[Estimation of maternal mortality in rural Niger using the Sisterhood method].
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Biomedical subjects
H Sekou
Publications and source records attributed to H Sekou.
[Estimate of maternal mortality in a rural area of Niger: use of the indirect sisterhood method].
Maternal mortality remains one of the major public health problems nowadays. Each year, all over the world, half a million women die of pregnancy-related complications most of which could be avoided. In spite of enormous efforts at handling this problem, the results have been small. In many countries, the extent of the problem is virtually unknown for lack of reliable birth and mortality data. Where vital statistics are incomplete or non-existent, one should have recourse to other sources of information. In reaction to the classic, yet inadequate methods of collecting information, indirect techniques for estimating maternal mortality have been developed. One of these procedures is the sisterhood method: using this technique, researchers are able to deduce indicators of maternal mortality based on the proportion of sisters, who, once reached childbearing age, survived or died during pregnancy, childbirth or postpartum. The authors tested this method in Niger in a rural area with difficult access to primary health care. They noted a maternal mortality rate of 1,050 every 100,000 live births. This practical and simple method of estimating maternal mortality in a given area, at a relatively low cost, could readily be incorporated into routine medical activities.
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Iron status in Nigerian mothers and their newborns.
An evaluation of iron status was carried out on 364 Nigerian pregnant women from Niamey at delivery and in cord blood from their newborns. Anemia, defined as a low hematocrit value, was observed in 46% of pregnant women. Iron deficiency, recognized by a combination of, at least, 2 abnormal values in the 3 independent indicators measured (serum ferritin level, erythrocyte protoporphyrin concentration and transferrin saturation) was present in 47.8% of pregnant women. Anemia was associated with iron deficiency in 60.1% of cases in anemic mothers. A correlation between maternal and newborn iron indicators was found. This study points out the necessity for developing strategies in Sahelian countries to combat iron deficiency during pregnancy by specific measures in combination with more general interventions.
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[Spontaneous dactylolysis or ainhum. Histopathologic study].
Ainhum or dactylolysis spontanea is characterized by the occurrence of a circular constriction located at the root of the 5th toe, rarely of a finger. It deepens, the toe becomes disabled and finally amputation occurs, spontaneously or by surgery. It is a tropical disease of the adult, the origin of which remains obscure. It seems frequent in Niger. 7 cases have been histologically studied. Classical features have been found, including hyperkeratosis, chronic dermatitis, osteoporosis with cortical bone resorption. This study has also revealed in all cases complete ligamental destruction. Moreover, vegetal foreign body granulomas have been found in 4 cases, lying deep in the dermis and in one case in a synovial membrane. Ainhum is compared with pseudo-ainhum seen in genodermatosis, in yaws and in congenital strictures. Among the usually considered etiopathogenetic hypotheses, our findings are in favor of a mechanical and inflammatory origin.
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High HBsAg and anti-delta carrier rate among asymptomatic Africans living on the campus of the University of Niamey, Niger.
In 1984 and 1985, a non-random survey was conducted among healthy Africans living on the campus of the University of Niamey, Niger. Of 238 asymptomatic subjects, 17.6% carried hepatitis B surface antigen (HBsAg) in their serum, while 50.8% demonstrated protective anti-HBs antibodies. Antibodies to delta virus were detected in 29.3% of HBsAg-positive sera. This suggests that hepatitis B virus (HBV) and hepatitis delta virus (HDV) are common in Niger, and the factors that increase the likelihood of HBV transmission may also enhance the risk of HDV transmission.
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Distribution of adult lactase phenotypes in the Tuareg of Niger.
The adult lactase phenotype, lactose absorber or malabsorber, was determined using the lactose tolerance test with breath hydrogen assay in a group of Tuareg, a traditionally nomadic pastoralist population in the central Sahara. Out of a total of 118 subjects, 103 (87.3%) were lactose absorbers and 15 (12.7%) lactose malabsorbers. The frequency of the "lactase suppression gene" in this population sample was .357 (SD .043). The low frequency of lactase suppression in the Tuareg supports the hypothesis of natural selection in favor of the "lactase persistence gene" in milk-dependent nomadic pastoralist.
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