[Nutritional status of street children in the district of Manga (Burkina Faso)]. / État nutritionnel des enfants de la rue dans la commune de Manga (Burkina Faso).

Malnutrition is an important indicator of development, and its consequences in children and adolescents produce a serious socioeconomic burden. Children living on the street are more vulnerable than others. Thus, our objective was to analyze the nutritional status of children living on the streets of Manga, through a cross-sectional and analytical study. The snowball technique was used for sampling. Data came from individual interviews, blood samples and medical examinations. Of the 237 children studied, 84.8% were boys; the overall mean age was 11.5 years, and 72.6% were adolescents (aged 10 to 17 years). Growth retardation (15.9%) predominated among the children aged 4 to 9 years, while a weight deficit (27.9%) was most common among those aged 10 to 17. Half of the children (50.2%) with blood tests (N = 119) had anemia. There was a link between anemia and underweight (p = 0.0145). Children who ate at least three times a day were 2.63 times less likely to be anemic (p<0.001). Factors associated with anemia (p<0.005) included survival activities. We frequently found nutritional deficits and anemia in these children. A targeted nutritional program would be a good entry point for their successful reintegration..

[Annual assessement of a mobile ultrasonography service in the region of Ziguinchor, Senegal]. / Bilan d'activité annuel de l'echographie en stratégie avancée dans la région de Ziguinchor (Sénégal).

To provide rural populations with access to ultrasound scanning, a mobile ultrasound service was set up in the health districts of Sédhiou, Oussouye, Bignona and Ziguinchor in Casamance, Senegal. In 2001 the mobile unit performed a total of 56 missions and provided examinations to 1273 patients. The main indications were pregnancy assessment, amenorrhea, detection of pregnancy, painful pelvic tumors and hemorrhage. Findings allowed diagnosis of disorders in 25% cases. Disorders were pregnancy-related in 47% of cases and gynecological in 53%. Ultrasound examinations were performed for follow-up purposes in 15% cases, for therapeutic purposes in 24% and for referral to the regional hospital center in 61%. These findings demonstrate the utility of a mobile ultrasound service in managing health problems not only for the community but also for health-care structures. This service should be maintained until ultrasound equipment becomes available in district hospitals and personnel at those facilities have adequate training in ultrasound scanning.

[Socio-cultural determinants of the lateness of the first prenatal consultation in a health district in Senegal]. / Determinants socioculturels du retard de la 1re consultation prénatale dans un district sanitaire au Sénégal.

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.