A la recherche des determinants institutionnels du bien-etre des populations sedentaires et nomades dans la plaine du Waza-Logone de la frontiere camerounaise et tchadienne

This article describes an ongoing research project designed to compile a database to promote pastoral development in the lowlands along the Logone and Chari Rivers in Cameroon. A number of sedentary and nomadic populations depend on these flood plains south of Lake Chad for their livelihood. However the natural resources of the area undergo sharp seasonal variations and sometimes become the property of sedentary groups. As a result nomadic communities experience difficulty not only in gaining access to grazing lands and water but also to quality health care (hospital centers; effective medication). The purpose of this study was to define institutional requirements necessary to ensure access to health care resources for both nomadic and sedentary groups. The main problem for the nomadic population is that; unlike the now defunct precolonial structures; today's institutions are not compatible with the subsistence strategies of rural populations. These findingss u ggest that new institutional framewo rks for nat u ral resource management could indirectly improve the health status of nomadic pastoralist

Repartition de la morbidite dans trois communautes nomades du Chari-Baguirmi et du Kanem; Tchad

Within the framework of an multidisciplinary research and action program; morbidity patterns were assessed in three nomadic communities; i.e.; Fulani; A rab cattle bre e d e rs and A rab camel breeders; l iving in Chari - B ag u i rmi and Kanem; Chad. This is the first data about the health of Chadian nomadic pastoralists who account for approximately 6of the total population. A total of 1092 women; men and children were interviewed and examined in the course of three surveys carried out by a physician during the dry and rainy season. Nomads reporting no health problems were rare. Tuberculosis was suspected in 4;6of adults after clinical examination and bronchopulmonary disorders in children less than five years of age. Febrile diarrhea was more prevalent during the wet season when access to clean drinking water was more difficult. Simple malaria was rarely diagnosed in Arabs during the dry season. In contrast simple malaria was frequent in Fulani who stay inthe vicinity of Lake Chad during the dry period. Protein-energy malnutrition was observed in only 3 of 328 children younger than 15 years of age

Seroprevalences des maladies zoonotiques chez les pasteurs nomades et leurs animaux dans le Chari-Baguirmi du Tchad

The sero p revalences of brucellosis and Q-fever we re eva l u ated in humans and live s t o ck in three Chadian nomadic commu n i t i e s ; i . e. ; Fulani cattle bre e d e rs and A rab camel and cattle bre e d e rs. The survey was carried out in 1999 and 2000. The total number of human sera and animal sera tested were 911 and 1 637; respectively; for antibodies against Brucella spp. and 368 and 613; respectively; for Coxiella burnetii. Sixteen brucellosis positive human sera resulted in a seroprevelance rate of 2. Male participants were significantly more often brucellosis seropositive than females. No association was found between brucellosis serostatus and physical findings or reported symptoms. Positive brucellosis serology was more frequent in c attle (seropreva l e n c e;7) than in camels (1.4) and small ruminants (0.5). Fifteen human sera from 11 A rab camel bre eders and 4 Arab cattle breeders were positive for Q-fever (seroprevalence below 1). Being a camel breeder was a significant risk factor for Q-fever seropositivity. Camels had the highest Q-fever seroprevalence (73) among livestock species

Taux sérique de rétinol chez les femmes nomades pastoralistes tchadiennes en relation avec la teneur en rétinol et en carotène dans le lait de leur bétail

Dans le cadre d'une étude sur le statut sanitaire des pasteurs nomades et de leur bétail exécutée en étroite colla-boration entre les services de santé publique et vétérinaire tchadiens,le taux de rétinol sérique humain a été analysé en cor-rélation avec celui contenu dans le lait du bétail. Parmi les femmes examinées (n = 99),43% (IC95% 33 - 54 %) étaient défi-c i t a i resen rétinol (tauxde0,35µmol/Là0,7µmol/L) et 17% (IC95% 10 -26%) sévèrement défi c i t a i resen rétinol (tauxinféri e u rà0,35µmol/L). Aucunedesfemmesinterrogées(n=87)n'indiquaituneconsommation defruitset seulesdeux avaientconsommédeslégumesfraisau coursdesdern i è res 24 heures. Lelait était donc pratiquement la seule source devitamineA pour ces popu-lations. Parmi le bétail,les chèvres (n=6) avaient les taux moyens de rétinol les plus élevés dans leur lait (329 ± 84 µg/kg),sui-vies des bovins (n=25; 247 ± 32 µg/kg) et des dromadaires (n=12; 120 ± 18 µg/kg). Les concentrations de rétinol dans le sérumhumain dépendaient de manière significative de la concentration de rétinol dans le lait du bétail (pente partielle 0,23; inter-valle de confiance de 95% 0,008 - 0,47). Notre étude confirme que le lait de chèvre et de vache est une source importante devitamine A chez les pasteurs nomades. Par ailleurs,la promotion de la consommation de légumes verts,de fruits et de sup-pléments vitaminés reste nécessaire pour lutter contre les carences en vitamine A

Premiers isolements de mycobacteries tuberculeuses chez l'homme et l'animal au Tchad

This report describes the first successful isolation and identification of mycobacterial infection in humans and animals of Chad. All mycobacterial strains from human specimens were M. tuberculosis and strains from animal specimens (cattle) were M. bovis. None of the 10 of M. tuberculosis strains tested for antibiotic resistance were multidrug resistant. Due to the intrinsic resistance of M. bovis to pyrazinamide and the growing number of tuberculosis cases in HIV-infected people in Africa and elsewhere; more information on the potential of M. bovis for human infection is needed to guide disease control policy

Quels types de service de sante pour les populations nomades? Apprentissages des activites de recherche et d'action au Tchad

To overcome barriers of access to health care of nomadic people and to alleviate inequities in health; a transd isciplinary team has initiated research and intervention activities among three nomadic groups of Chad: Foulbe; A rabes and G o u ranes. A regular and consistent commu n i c ation among all actors involved (nomadic groups; re s e a rchers; planners and administrators of health and veterinary services; etc.) through repetitive meetings and workshops showed to be a crucial element for success. Differences between ethnic nomadic groups made it necessary to develop specific communication strategies adapted to each group. As to interventions to improve the va c c i n ation cove rage; m i xed teams combining health and veteri n a ry specialists were able to vaccinate an important number of children and women and showed to have a high potential in terms of o rga n i s ational and logistic feasibility; acceptability as well as good cost-effe c t iveness. With rega rd to improving access to health care; Information - Education and Communication approaches adapted to the intervention context and linked to the provision of essential services and generic drugs showed to be crucial

Approche novatrice des vaccinations en sante publique et en medecine veterinaire chez les pasteurs nomades au Tchad: Experiences et couts

The purpose of this report is to describe a network of public health care workers; veterinarians and nomadic pastoralists that was set up in Chad to increase vaccination coverage to nomadic children and women who had rarely been va c c i n ated befo re. The objectives of the project we re to provide human vaccination in conjunction with existing ve t e ri n a ry serv ices; to evaluate the feasibility and limitations of such campaigns; to determine wh at other services could be provided concurrently; and to estimate the savings for public health care cases in comparison with carrying out vaccination separately. In a s e ries of 12 vaccination campaigns in the Chari-Baguirmi and Kanem distri c t s ; more than 2100 children; 2100 women and 52000 c attle we re fully immu n i ze d. These results confirmed the feasibility of joint campaigns in nomadic settings and provided important experience for improving organization. Information-Education-Communication (IEC) campaigns adapted to the realities of the pastoral setting were an important factor in mobilizing nomadic pastoralists for attendance at vaccination clinics. The savings in logistics costs (i.e. ; personnel; transportation and cold chain costs ex cluding vaccine costs) was 15in Gre d aya where 3 out of 6 campaigns were carried out together with veterinarians and 4in Chaddra/Am Dobak where only 1 out of 6 campaigns was carried out in conjunction with veterinarians. The cost per fully immunized child (FIC) was considerably higher in Chaddra/Am Dobak than Gredaya (EUR 29.2 vs. EUR 11.5). The joint vaccination campaign approach is innovative; appreciated by nomadic pastoralists and less expensive than separate vaccination. By using the mobility of veterinarians in remote zones far from health care facilities; vaccination can be provided to nomadic children and women in countries with limited resources