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Biomedical subjects

P Ndiaye

Publications and source records attributed to P Ndiaye.

At least 19 recordsLinked to original sources
PubMed2006

[Self-treatment of fever in the northern district of Dakar, Senegal].

Malaria is assimilated with its cardinal symptom, i.e., fever. Treatment of fever with antimalarial drugs is crucial to the prevention of malaria-related death in Senegal. The objective of this study was to analyze fever-treatment practices as a basis for making realistic recommendations for self-treatment in the northern health district of Dakar, Senegal. This cross-sectional study was conducted from March 1 to April 30, 2003. The population included all patients with body temperature higher or equal to 37.5 degrees C (99.5 degrees F) associated with at least one of the following symptoms: headache, shivering, vomiting and diarrhoea. Study endpoints included demographic data and fever treatment modalities including the nature, dosage, and duration of the drugs used. Malaria was suspected in 180 of the 271 patients enrolled in the study. Treatment had already been undertaken in 134 patients including 108 (81%) who had initiated self-treatment. Drugs included antipyretics, antibiotics, and/or antimalarials. Antimalarial drug dosage was incorrect in 84% of those who initiated self-treatment. Dosage errors involved number of daily doses (55%), duration of treatment (13%), or both (32%). Only 45% of patients fully completed treatment. Medical advice was sought in 30% of the cases and drugs were obtained over the counter in pharmacies in 59%. Patients under the age of 15 years were significantly more likely to initiate self-treatment (p=6.10-6), to treat symptoms early, and to use an antimalarial (p=4.10-6). Although self-treatment shortened the delay between onset of symptoms and initiation of treatment, it is likely that indiscriminate and incomplete treatment is responsible for development of resistance to chloroquine in the northern health district of Dakar. Strategies must be adapted to numerous local factors influencing self-treatment including the availability of health-care services and drugs of quality. Special attention must be given to the improvement of antimalarial drug packaging and of the awareness of people that provide self-treatment drugs.

Adolescent↗
PubMed2005

Prevalence of epilepsy its treatment gap and knowledge, attitude and practice of its population in sub-urban Senegal an ILAE/IBE/WHO study.

A door-to-door survey was used to determine the prevalence of epilepsy among 4500 people within the Pikine Health District (population 480,000) Senegal. Prevalence was 14.2/1000, and 23.4% of all people with epilepsy had never received appropriate treatment. Figures for the prevalence had increased since a previous survey in 1989. In parallel a study of knowledge attitude and practice was performed in the same district. Salient findings were that: two-thirds of interviewees had at some time witnessed a seizure, 51% agreed when asked if epilepsy is caused by evil spirits, 35% said epilepsy is contagious, only about 18% said that traditional therapy is best, 60% would not mind their child to play with a child with epilepsy but only 32% would agree if their child would want to marry a person with epilepsy.

Adolescent↗
PubMed2005

[Socio-cultural determinants of the lateness of the first prenatal consultation in a health district in Senegal].

OBJECTIVE: to evaluate the socio-cultural determinants of the delay in having the first pre-natal exam (CPN) in order to make recommendations which aim to reduce maternal and fetal morbidity and mortality in the Richard-Toll health district in Senegal. METHOD: the study was cross-sectional, descriptive and analytical, and was conducted on the entire population of pregnant women who came in for a CPN between March 1st and April 30th, 2003. A questionnaire which was developed on the basis of studied variables steered the interview process which was carried out upon completion of each pregnant woman's CPN in 15 different health facilities. Data were recorded and analysed using Epi Info 6.04d software. RESULTS: The sample population studied included 351 pregnant women. The cultural environment over the unexpected nature of the pregnancy, the discretion surrounding the pregnancy, the ignorance of the risks, and the refusal to be examined by male health workers all have a statistically significant influence on the tardiness of the first CPN. Similarly, the late CPN has a statistically strong link with three distinctive elements of the pregnant woman's social profile: namely, illiteracy, at risk age (< 18 or > 34 years old), and total number of deliveries (> 3 births). Illiteracy has a statistically significant link with the refusal to be examined by a male health worker, ignorance of the risks, unexpected pregnancies, and trying to hide one's pregnancy, which has an additional link with the age at risk. DISCUSSION: the social profile of the pregnant women studied is quite similar to that of greater population from which they come. The early CPN allows the care provider to forecast the delivery date with greater presicion and to estimate the delivery conditions more accurately at the time of the fourth CPN at which time the risk for potential complications which may necessitate a Ceasarean section is thoroughly assessed (DRS). Thus, the delay of the first CPN constitutes a limiting factor in the correct monitoring and surveillance of the pregnancy. The various social and cultural factors are intricately intertwined, and this interaction supports the need for multi-sectoral and multi-disciplinary actions which are generally necessary for the resolution of public health problems. Three recommendations are proposed which aim to improve the frequency of the early CPN. CONCLUSION: the influence of socio-cultural factors on the CPN requires that the CPN be fully integrated into a more advanced strategy and that a behaviour change within the community be influenced and take place through health education.

Adolescent↗
PubMed2005

[Monitoring and evaluation of health care programs in Subsaharian Africa].

The monitoring and evaluation is usually the weakest component of health programs in sub-Saharan Africa, what is undermining the sustainability of funding. The problems are complex and the weaknesses of the health systems are reflected on the monitoring and evaluation of specific programs. This paper gives an insight of the problems faced during field missions for monitoring and evaluation. The steps for building the M&E system have been reviewed and keys points for implementation have been provided.

Africa↗
PubMed2004

[Fertility, maternal mortality and survival of the children in the medical district of Kolda (Senegal)].

Maternal mortality and lethality in childhood constitute a major problem in Senegal. These two rates are often hight in areas off hight birth rate. In the medical district of Kolda (Senegal) no reliable data on reproductive health exists. We report the results of a preliminary investigation of a community based reproductive project. We've used the sisterhood methods reproductive health's indicators. This cross-sectional study was carried out in a sample of 1287 women in age of procreating. An "aggregative" fertility index of 6.59 was found in the "intervention" area as compare to 5,53 in the control area. The maternal death rate was estimated at 1285 per 100.000 alive births [998-1576]. The infant mortality rate was 83 per 1000. These results justify impremantation of a "vigorous" reproductive health policy in this area.

Adolescent↗
PubMed2003

[Impact of the number of antenatal consultations on the morbidity and mortality of children and women in the health district of Ziguinchor].

In order to assess the impact of the number of antenatal consultations (CPN) on the foetal and maternal morbidity and mortality, a prospective survey has been carried out in 1999, in the health district of Ziguinchor, Senegal. The investigation was led in seven health facilities which offered obstetrical cares, from January 1 to march 31, over a sample of 862 delivered women and 870 newborns. The number of antenatal consultations was zero in 26 cases (3%), one in 130 cases (15%), two in 198 cases (23%), three in 302 cases, and more than three in 206 cases (24%). Three elements of the mothers' profile have a statistically significant influence on the number of antenatal consultations: the delivery facilities, the ethnic groups, and the caesarean antecedent. For the other elements, the test is not significant. The number of antenatal consultations has a statistically significant link with: eclampsia, abruptio placentae, distich and maternal death. Some elements of the mothers' profile seem to be a cause of morbidity and mortality of children and women. In fact, we have notice: a statistically significant link between the health facilities and the dystocy; and between ethnic groups and abruptio placentae; an impossibility of drawing conclusion for the other cases. In short, the eclampsia and the maternal death are the only elements which seem to be improved by an increasing number of CPN without any influence of external factors.

Adolescent↗
PubMed2002

[Outcome of early pregnancies at the Gynecological and Obstetrical Service of the Regional Hospital Center of Ziguinchor].

In order to evaluate the evolution and the issue of pregnancies among women who are less than 20 years old, a retrospective inquiry has been made in the gynecological and obstetrical service at the regional hospital center of Ziguinchor, in Senegal. It covered a period of three years from January 1st 1997 to December 31st 1999. It concerned 477 cases of patients received at the end of their pregnancy. The risks of morbidity and mortality were globally higher in the group of 13-17 than that of 18-19. The Khi2 test has confirmed a statistically significant difference (p < 0.05) for evacuation, hospitalizations, abortions and dead-born frequencies. For the study of the other parameters (causes of evacuations, length of stay in hospital, evolutive term, way of delivery, maternal death frequency and theircauses, and the types of dead-born), the frequencies haven't been significantly different. So, the risk of morbidity and mortality is higher with the pregnancy of adolescents who are less than 18 years old. Hence the interest of doing every thing to prevent pregnancies among adolescents by an appropriate contraceptive method and to look with priority after any pregnancy occurring among this age group.

Adolescent↗
PubMed2002

[Barriers in the community management of child malaria in the city of Mékhé (Senegal)].

In Senegal, governmental fight plan against malaria emphasizes the need to community actions, particularly for early treatment of child malaria at home. So, we carried out a cross sectional survey, to determine factors linked with treatment of child malaria at home. During February 2001, we had an interview with persons taking care of a child under five years. These persons were randomly chosen among population of a rural town. Their median age was 32 years, 90.5% of them were women, 77.8% were the mother of the child. Their level of knowledge about malaria was fair (hightest transmission period, promoting environmental factors); 85.1% quoted children as vulnerable group; for 85%, fever was chief sign of malaria. When the child had fever, 45% of them brought him to a health center and 44% gave him chloroquin; 67.5% related no harmful effects. But at the time of the survey, only 28.8% had chloroquin at home. Literacy was very linked with home care: literate persons knowed most frequently the way of transmission by mosquito bites (72.4% versus 52.9% p<10-4 OR=2.3[1.5-3.6]); they considered most frequently chloroquin as the malaria treatment (74% versus 60.1% p=.003 OR=1.8 [1.2-2.9]) ;they had more often chloroquin at home (35.4% versus 22.6% p=.004 OR=1.8 [1.1-2.9). In conclusion, chloroquin might be available at home. The high ratio of illiterate persons in the population taking care of children in Mekhe emphasizes the need to organize information, education and communication strategies, using persons coming from the same community. The real impact of literacy on knowledges, behaviours and practices of persons taking care of malarial child at home emphasizes the need of reinforcing it, especially for women.

Adolescent↗
PubMed2001

[Cost analysis of psychiatric health care at the University Hospital of Fann (Senegal)].

In the current senegalese context, marked by a political will of autonomisation of health services, is proves very important to study the costs of the services provided in hospitals. Our study, which consists in a retrospective analysis of accounting archives of the psychiatric department of Fann Hospital during the year 1998, had the following objectives: determine the costs related to the functioning of the service of psychiatry, according to the source of financing, determine the average cost of the main services provided by the psychiatric department, analyze the recovery of the cost of these services. The operating costs of the psychiatric department came to 86.824.477 FCFA in 1998. 88% of the total amount were brought by the State and the remaining 12% came from community participation. The average cost of hospitalization in Clinique Moussa Diop was 91.398 F CFA. For the former patients the visit cost 6.664 F CFA; for the outpatients the price was 12,886 F CFA. The average cost of a child psychiatric visit was 8.140 F CFA and 28 days of hospitalization in the same service cost 354.825 F CFA. The share supported by the community participation is in general largely covered by the current fees in spite of the high cost of these services.

Costs and Cost Analysis↗
PubMed1997

[In vivo chemosensitivity tests of Plasmodium falciparum to chloroquine in Senegal: the development of resistance and the assessment of therapeutic efficacy].

The efficacity of oral chloroquine was assessed in 360 out-clinic patients with symptomatic Plasmodium falciparum malaria who were enrolled at five sites, in four administrative regions of Senegal, between 1991 and 1995. They were three rural areas: Mlomp (Casamance), Bandafassilbel (Eastern Senegal), Diohine (Sine-Saloum) and one urban area: Pikine (agglomeration of Dakar). Parasitological failure at Day-7 was observed in 108 patients (30%) and ranged from 14% to 50% according to the study areas. The proportion of RI, RII and RIII responses were 6%, 23% and 1%, respectively. Chloroquine resistance was lowest in Bandafassi, one of the most remote area of Senegal. It was highest in Mlomp where a malaria control programme with mass chemoprophylaxis had been carried out since 1975. The therapeutic failure rate defined by the persistence or reappearance of fever and P. falciparum trophozoites on days 4-7 was 6%. The percentages of therapeutic failure for RI, RII and RIII patients were respectively 14%, 19% and 100%. These results and those of previous studies in Senegal suggest that chloroquine resistance, which first emerged in vivo in 1988 in Dakar, spread between 1990 and 1993 in all regions of this country. The limitations of in vivo tests for the determination of the therapeutic efficacy of chloroquine in malaria endemic regions with increasing chemoresistance are discussed. The low proportion of potentially severe malaria infections in semi-immune persons, the biases in patients selection, and the possibility of delayed complications, considerably limit the potential of these tests for guiding the choice of the best adapted first line treatment.

Administration, Oral↗
PubMed1996

[Pathologies associated with HTLV-1 virus in Dakar (1992-1995)].

A clinical and laboratory study was conducted in Dakar (Senegal) to assess the involvement of HTLV-1 virus (human T lymphotrophic virus type 1) in various diseases. Patients were enrolled at three locations: the Dermatology Department of the Fann University Hospital Center (845 patients) from 1992 to 1995, the Dermatology Department of the Le Dantec University Hospital Center and the Oncology Department of the Principal Hospital (7 patients) in 1994 and 1995. The incidence of involvement of human retroviruses in neurologic complications seemed low (HTLV-1: 2%, HIV: 3%) and only 6 cases of tropical spastic paraparesis associated with specific anti-HTLV-1 antibodies were diagnosed in 3 men and 3 women with a mean age of 51 years. These cases which were identical to those previously described cases in the West Indies and Japan confirms the existence of this disease in Senegal. In addition 3 cases of isolated facial paralysis were observed in HIV positive patients. Combined HIV/HTLV-1 infection was observed in 3 cases and was not associated with special clinical findings. Adult T-cell leukemia/lymphoma (ATL) was detected in 4 patients including leukemia with proliferation of CD4 and CD25 in two cases and lymphoma in one case. In one case of ATL two proviruses were identified in circulating tumor cells. These are the first cases of ATL to be reported in Senegal. Molecular characterization of part of the envelope gene (gp 21) from patients with PST hospitalized in a neurology ward showed that the virus present in Senegal belonged to the universal HTLV-1 A type. This study indicates that two types of diseases are associated with HTLV-1 infection in Senegal. Further epidemiologic studies will be needed to evaluate the incidence of the virus and of the diseases associated with it. Prevention will depend partly on screening blood donors as has now been started at the Blood Transfusion Center of Dakar.

Adult↗
PubMed1994

The Dielmo project: a longitudinal study of natural malaria infection and the mechanisms of protective immunity in a community living in a holoendemic area of Senegal.

The Dielmo project, initiated in 1990, consisted of long-term investigations on host-parasite relationships and the mechanisms of protective immunity in the 247 residents of a Senegalese village in which malaria is holoendemic. Anopheles gambiae s.l. and An. funestus constituted more than 98% of 11,685 anophelines collected and were present all year round. Inoculation rates of Plasmodium falciparum, P. malariae, and P. ovale averaged respectively 0.51, 0.10, and 0.04 infective bites per person per night. During a four-month period of intensive parasitologic and clinical monitoring, Plasmodium falciparum, P. malariae, and P. ovale were observed in 72.0%, 21.1% and 6.0%, respectively, of the 8,539 thick smears examined. Individual longitudinal data revealed that 98.6% of the villagers harbored trophozoites of P. falciparum at least once during the period of the study. Infections by P. malariae and P. ovale were both observed in individuals of all age groups and their cumulative prevalences reached 50.5% and 40.3%, respectively. Malaria was responsible for 162 (60.9%) of 266 febrile episodes; 159 of these attacks were due to P. falciparum, three to P. ovale, and none to P. malariae. The incidence of malaria attacks was 40 times higher in children 0-4 years of age than in adults more than 40 years old. Our findings suggest that sterile immunity and clinical protection are never fully achieved in humans continuously exposed since birth to intense transmission.

Adolescent↗