[People's perceptions of violence against women in Senegal.] / Perceptions des populations sur les violences faites aux femmes au Sénégal.

INTRODUCTION: The lack of empowerment and the poverty in which women and girls live are factors that perpetuate violence in society. The purpose of this study is to analyze people’s perceptions of violence against women and girls in Senegal. METHOD: A qualitative analytical study was conducted from April 10 to May 9, 2017 on all 11 regions of Senegal with a High Court (HC). The populations were represented by 86 victims, 11 HC prosecutors, 23 chiefs of emergency services and 23 heads of gynecological services. Individual interviews were conducted. Content analysis supported by a thematic analysis was conducted with Iramuteq software. RESULTS: In relation to sexual assault, the prevailing feeling among the victims is that of losing the precious thing that is the hymen. According to the providers, the victims find it difficult to pay the invoice for the medical certificate. According to the prosecutors, the management of the evidence is, according to them, a great hindrance to the judicial care of the victims. CONCLUSION: The aggressor’s domination use threats to compel the victim to denunciation. Indeed, sexual coercion, the physical or verbal pressure to have sex, are among the most frequently noted gestures in this regard. It is important for the health and judicial authorities to implement a plan for the fight against violence, which focuses on communication in order to make people aware of the rights and place of women in the community.

21st century research in urban WASH and health in sub-Saharan Africa: methods and outcomes in transition.

Tackling global inequalities in access to Water, Sanitation and Hygiene (WASH) remains an urgent issue - 58% of annual diarrhoeal deaths are caused by inadequate WASH provision. A global context of increasing urbanisation, changing demographics and health transitions demands an understanding and impact of WASH on a broad set of health outcomes. We examine the literature, in terms of health outcomes, considering WASH access and interventions in urban sub-Saharan Africa from 2000 to 2017. Our review of studies which evaluate the effectiveness of specific WASH interventions, reveals an emphasis of WASH research on acute communicable diseases, particularly diarrhoeal diseases. In contrast, chronic communicable and non-communicable health outcomes were notable gaps in the literature as well as a lack of focus on cross-cutting issues, such as ageing, well-being and gender equality. We recommend a broader focus of WASH research and interventions in urban Africa to better reflect the demographic and health transitions happening. Abbreviations: CBA: Controlled Before and After; GSD: Government Service Delivery; IWDSSD: International Drinking-Water, Supply and Sanitation Decade (IDWSSD); KAP: Knowledge, Attitudes and Practices; IBD: Irritable Bowel Diseases; MDG: Millennium Development Goals; NTD: Neglected Tropical Diseases; PSSD: Private Sector Service Delivery; SDG: Sustainable Development Goals; SSA: Sub Saharan Africa; SODIS: Solar Disinfection System; STH: Soil Transmitted Helminths; RCT: Randomised Control Trial; WASH: Water Sanitation and Hygiene; WHO: World Health Organization.

Analysis of public policies in favor of the elderly people in Senegal: state of legal protection.

Senegal will be spared by phenomenon of population ageing, which will surely have socioeconomic and cultural consequences that will not be easy to tackle, as all sectors will be affected. In regard to legal protection, there are not any special legal acts for the elderly as is the case for children and women. They are treated just as responsible adults whose legal status is the same as everyone else. As far as the framework of legal protection of elderly people is concerned, Senegal has ratified all international and regional means and mecanisms for the protection of the rights of the elderly. In addition, the authorities have adopted policies and programs that favor taking charge of old people's interests. At the present, Senegal possesses a legal framework for the protection of its elderly people. So the matter is about creating new rights, because even the existing rights are not known to their beneficiaries. What is important is to ensure that the elderly fully enjoy their rights in the same way as the other members of society. It is wise, therefore, to put in place plan for information, public awareness and communication concerning the legal regulating framework. Thus, Senegal could be regarded as a pioneer in terms of the protection the elderly, and these leading programs can represent models for the countries of the region, whose social, sanitary and economic contexts are similar.

[Determinants of enrolment and retention in mutual health organization in the region of Ziguinchor (Senegal)]. / Déterminants de l'adhésion et de la fidélisation aux mutuelles de santé dans la région de Ziguinchor (Sénégal).

Introduction: Despite the recognition of the role of Mutual Health Organization (MHO) as a mechanism to ensure the financial sustainability of health systems, recent studies have shown the existence of obstacles to enrolment and retention in these MHOs. The objective of this study was to examine the determinants of enrolment and retention in MHO in Senegal.Methods: Data collection was conducted from 22 June to 30 September 2015 in Ziguinchor, located 450 km from Dakar by stratified two-stage sampling (n = 912 households). The analysis was conducted by multiple logistic regression with selection of predictors in the Stepwise Backward method based on the likelihood ratio.Results: Low enrolment was significantly associated with rural residence, size of the household, low level of household head literacy and income, poor perception of the quality of care and distance from the nearest health facility. Low retention in MHO was also significantly associated with low household income, poor perception of quality of care, and presence of a person over the age of 60 years in the household.Conclusion: The determinants of enrolment and retention of consumers in MHO must be taken into account to ensure successful development of a Universal Health Coverage strategy.

Widespread Rift Valley Fever Emergence in Senegal in 2013-2014.

Rift Valley fever (RVF), which caused epizootics and epidemics among human and livestock populations, occurred in Senegal in 2013-2014. A multidisciplinary field investigation was carried out in 3 regions of Senegal. We found 11 confirmed human cases of Rift Valley fever, including severe cases with encephalitis and retinitis, 1 pool of mosquito (Aedes ochraceus), and 52 animals tested positive for the disease. Symptoms such as encephalitis and macular retinitis were the most severe cases reported so far in Senegal. The outbreak was widespread due to animals' movements, leading to the largest RVF outbreak in Senegal in terms of geographic spreading and reaching areas that never reported RVF activity previously.

Elderly and preventive care of the geriatric pathologies in African environment.

Senegal will not be spared by the process of the aging of its population. In fact, according to surveys, the demographic increase in the population of the old people, which is 3.5% higher than the national average (2.5%). But for the time being, gerontology problems are not arising in terms of demographic weight, but rather in terms of the breaking up of solidarity networks, uncontrolled urbanization and poverty. As far as health is concerned, the old people generally are faced with the same problems as their Northern counterparts; they are exposed to chronic diseases that demand their taking in charge in a long period of time. Besides, these diseases are a great handicap and they are also disabling diseases. So taking them in charge puts a financial on their meager family budgets or their pensions. In addition, there are no specialists in geriatrics, and those working in the field did not receive any training for that. Moreover, most of our health facilities are lacking in diagnostic means. Therefore, gerontology-geriatrics solutions that are adapted to our socio-economic context should be assigned straight away. The problem is not about stopping the process of aging, which, as a physiological process, is inevitable and irreversible, but rather delaying its effects. The matter at issue will be about how to set up a decentralized and integrated program that is designed to fight against geriatric diseases and disorders and that mainly focuses on screening and primary and secondary prevention, for our low financial resources and the low medical equipment of our health facilities cannot help us to adequately take charge of complications related to these diseases.

[Sesame Health Programme at Senegal: Limitations of this free healthcare model]. / Plan Sésame au Sénégal : limites de ce modèle de gratuité.

INTRODUCTION: Up until now, elderly people have experienced medical management difficulties despite the free care provided by the Sesame Health Programme. The objective of this study was to determine the costs borne by beneficiaries and/or their families and to evaluate these costs in relation to overall management. This comprehensive, cross-sectional, quantitative study was conducted from 21 February to 21 March 2011 in the Ouakam gerontology centre. METHODS: Epi Info Version 6 software was used for data analysis. The study population was composed of 203 patients with a mean age of 68 years, with 59% of women and 63% of retired subjects. The most common diseases were hypertension (52%), cataract (16%), and osteoarthritis (12%). RESULTS: The beneficiaries healthcare costs were covered by the Sesame Health Programme, apart from most of the drugs used to treat chronic diseases, which remained at the charge of patients and/or their families. The overall mean cost of monthly management of the diseases detected in elderly people was estimated to be CFA 37,700, a large share of which (65%) was supported by the patient and/or the family corresponding to the purchase of these drugs. Other dysfunctions were also observed, particularly the difficulty of targeting beneficiaries, generic stock shortages, absence of generics for the treatment of chronic diseases. CONCLUSION: Recommendations are formulated to improve implementation of the Sesame Health Programme.

Concurrent malaria and arbovirus infections in Kedougou, southeastern Senegal.

BACKGROUND: Malaria is one of the leading causes of acute febrile illness (AFI) in Africa. With the advent of malaria rapid diagnostic tests, misdiagnosis and co-morbidity with other diseases has been highlighted by an increasing number of studies. Although arboviral infections and malaria are both vector-borne diseases and often have an overlapping geographic distribution in sub-Saharan Africa, information about their incidence rates and concurrent infections is scarce. METHODS: From July 2009 to March 2013 patients from seven healthcare facilities of the Kedougou region presenting with AFI were enrolled and tested for malaria and arboviral infections, i.e., yellow fever (YFV), West Nile (WNV), dengue (DENV), chikungunya (CHIKV), Crimean Congo haemorrhagic fever (CCHFV), Zika (ZIKV), and Rift Valley fever viruses (RVFV). Malaria parasite infections were investigated using thick blood smear (TBS) and rapid diagnostics tests (RDT) while arbovirus infections were tested by IgM antibody detection (ELISA) and RT-PCR assays. Data analysis of single or concurrent malaria and arbovirus was performed using R software. RESULTS: A total of 13,845 patients, including 7387 with malaria and 41 with acute arbovirus infections (12 YFV, nine ZIKV, 16 CHIKV, three DENV, and one RVFV) were enrolled. Among the arbovirus-infected patients, 48.7% (20/41) were co-infected with malaria parasites at the following frequencies: CHIKV 18.7% (3/16), YFV 58.3% (7/12), ZIKV 88.9% (8/9), DENV 33.3% (1/3), and RVF 100% (1/1). Fever ≥40 °C was the only sign or symptom significantly associated with dual malaria parasite/arbovirus infection. CONCLUSIONS: Concurrent malaria parasite and arbovirus infections were detected in the Kedougou region from 2009 to 2013 and need to be further documented, including among asymptomatic individuals, to assess its epidemiological and clinical impact.

Application of geographically-weighted regression analysis to assess risk factors for malaria hotspots in Keur Soce health and demographic surveillance site.

BACKGROUND: In Senegal, considerable efforts have been made to reduce malaria morbidity and mortality during the last decade. This resulted in a marked decrease of malaria cases. With the decline of malaria cases, transmission has become sparse in most Senegalese health districts. This study investigated malaria hotspots in Keur Soce sites by using geographically-weighted regression. Because of the occurrence of hotspots, spatial modelling of malaria cases could have a considerable effect in disease surveillance. METHODS: This study explored and analysed the spatial relationships between malaria occurrence and socio-economic and environmental factors in small communities in Keur Soce, Senegal, using 6 months passive surveillance. Geographically-weighted regression was used to explore the spatial variability of relationships between malaria incidence or persistence and the selected socio-economic, and human predictors. A model comparison of between ordinary least square and geographically-weighted regression was also explored. Vector dataset (spatial) of the study area by village levels and statistical data (non-spatial) on malaria confirmed cases, socio-economic status (bed net use), population data (size of the household) and environmental factors (temperature, rain fall) were used in this exploratory analysis. ArcMap 10.2 and Stata 11 were used to perform malaria hotspots analysis. RESULTS: From Jun to December, a total of 408 confirmed malaria cases were notified. The explanatory variables-household size, housing materials, sleeping rooms, sheep and distance to breeding site returned significant t values of -0.25, 2.3, 4.39, 1.25 and 2.36, respectively. The OLS global model revealed that it explained about 70 % (adjusted R(2) = 0.70) of the variation in malaria occurrence with AIC = 756.23. The geographically-weighted regression of malaria hotspots resulted in coefficient intercept ranging from 1.89 to 6.22 with a median of 3.5. Large positive values are distributed mainly in the southeast of the district where hotspots are more accurate while low values are mainly found in the centre and in the north. CONCLUSION: Geographically-weighted regression and OLS showed important risks factors of malaria hotspots in Keur Soce. The outputs of such models can be a useful tool to understand occurrence of malaria hotspots in Senegal. An understanding of geographical variation and determination of the core areas of the disease may provide an explanation regarding possible proximal and distal contributors to malaria elimination in Senegal.

[Determinants of modern contraceptive use in the Mbacké health district (Senegal)]. / Determinants de l'utilisation de la contraception moderne dans le district sanitaire de Mbacké (Séngal).

INTRODUCTION: Contraceptive prevalence is low in Senegal, particularly in the Mbacké health district. The objective of this study was to identify the determinants of use of modern contraception by women of reproductive age in this district. METHODOLOGY: A quantitative and qualitative analytical study was conducted. The quantitative survey was conducted from 1st to 20 July 2011. The study population consisted of women of childbearing age living in the district. A two-stage survey was conducted. Data were entered and bivariate analysis was performed using Epi Info 3.3.5software. Multivariate analysiswas performed by R 2.2.9 software. The adjusted odds ratios were calculatedfor variables with significant p values. The qualitative study was conducted from 25 to 31 July2011. Grouped interviews were used to collect women's perceptions of modern contraception. Content analysis was performed. CONCLUSION: Improving the socio-economic characteristics of women and raising public awareness about modern contraception would contribute to a better use of modern contraceptives in the Mbacké health district.

Identifying malaria hotspots in Keur Soce health and demographic surveillance site in context of low transmission.

BACKGROUND: Malaria is major public health problem in Senegal. In some parts of the country, it occurs almost permanently with a seasonal increase during the rainy season. There is evidence to suggest that the prevalence of malaria in Senegal has decreased considerably during the past few years. Recent data from the Senegalese National Malaria Control Programme (NMCP) indicates that the number of malaria cases decrease from 1,500,000 in 2006 to 174,339 in 2010. With the decline of malaria morbidity in Senegal, the characterization of the new epidemiological profile of this disease is crucial for public health decision makers. METHODS: SaTScan™ software using the Kulldorf method of retrospective space-time permutation and the Bernoulli purely spatial model was used to identify malaria clusters using confirmed malaria cases in 74 villages. ArcMAp was used to map malaria hotspots. Logistic regression was used to investigate risk factors for malaria hotspots in Keur Soce health and demographic surveillance site. RESULTS: A total of 1,614 individuals in 440 randomly selected households were enrolled. The overall malaria prevalence was 12%. The malaria prevalence during the study period varied from less than 2% to more than 25% from one village to another. The results showed also that rooms located between 50 m to 100 m away from livestock holding place [adjusted O.R = 0.7, P = 0.044, 95% C.I (1.02 - 7.42)], bed net use [adjusted O.R = 1.2, P = 0.024, 95% C.I (1.02 -1.48)], are good predictors for malaria hotspots in the Keur Soce health and demographic surveillance site. The socio economic status of the household also predicted on hotspots patterns. The less poor household are 30% less likely to be classified as malaria hotspots area compared to the poorest household [adjusted O.R = 0.7, P = 0.014, 95% C.I (0.47 - 0.91)]. CONCLUSION: The study investigated risk factors for malaria hotspots in small communities in the Keur Soce site. The result showed considerable variation of malaria prevalence between villages which cannot be detected in aggregated data. The data presented in this paper are the first step to understanding malaria in the Keur Soce site from a micro-geographic perspective.

[Study of determinants of rape in minors in the Kolda region of Senegal]. / Etude des déterminants de viols chez les mineurs dans la région de Kolda au Sénégal.

INTRODUCTION: The objective of this study was to investigate the determinants of rape among minors in the Kolda region. METHODOLOGY: A retrospective, cross-sectional, descriptive and analytical was conducted from 23 December 1992 to 31 December 2011, based on the charts of rape victims under the age of 18 years. Sampling was complete. Bivariate and multivariate analyses were performed using Epi Info 3.3.2 and R 2.9.2 software, respectively. RESULTS: The study included 162 cases of sexual assault. The mean age of victims was 12.3 +/- 3 years (range: 4-17 years). The mean age of perpetrators of sexual assault was 26.4 +/- 9.5 years and minors accounted for 13% of perpetrators. 54.9% of victims, were raped. Victims of sexual assault knew the perpetrator in 66% of cases and were attacked in broad daylight in 53.4% of cases. The perpetrators were drunk at the time of sexual assault in 15.3% of cases. The assault took place in the bush (14.8%). Twenty eight percent (28%) of rapists were jailed and 38.6% of them were jailed for between 5 and 10 years. Sexual assault in the bush [adjusted OR = 3.46 (1.02-11.77)] and intoxication of the perpetrator at the time of sexual assault [adjusted OR = 3.47 (1.04-11.61)] were associated with a high risk of rape. In contrast, victims who knew their assailants were at a lower risk of rape [adjusted OR = 0.09 (0.03 to 0.24)]. CONCLUSION: Extension of this study to the national scale would provide health and judicial authorities with an overview of sexual assault among minors, to allow more effective prevention at the national level.

[Measles epidemic and response in the region of Dakar (Senegal) in 2009]. / Épidémie de rougeole et de sa riposte en 2009, dans la région de Dakar, Sénégal.

In 2009, the region of Dakar (Senegal) experienced a major measles epidemic, in the context of the failure of the immunization program. The objective of this study was to examine the epidemic and the effectiveness of the response. A cross-sectional epidemiological study of all cases of measles confirmed by laboratory tests or epidemiological linkage was conducted between June and December 2009. The study also assessed the effectiveness of the response. The results show that out of 767 confirmed cases, less than a third (30 %) were laboratory-confirmed, while the remaining cases were confirmed by epidemiological linkage with one or several other confirmed cases. The minimum age was 4 months and the maximum age was 35 years. Children under 5 accounted for 67.4 % of the total number of cases. The male population was more affected than the female population (52.2 %). Most of the cases of were not vaccinated (88.5 %). The southern district had the highest incidence of measles, with more than 68 cases per 100,000 inhabitants. The vaccination coverage rate over the last 3 years was found to be satisfactory (average rate: 82.2 %). The response campaign resulted in the vaccination of 54,793 children aged 9 to 59 months (55.9%) distributed throughout the high-risk areas with low immunization coverage. No deaths were reported. The results suggest that it is important i) to continue to promote measles vaccination; ii) to combine routine vaccinations with supplements (for example vitamin A); iii) to introduce national vaccination campaigns targeting specific groups (new army recruits, students, refugees, etc.); and iv) to introduce a second dose of vaccine to ensure that the children who did not receive the first vaccine are covered and to address primary vaccine failures among those who were vaccinated.

[Quality of water for household consumption: analysis and action plan in rural area of Senegal]. / Qualité de l'eau de consommation des ménages: analyse et plan d'action en zone rurale sénégalaise.

This study aimed to evaluate the supply and the conservation of water for household consumption, in order to propose solutions for its quality improvement. An inspection of the drilling tank was completed by a two-part process, first consisting of doing a bacteriological analysis of the tank's water, and second by conducting a survey of 216 household leaders and the 32 Rural Council members. The drilling tank was left uncovered in open air, and it was overrun with algae and other various objects. It did not have any chemical treatment device, and the distribution pipes lacked water tightness. Serratia marcescens and Streptococcus faecalis were found in the tank's water. The tank's lack of a cover and absence of chlorination treatment were ignored by 55% and 56% of the household's leaders respectively. The storage containers, in 88% of cases, were inappropriate. The water was not chlorinated for 53% of the households. Among the 32 Rural Council members, 26 suggested chlorination and 18 suggested covering the tank for the quality improvement of water drilled and stored in the tanks. As a next step towards the resolution of this problem, an action plan was established with a budget up to 664,000 CFA francs, coordinated by the head doctor of the health district. The community participation facilitated such a level of involvement that eventually a water tower was constructed in 2005, which was beneficial to the health of the entire population of Mbar.

[Community participation for a latrine project in Senegalese rural area]. / Participation communautaire dans un projet de latrines en zone rurale sénégalaise.

The rural community of Ngohé faces serious hygiene and sanitation problems because of the poor quality of water, and in particular due to the lack of latrines in shelters. As of 2003, a three-year project for the construction of latrines was initiated within the framework of a donor agency programme to support the health region of Diourbel. After three years of activity, the poor results recorded provided considerable justification for the analysis of community participation in the project. A cross-cutting descriptive and analytical survey was carried out from December 14 -17th, 2005. Two trained investigators collected the data through individual and group interviews. It was found that there was close community participation in the decision-making process to determine which activities would be undertaken; however, it was limited in the areas of need assessment, mobilization and management of resources as well as monitoring and evaluation. Community participation was considered average concerning the implementation of activities. The low rate of latrines (1.7%), correlated with the high proportion of diarrhea as one of the main reason for consultation in 2004 (33.4%) and 2005 (29.4%), expressed the non-achievement of the project's objectives, which was planned to end in 2006. Many projects have shortcomings and pitfalls in their participatory strategy at al phases, especially during that of implementation. Frequently, participation efforts are limited to the recruitment of community participants. The organization and coordination that should accompany and support strategies for community participation must be adapted to the context of the poor and disadvantaged populations, a majority of whom are illiterate, as they are less sensitized to the benefits of hygiene and health promotion. It is the responsibility of health professionals to organize community representatives and to strengthen their capabilities in the field of hygiene and health in order to ensure the community ownership and sustainability of such projects.

[Economic evaluation of rapid diagnostic tests in malaria treatment]. / Evaluation économique des tests de diagnostic rapide dans le traitement du paludisme.

This study aimed to evaluate the economic implications of rapid diagnostic tests (RDTs) on malaria management through the rational use of artemisinin-based combination therapy (ACT). The study was carried out in 2006 from November 10th to December 10th; it focused on patients who were seen and treated with ACT for suspicion of uncomplicated malaria in the health district of Ziguinchor, Senegal. The variables studied included age, sex, RDT results, and costs of care and RDT. The cost of care for malaria, estimated in CFA Francs, was evaluated both with and without the use of RDT. Among the 379 patients, 25,1% were aged 0-4 years, 12,7% of 5-14 years and 62,2% of at least 15 years; 51% were women. The result of the RDT was negative in 60% of cases. Without the use of diagnostic testing, the cost of care for all 379 cases was estimated at 299 957 CFA: patient contributions would cover 184 500 CFA and the State would cover the rest (115 457 CFA). With the use of RDTs, the overall cost of the RDT screening for 379 patients and the cost of treatment for the 150 positive cases amounted to 254 786 CFA, with patients bearing the cost of 205 550 CFA and the State subsidizing up to 49 236 CFA. RDT can help identify the positive cases of malaria, and avoid up to 60% of unnecessary treatments, corresponding to an estimated 27 297 cases at the district level and 584 630 cases nationally. The RDT also allow a more rational use of ACTs and a lower risk of emergence of Plasmodium resistance. The use of RDTs could result in savings of 45 171 CFA at the level of the district health centre and 111 240 136 CFA nationally.

[Contribution of supplementation by spirulina to the performance of school children in an introductory course in Dakar (Senegal)]. / Apport de la supplémentation en spiruline sur les performances scolaires des enfants en cours d'initiation a Dakar (Sénégal).

Senegal initiated a program to improve the nutritional status of school-age children with the use of spirulina. The objective of this study was to evaluate the effects of spirulina on academic performance of school children in the municipality of Dakar, Senegal. The evaluation was conducted as a prospective study, comparing school performance of schoolchildren from public elementary schools located in three National Education Departments of Dakar (before supplements, during and after). The study population consisted of students from six schools randomly selected among the 100 who were in the program. We included all children with agreement of their parent or guardian, and those who rejected the spirulina were not included. Supplemental feeding with spirulina was given to young children during two months (from mid-April to mid June 2005). Over these 60 days, the students took a daily dose of 2 grams of spirulina mixed with 10g of honey to make the taste acceptable. The data on age, gender and monitoring of school performance (i.e. the average compositions of the second and third quarters) were collected. Mean differences in grades between second quarter and third quarter (after two months of supplementation) were analyzed and compared by the paired student test. The sample size was a total of 549 schoolchildren: 273 (49.72%) were girls, and 276 (50.28%) boys. The mean age was 91 months [90.29-91.71]. The average of 2rd quarter marks before supplementation was 5.17 out of 10 IC = [4.99-5.35] and the same for the 3rd quarter after two months of supplementation was 5.78 out of 10 IC = [5.59-5.97]. The mean difference between pupils' marks at the 3rd and the 2nd trimester was 0.59 (p <-- 0.0001). After two months of supplemental feeding, the academic performance of the children was improved.

[Prevalence of cannabis use among students in Dakar]. / Prévalence de l'usage du cannabis en milieu étudiant à Dakar.

Cannabis (Cannabis sativa) is the most frequently used drug worldwide. It has multiple dangers, related to its power to involve abuse and dependency phenomena and to their social implications. Our study, which was carried out on a representative sample of 446 students living on the Dakar campus, aimed at measuring the prevalence of Cannabis use and at describing the main factors associated with it. We found a prevalence rate of 19.7%. Cannabis use starts relatively early, around 16-17 years. Young users are generally initiated by a close friend or relative and are motivated by curiosity for their first experience. The fact of having a grant or not and the field of study have no influence on the use of cannabis. On the other hand, religion might play a determining role, Christians seeming to be more affected than Moslems (p = 0.026). A similar prevalence among students has been noted in Kenya, but the rate is definitely lower than those found in developed countries. The identification of cannabis use predictors would make it possible to consider interesting prevention perspectives based on targeted education and on a more adequate legislation. .