matched and that they must know each other so as to establish a relation of confidence. Participation to the biological part of the study may prove to be poor since, in each two communities, 27% and 40% of the interviewees declared they would refuse to provide a blood sample if asked. Finally, preliminary results suggest that at risk sexual behaviors and motivation of casual sex may be different between the two communities. The present pilot study shows that the use of our questionnaire is possible among rural communities in sub-Saharan Africa. However, it will be necessary to further explain the importance of the biological part of the study to achieve a satisfactory participation rate.

Adolescent↗

PubMed1996

A study of sexual behavior change in rural Senegal.

This study describes recent sociodemographic and behavioral changes in a rural community in Senegal and investigates how these changes may have modified the risk of HIV/STD transmission. The authors combine findings from two surveys: (a) a marriage survey among all adults of a rural community of approximately 7,000 inhabitants; and (b) a sexual practices survey conducted among a sample of the same population (165 men and 165 women) between 1989 and 1994. During the last 30 years--between 1955-64 and 1985-92--age at first marriage increased in the study area from 25 to 32 years for men and from 21 to 24 years for women. At the same time, age at first sexual intercourse decreased by approximately 10 years on average for men. As expected, this has led to an increase in premarital sexual activity, and we have documented both an increase in the percentage of individuals declaring sexual relations before marriage and, for men, an increase in the number of sexual partners before marriage. Multipartnership is more frequent among men than women (OR=4.4), among those who had their first intercourse at an early age (OR=3.3), among rural migrants (OR=2.7), and among those who had a good knowledge of AIDS. These findings show how recent changes in marriage, sexual behaviors, and seasonal migration have combined to increase the risk of HIV/STD infection within the community. Male rural migrants and their partners are particularly exposed.

Adult↗

PubMed1996

Knowledge, attitudes and perception of AIDS in rural Senegal: relationship to sexual behaviour and behaviour change.

OBJECTIVES: To describe the determinants of 'at risk' sexual behaviour and perception of AIDS-related prevention messages in rural Africa. SETTING: A rural area in Southern Senegal. DESIGN: Cross-sectional study using a standardized questionnaire administered by local interviewers to 240 men and 242 women aged 15-59 years, randomly selected among the general population. RESULTS: Twenty-eight per cent of the sexually active men and 27% of the sexually active women declared at least one casual sexual partner in the 12 months preceding the interview. Among these, 27% of men and 30% of women declared having used a condom in most acts of casual intercourse. Seasonal migrants and divorced or widowed women were more likely to declare casual sex. Causal sex was motivated by material needs for 66% of the women who experienced it, and those of the women who reported casual sexual intercourse were less likely to feel at risk of AIDS [odds ratio (OR), 3.9; P = 0.01] and were more optimistic about their future (OR, 3.6; P = 0.03). For men, the motivations explaining a change in sexual behaviour in order to avoid HIV infection included the perception of AIDS as a health problem (OR, 11; P = 0.004), the perception of the disease as serious (OR, 5.4; P = 0.001) and the feeling of personal risk of becoming HIV-infected (OR, 3.2; P = 0.02). Perceived skill in changing one's behaviour was strongly associated with declaration of past behaviour change for both men and women (men: OR, 3.4; P = 0.02; women: OR, 6.3; P = 0.0001). CONCLUSION: Men and women exhibit two different patterns regarding their behaviour and perception towards AIDS. Material needs appear to be of importance for women, whereas perception of a real threat lead men to adopt protective behaviours. In the very area of this study, widowed and divorced women as well as male seasonal migrants are particularly exposed to HIV infection. They are characterized by a higher risk behaviour, a low rate of condom use and seldom declared any protective measures to avoid HIV infection.

Acquired Immunodeficiency Syndrome↗

PubMed1995

Reliability of reports of sexual behavior: a study of married couples in rural west Africa.

A heterosexual partners survey in rural Senegal, Africa, was carried out in 1992 to evaluate the reliability of self-reported answers about sexual practices. The authors followed 62 married couples weekly during a 5-week period to assess the level of agreement 1) between answers made by members of the same couple but collected separately, 2) between retrospective reporting of sexual activity during the last 4 weeks versus weekly reporting of sexual activity during 4 weeks, and 3) between answers to a set of identical retrospective questions asked 5 weeks apart. Reports over recent and short periods of time such as 7 days are reliable: The dates of sexual acts with spouse reported during the weekly interviews were concordant between members of a couple at 0-day or 1-day intervals in 72% of cases. The concordance of weeks reported with or without intercourse was also high. Reports over longer periods of time are less reliable: The comparison of retrospective reports versus weekly reports regarding mean number of sexual acts during the last 4 weeks shows a clear overreporting that was higher among men (4.5 vs. 2.7 sexual acts) than among women (3.7 vs. 2.7).

Adolescent↗

PubMed1995

Risk factors for hepatitis A infection in France: drinking tap water may be of importance.

The prevalence of serologic markers for hepatitis A was investigated in 936 French male military recruits from October 1992 to June 1993. Data were collected in order to assess the evolution of seroprevalence level according to the decline observed for several years and to appreciate the importance of potential risk factors. The overall prevalence of antibody against hepatitis A virus was 16.3%. The prevalence was higher among those with high number of siblings and whose Father's occupation falls into low professional class categories. Multivariate analysis found that high level of seroprevalence was also associated with tap water consumption (odd ratio (OR) = 1.56; p < 0.04), overseas travels (OR = 2.26; p < 0.001) and was higher for recruits reporting an history of clinical jaundice (OR = 2.27; p < 0.01). Together with more anticipated factors, tap water consumption may be of importance in France and this study points out the potential part taken by chlorinated water.

Adolescent↗

PubMed1994

The evaluation of surveys of sexual behaviour: a study of couples in rural Senegal.

The reliability of self-reported answers about sexual behaviour is assessed by means of a survey of couples in rural Senegal, Africa, carried out in 1992. A total of 51 married couples were followed weekly over a five-week period. Reports for a recall period of seven days are reliable: dates of sexual acts differed by no more than a day in 73 per cent of cases. Reports over longer periods are less reliable. Retrospective recall of coital frequency for a four-week period yields much higher estimates than those obtained with a seven-day recall, particularly for men.

Adult↗

PubMed1993

Seasonal migration: a risk factor for HIV infection in rural Senegal.

Sociodemographic and epidemiological data collected on a rural population of the Ziguinchor region of Senegal showed that a large part of the adult population, 80% of women between 15 and 24 years old and 82% of men between 20 and 40 years old, move each year on seasonal labor migrations to the main cities of Senegal or the Gambia or their proximity. In October 1990, an exhaustive seroprevalence survey of the population aged 20 years or older (3,230 persons tested) showed that 0.8% was HIV-2 and 0.1% HIV-1 seropositive. Interviews of 91 persons (24 seropositive persons and 67 seronegative controls) revealed that seropositivity was associated with a history of blood transfusions, injections, sexually transmitted diseases, and seasonal migration. Our findings suggest that in the rural area under study, beside a few cases of transmission by blood transfusion or injection, HIV-2 and HIV-1 are mainly transmitted first to adult men through sexual contacts with infected women met during their seasonal migration and second to their wives or regular partners once they are back home.

Adult↗

PubMed1992

HIV-2 infections in a rural Senegalese community.

In a community study in rural Senegal, 22 human immunodeficiency virus type-2 (HIV-2) seropositive cases and 64 matched controls were examined clinically and evaluated immunologically. The presence of clinical signs was highly correlated with HIV-2 seropositivity: 9 anti-HIV-2 positive patients and 5 controls presented with clinical signs (odd ratio [OR] = 8.2, confidence limits [CL] 2-35). The main symptom associated with HIV-2 seropositivity was a chronic cough (OR = 18.5, CL 1.8-899). The presence of diarrhoea was not significant (OR = 3.1, CL 0.3-3.5). The total number of CD8 cells, CD4/CD8 ratio, beta 2 microglobulin, and IgG level discriminated between seropositive and seronegative individuals (P less than 0.05). When the anti-HIV-2 positives were grouped as 13 healthy and 9 sick people, red blood cells, lymphocytes, T lymphocytes, CD4 cells, and beta 2 microglobulin differed significantly. Clinical symptoms were associated with immunodepression: 5 of 14 sick people had less than 500 CD4/microliters vs. 1 of 72 healthy persons. This study at the community level emphasizes the clinical and immunological impact of HIV-2 infection. Even if it presents with a longer incubation period than HIV-1, this virus is a major threat to public health.

Adult↗

PubMed1990

[Transmission of HIV-2 virus in a rural area of Senegal].

Various investigations into the prevalence of HIV2 infection undertaken on samples of senegalese rural populations from Casamance, Eastern Senegal, the Thies Region and the Ferlo Region, show a gradient from south to north. Levels vary from 0.9% (western Casamance) to 0% (Ferlo). These results led to a detailed investigation being undertaken in a Casamance village, paralleled by questioning reference cases to define risks associated with HIV2 seropositivity. Prevalence in this village is 0.82%, and all age groups are affected. HIV2 disrupts the immune system before clinical symptoms appear. 10% of the seropositives can be classed as CDCIV.

Adult↗

PubMed1974