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I Diallo

Publications and source records attributed to I Diallo.

48 records · Page 3Linked to original sources

Prolonged breast-feeding: no association with increased risk of clinical malnutrition in young children in Burkina Faso.

Reported are our findings from a case-control study of the association between prolonged breast-feeding and clinical malnutrition in an urban setting in West Africa. The cases were children aged 12-36 months who had been hospitalized with a diagnosis of clinical malnutrition. Children of a similar age who lived in neighbouring courtyards were recruited as controls. For 152 case-control pairs in which both children were receiving solid foods, non-breast-feeding was associated with an increased risk of clinical malnutrition (crude odds ratio = 2.37; 95% confidence interval = 1.24, 4.55). This association remained statistically significant after controlling for various potentially confounding variables (P = 0.03). Our findings suggest that either prolonged breast-feeding may offer substantial protection against clinical malnutrition in the study population or malnutrition leads mothers to stop breast-feeding. These results are inconsistent with those of a number of workers who have reported that prolonged breast-feeding is associated with an increased risk of malnutrition. This inconsistency might have arisen because of differences in the definition of malnutrition used or because of variations in the quantity and quality of weaning foods available in different settings. We found no evidence to support the hypothesis that prolonged breast-feeding may be detrimental to children.

Breast Feeding↗

Structured observations of hygiene behaviours in Burkina Faso: validity, variability, and utility.

The use of observation techniques has been promoted for the study of hygiene practices; however, questions still remain about the validity and repeatability of such techniques. In this article we compare data on hygiene behaviours obtained from questionnaires with data obtained using a structured observation approach and examine the repeatability of structured observations of behaviours and spot observations of environmental conditions. Poor agreement between questionnaire responses and observations was found for child defecation and stool disposal practices (kappa statistic: 0.25 and 0.28, respectively). There was evidence of over-reporting of "good" behaviours (P < 0.0001). Repeated observations of child defecation and stool disposal behaviours showed better agreement (kappa statistic: 0.76 and 0.62, respectively) based on small sample sizes. These findings suggest that our questionnaire data are less valid than data obtained by direct observation. However, different approaches to questioning may be less prone to over-reporting of "good" behaviours than our approach. Further research into the validity of different forms of question is warranted. Behaviours and conditions related to hygiene vary. Observations may be useful in determining the frequency of different behaviours/conditions in the community. However, individual practices may be too variable to assign individuals to exposed and non-exposed groups for the purpose of identifying links with health outcomes. Further studies on the variability of behaviours and the repeatability of observations are therefore needed.

Adult↗

[Serological and allergological survey of cattle in Niger].

A serosurvey and a tuberculination campaign have been conducted throughout Niger in 1989-1990 on cattle to measure the prevalence rate of six diseases: brucellosis (1.4%), haemorragic septicemia (3.9%), tuberculosis (2%), coxiellosis (15.4%), pleuropneumonia (3.7%), Rift Valley fever (0.52%). The results were analysed and compared to livestock service reports.

Animals↗

[Serological survey of small ruminants in 4 districts of Niger].

In 1990, a serosurvey on 1,474 small ruminants was conducted in four districts of Niger (Maradi, Zinder, Diffa and Dosso). The epidemiology and seroprevalence of eight diseases were studied: Brucella melitensis and B. ovis brucellosis, chlamydiosis, coxiellosis, contagious caprine pleuropneumonia, type A pasteurellosis, peste des petits ruminants, Rift Valley fever, Crimée-Congo haemorragic fever. The main health problem for the development of small ruminants farming, seems to be both pasteurellosis and peste des petits ruminants.

Animals↗

Thyroid carcinomas after irradiation for a first cancer during childhood.

BACKGROUND: The thyroid gland is among the most radiosensitive organs. However, little is known about the long-term risk of developing a thyroid tumor after fractionated external radiotherapy for cancer during childhood. OBJECTIVE: To study the long-term risk of developing a thyroid tumor in 4096 three-year survivors of childhood cancer treated between May 1942 and December 1985 in 8 centers in France and the United Kingdom, 2827 of whom had received external radiotherapy. METHODS: A wide range of radiation doses were given to the thyroid: 1164 children received less than 0.5 Gy and 812 received more than 5.0 Gy, the average dose being 7.0 Gy. RESULTS: After mean follow-up of 15 years (range, 3-45 years), 14 patients-all of whom had received radiotherapy-developed a clinical thyroid carcinoma. Within the cohort, the relation between radiation dose to the thyroid and risk of thyroid carcinoma and adenoma was similar to that observed in patients who received radiotherapy during childhood for other reasons, such as an excess relative risk per gray of 4 to 8, up to a few gray. In contrast, compared with thyroid cancer incidence in the general population, the standardized incidence of thyroid carcinoma was much higher than expected from the dose-response relationship estimated within the cohort and from patients who received radiotherapy during childhood for other reasons: a dose of 0.5 Gy was associated with a standardized incidence ratio of 35 (90% confidence interval, 10-87) and a dose of 3.6 Gy with a standardized incidence ratio of 73 (90% confidence interval, 28-153). We did not show a reduction in excess relative risk per gray with use of an increasing number of fractions. CONCLUSION: Although we cannot estimate the exact proportion, it is probable that some or all children who are treated for cancer are predisposed to developing a thyroid carcinoma.

Adenoma↗

[A new decision support tool in the campaign against maternal mortality: the Dystocia Risk Score].

At Ziguinchor Regional Hospital (ZRH) in Senegal, 80% of maternal deaths are associated with late referral of dystocia cases. The gynecology and obstetrics team of the ZRH, in collaboration with the teaching staff of the Institute of Health and Development (ISED), tried to find ways to combat maternal mortality and stillbirth, based on double-entry contigency tables and a logical framework. We developed a tool more elaborate than a simple decision tree: the dystocial risk score. This tool has three components: A column provides a list of eight characteristics to check for in the woman: history of cesarean section, limping, less than 150 cm in height, no living child, less than 18 years old, more than 35 years old, other risk factors, no risk factors. A horizontal section provides a checklist of possible outcomes of the pregnancy itself: obstacle praevia, precedence, noncephalic presentation, uterine length of over 35 cm, loss of amniotic fluid over 12 hours or more, other abnormalities, no abnormalities. A rectangular grid indicates the prognosis. This grid consists of three zones: a large blue zone (dangerous), a medium-sized grey zone (doubtful) and a small blue zone (hopeful). A positive DRS is obtained if there is at least one cross in the dangerous zone and/or at least two crosses in the doubtful zone. If these conditions are not fulfilled, the DRS is negative. A positive DRS indicates that the woman should be referred to a center specialized in obstetric emergency care. This tool was validated in a study of 376 pregnant women carried out over a period of six months. It was found to have a sensitivity of 83.6%, a specificity of 90.1%, a positive predictive value of 72.3% and a negative predictive value of 94.1%. The DRS is a simple, easy-to-use decision-making tool. The large-scale use of this tool (by midwives, chief nurses and health workers) would accelerate the identification of pregnant women with a high risk of dystocia. The timely referral of these women to specialized emergency obstetrics centers would increase the efficacy of care and would reduce the levels of maternal mortality and stillbirth.

Decision Support Techniques↗

[Prognostic factors of pregnancy and delivery complications in Senegalese adolescents and their newborn].

Developing countries exhibit the highest adolescent fertility rate in the world. Undesirable outcome frequency during adolescents' pregnancy and delivery is debated. The aim of this study is to determine the incidence of these events and the factors predicting their occurrence among pregnant Senegalese adolescents and their newborn. The study was conducted between August 1st, 1999 and July 31st, 2000 in a national sample of 435 women attending prenatal clinics after a 20-week gestation. The data were collected by interviews: sociodemographic characteristics, obstetrical antecedents, current pregnancy history before inclusion in the study; the clinical characteristics were determined at inclusion. Then pregnancy and delivery complication occurrences were observed for mothers and their newborn during follow-up. Logistic regression analyses were performed to determine the factors associated with each complication, controlling the effects of other sociodemographic and clinical factors. The most frequent pregnancy complications were pregnancy-induced hypertension and toxaemia (17.5%). Anemia occurred in 25% of the women. At delivery, at least one of dystocia, eclampsia, or placenta haemorrhage complications occurred in 46% of women. The caesarian rate was 20% and the mortality rate was 71%. When planned, caesarian interventions lowered mortality. Forty percent of the newborns presented a neonatal distress while 17.9% of them weighed less than 2,500 g. The pregnancy-induced hypertension and toxaemia incidence rates were higher when the weight at onset of pregnancy was unknown (OR = 3.7 [1.9-7.5] for hypertension and 3.1 [1.3-7.6] for toxaemia). When a woman with a narrow pelvis was less than 1.50 m tall, the delivery was more frequently assisted by forceps and extracting action in breech delivery. Dystocia, eclampsia, placenta haemorrhage and premature delivery were associated with high mortality. Overall, complications were not more frequent in the youngest (16 years and below), as suggested in previous studies. Those results suggest that undesirable events occur frequently during adolescents' pregnancy and delivery, and in their newborn, while attendance in prenatal clinics is adequate. The prognostic factors of these complications are identified. These complications can be avoided by improving ante- and perinatal care quality.

Adolescent↗