ABSTRACT
The investigation of this outbreak took place in Niakhar (IRD project study area), a rural area located 150 km East of Dakar. Covering 30 villages, with a population of about 30,000 inhabitants, the area has been under demographic and epidemiological surveillance. In 1999, the surveillance allowed 973 cases of shigellosis to be recorded out of 1,751 cases of dysenteric diarrhoeas. The outbreak reached a peak during the raining season (73% of the cases in September and October). All the villages and all age groups were concerned. The attack rate in the population was 3%. During the same period, 22 deaths were attributed to shigellosis, leading to a lethality of 2.3%. Children under five were the most affected. The bacteriological examination isolated S. flexneri in 72% of 12 stools samples and S. dysenteriae A1 (SD1) in 14%. All serotypes were resistant to ampicillin and susceptible to quinolones. Susceptibility to cotrimoxazole was unconstant. Apart from the usual factors involved in the spread of diarrhoeas, the main reason evoked to explain the duration of the epidemic has been the lack of adequate emergency antibiotherapy treatment. Quinolones, recommended by the health authorities, could not be provided by health services. The identification of the SD1 serotype confirmed its involvement in the outbreak of shigellosis. The exact role of S. flexneri in shigellosis epidemics should be further studied.
Subject(s)
Disease Outbreaks , Dysentery, Bacillary/epidemiology , Adolescent , Adult , Age Factors , Ampicillin/pharmacology , Ampicillin/therapeutic use , Anti-Bacterial Agents/pharmacology , Anti-Bacterial Agents/therapeutic use , Child , Child, Preschool , Dysentery, Bacillary/drug therapy , Dysentery, Bacillary/mortality , Emergencies , Female , Humans , Infant , Infant, Newborn , Male , Metronidazole/pharmacology , Metronidazole/therapeutic use , Penicillins/pharmacology , Penicillins/therapeutic use , Retrospective Studies , Rural Population , Seasons , Senegal/epidemiology , Sex Factors , Shigella dysenteriae/drug effects , Shigella dysenteriae/isolation & purification , Shigella flexneri/drug effects , Shigella flexneri/isolation & purification , Tetracycline/pharmacology , Tetracycline/therapeutic use , Time Factors , Trimethoprim, Sulfamethoxazole Drug Combination/pharmacology , Trimethoprim, Sulfamethoxazole Drug Combination/therapeutic useABSTRACT
Tea drinking after meals is a traditional practice in Senegal where more than 80% of the population from 15 to 60 years old drink tea. According to the tradition, in one session, each tea consumer has to drink 3 cups of decocted tea. The content of a cup is about 30 ml of liquid. Some people drink tea three times daily, that is to say after each meal. Tea plant is rich in fluoride. To determine the effective intake of the Senegalese population from this source, we measured the fluoride concentration not only for each component of the prepared tea but also for each cup of prepared tea. For this study, we used the two main kinds of tea existing locally. The analyses have been done at Rochester, NY Eastman Dental Center, Oral Biology Dept Fluoride Laboratory using the Taves Microdiffusion Method and the fluoride Ion Specific Electrode. The results so that the mean total fluoride concentration of each cup, from the first to the third one, is: 4.0 mg F-/L, 7.436 mg F-/L and 1.230 mg F-/L. It means that on an average in one session, a Senegalese tea consumer has a daily fluoride intake of 1.139 mg F-/L when taking in count the total fluoride and drinking only 90 ml of tea. If we consider the ionic fluoride the amount of daily ingested fluoride for someone who takes only 3 tea-pots of 30 ml each, is 0.830 mg. To conclude, we state that this traditional practice may have a caries preventive effect. Further studies will be grateful for that practice when setting up a caries preventive program in our country. We will also be careful in extending that practice to children less than 8 years old because it might cause dental fluorosis as in Senegal the optimal dose of fluoride is 0.8 mg F-/L.
Subject(s)
Cariostatic Agents/administration & dosage , Fluorides/administration & dosage , Tea , Adolescent , Adult , Age Factors , Beverages/analysis , Child , Dental Caries/prevention & control , Diffusion , Feeding Behavior , Fluorosis, Dental/prevention & control , Humans , Ion-Selective Electrodes , Micromanipulation , Middle Aged , Senegal , Tea/chemistry , Tea/classificationABSTRACT
Il est admis que la prevention percue comme prioritaire participe hautement a l'amelioration de la sante bucco-dentaire. La mise en oeuvre d'une politique de prevention se heurte a diverses difficultes. Les auteurs cherchent a les identifier en vue de proposer des solutions. La methologie consiste a recueillir des informations relatives a une enquete exhaustive transversale chez les professionnels de la sante dentaire au Senegal et des donnees de sondages (empirique et aleatoire) respectivement aupres des populations et des professionnels de la sante dentaire. Pour le sondage aleatoire; la difficulte essentielle reside dans le manque de temps bien que l'education pour la sante soit reconnue en general comme n'etant pas une perte de temps par les professionnels de la sante. Le sondage empirique par contre a concerne toutes les couches de la population; 65 pour cent de ces dernieres disent ne pas recevoir de conseils de prevention en consultation et un peu plus du 1/3 affirment se brosser pour le plaisir. Les resultats de l'enquete exhaustive montrent aussi la negligence des praticiens pour la prevention alors que les populations semblent motivees bien que la plupart analphabetes (3/4 de la population senegalaise est analphabete). Il est donc temps de reformuler une veritable politique de prevention avec comme orientations l'augmentation du nombre et du type de professionnels; l'enseignement et/ou l'alphabetisation des populations pour une meilleure connaissance de la sante bucco-dentaire
Subject(s)
Oral Health , Oral HygieneABSTRACT
Dental fluorosis isn't unknown in Senegal. With the implication of drilled-wells in the country for the satisfaction of the needs of the population in drinking water; the pravalence of disease has increased at the same time. To determine the relation between this increasing of the prevalence of dental fluorosis and the multiplication of the sinkings; we did an epidemiological study based on a comparative investigation of the rate of dental fluorosis in children using solely well-water or sinking-water for their alimentation. We did 25 sampling waters through 17 localities. In some localities; we did both sampling of well-water and sinking-water. In some others; we did only one of the two types of sampling; because it was the only one possible. We constitued also samplings of scholar children between 10 and 12 years aged. The analysis of the sampling-waters had been done at the Oral Biology Laboratory of Eastman Dental Center; Rochester; N.Y.; U.S.A. Correlatively; the epidemiological studies and the results of analysis show a relation between the prevalence of dental fluorosis in children using exlusively sinking-water and the level of fluoride contained in the studied waters
Subject(s)
Fluorosis, Dental/epidemiologyABSTRACT
Le personnel dentaire auxiliaire souvent considere comme un personnel de plus; a une place bien precise dans l'equipe de sante publique dentaire. Dans les pays en voie de developpement; il joue un role non negligeable dans la gamme des prestations de services dentaires. Le cas du Senegal sera presente comme exemple
Subject(s)
Allied Health Personnel , Dental Staff , Public HealthABSTRACT
An epidemiological survey on 2.067 children from 7 to 12 years old in average carried in three urban, suburban and rural school environments, has shown that dental caries prevalence is not yet alarming in the district of Dakar, and that the caries index remain more high in the urban environment than in the rural environment. However face to the urbanization and the industrialization of this region, the modification of the alimentary habits appear to be facilitating factors of the raising of the dental caries prevalence in the coming years if nothing is done. It's why preventive measures have to be taken based over all on dental health education and dental health information in organized structures like school.
Subject(s)
Dental Caries/epidemiology , Child , Female , Humans , Male , Prevalence , Rural Population , Senegal/epidemiology , Suburban Population , Urban PopulationABSTRACT
Une enquete epidemiologique portant sur 2067 enfants de 7 a 12 ans en moyenne menee dans 3 milieux scolaires urbain; suburbain et rural a montre que la prevalence de la carie dentaire n'est pas encore alarmante dans la region de Dakar et que l'indice de carie reste plus eleve en milieu urbain qu'en milieu rural. Cependant devant l'urbanisation et l'industrialisation accelerees de cette region; les modifications des habitudes alimentaires apparaissent comme des facteurs favorisant une augmentation de la prevalence de la carie; si rien n'est fait. C'est pourquoi des mesures preventives doivent etre prises basees surtout sur l'education et l'information pour la sante bucco-dentaire dans des structures organisees comme l'ecole
