[Conceptual framework for integrating reproductive health in school: experience in Senegal]. / Cadre conceptuel pour l'intégration de la santéde la reproduction en milieu scolaire: expérience au Sénégal.

OBJECTIVE: Adolescent reproductive health is a public health concern. The objective of this article is to report the conceptual framework for integrating reproductive health services in school from a pilot project carried out in Senegal. MATERIALS AND METHODS: A 10-year strategic plan from 2000 to 2010 for education and training has been established by the Ministry of Education and the component related to health and nutrition has been in charge by the medical health control division (DCMS). By putting into action the strategy of this component, a pilot project for integrating reproductive health in school had been set up and carried out from 2002 to 2006. This project was held within a secondary grade school and in a health structure especially designated for students. RESULTS: School health policy established by the Ministry of Education and the choice of the DCMS as the institutional leadership has helped to define a framework for synergic interventions directed to school-aged children. Thus, the coordination team with health experts has carried out the project held through a participatory process and advocacy since its conception phase putting together the authority of the Ministry, the school-aged children, the teachers and the parents. Capacities strengthening of different stakeholders through training, sensibilisation and information have been made with partnership development and a signed protocol between the Ministry of Education and the Ministry of Health. CONCLUSION: The magnitude of adolescent reproductive health problems justifies the integration of reproductive health services in school.

[Conceptual framework for integrating reproductive health in school: experience in Senegal]. / Cadre conceptuel pour l'intégration de la santé de la reproduction en milieu scolaire : expérience au Sénégal.

OBJECTIVE: Adolescent reproductive health is a public health concern. The objective of this article is to report the conceptual framework for integrating reproductive health services in school from a pilot project carried out in Senegal. MATERIALS AND METHODS: A 10-year strategic plan from 2000 to 2010 for education and training has been established by the Ministry of Education and the component related to health and nutrition has been in charge by the medical health control division (DCMS). By putting into action the strategy of this component, a pilot project for integrating reproductive health in school had been set up and carried out from 2002 to 2006. This project was held within a secondary grade school and in a health structure especially designated for students. RESULTS: School health policy established by the Ministry of Education and the choice of the DCMS as the institutional leadership has helped to define a framework for synergic interventions directed to school-aged children. Thus, the coordination team with health experts has carried out the project held through a participatory process and advocacy since its conception phase putting together the authority of the Ministry, the school-aged children, the teachers and the parents. Capacities strengthening of different stakeholders through training, sensibilisation and information have been made with partnership development and a signed protocol between the Ministry of Education and the Ministry of Health. CONCLUSION: The magnitude of adolescent reproductive health problems justifies the integration of reproductive health services in school.

[Norplant contraceptive implant]. / Les implants contraceptifs Norplant: évaluation des effects secondaires, du poids et de la tension artérielle dans les cliniques de planification familiale à Dakar (Sénégal).

OBJECTIVE: Norplant is a long lasting contraceptive method which protect again pregnancy for five years. We studied the side effects and the variations related to weight and blood pressure. MATERIAL AND METHODS: The study was carried out in three family planning clinics in Dakar with 450 women who have had their implants for at least six months. Data collection was based on patient interviews and review of medical files. RESULTS: The side effects reported were mainly menstrual problems with 54.7% of the women reporting menstrual spotting. The other non-menstruel side effects were headaches (64.2%) and dizziness (59.1%). The side effects at the insertion site were pruritus (16%) and pain (3.1%). Regarding weight and blood pressure, an increase in weight was observed up to three years of Norplant use and a decrease to the initial weight was seen during the fifth year of use. No variation was noted regarding blood pressure. CONCLUSION: Norplant is a contraceptive method widely used in Senegal. Most of the side effects involve menstrual problems. A slight increase of weight was observed in general with no variation in blood pressure.

[Congenital rubella: a case report]. / Rubéole congénitale : à propos d'un cas.

Rubella is an innocuous illness in adult unless it is contracted by a pregnant woman. We recently observed a case of congenital rubella in the department of neonatology of Abass Ndao hospital in Dakar. It's a female new-born, born after 40 week gestation, with a well followed pregnancy. The first clinical examination shows a severe intrauterine growth retardation and bilateral comeal opacity. Maternal and new-born serologic confirmation is obtained with positive rubella specific IgM and IgG. We also find severe ocular pathology, hearing deficit and associated cardiac disease. This case shows the needs for preventive strategies, such as vaccination against rubella for women of child bearing age.

[Giant ovarian cyst and pregnancy (a case report)]. / Kyste géant de l'ovaire et grossesse (à propos d'un cas).

We report a case of giant ovarian cyst in pregnancy of 23 weeks of amenorrhea revealed by digestive and respiratory compression. As the absence of ultrasonographic and biologic malignancy criterias, several punctures of the cyst were done permitting the evolution of pregnancy until the preterm period. An annexectomy done in the immediate post-partum permitted to avoid the frequent mechanical accidents during this period. From this case, we discuss clinical and therapeutic problems of this association.

[Epidemiologic and obstetric aspects of adolescent pregnancies in the hospital milieu]. / Aspects épidémiologiques et obstétricaux de la gravidopuerpéralité des adolescentes en milieu hospitalier.

Adolescence is a period of change where the person is seeking an identity. This period is characterized by an early sexuality with early pregnancies and risky deliveries. The objectives of our study are to show the epidemiologic aspects of adolescent pregnancy and to identify its obstetrical factors. It is a prospective study held in one year, from August 1st 1991 to July 31 1992 including all pregnant adolescents and those coming for delivery at the Obstetrics and Gynecology clinic at the University teaching hospital Le Dantec. The prevalence of adolescent pregnancy is 3.7% and 84% are primiparous. The non-educated represent 65% and 55% are married. Early sexuality and early pregnancy are mostly seen among Pulars. The complications during pregnancy are toxemia and its accidents (17.6%), premature rupture of membrane (4.4%) and anemia (2.5%). Adolescent who had not received prenatal care represent 11% and 38% had not received enough care. Normal delivery happened in 67.5% and the C-section represented 7.5%. 3% of the adolescents had done unsafe abortion. No maternal death was observed. 89.1% live births were reported, however, 18.4% needed intensive care. Because of the obstetric and neonatal problems, early pregnancy should be prevented through a active collaboration of divers partners.