[Geographic Information Systems and health: application to Antananarivo city]. / Système d'Information Géographique et Santé: application à la ville d'Antananarivo.

The general health status of the population in the capital, Antananarivo, is determined by a number of different socio-economical and environmental factors. A study was undertaken in 1998 by which the Geographic Information System (GIS) was implemented in order to describe characteristics in town areas (fokontany) suffering from a high disease burden. It was observed that there was a heterogeneous distribution of health care supporting facilities in comparison to population density in the different areas of the capitol. A risk-score system by use of an image-technique was elaborated. The most important problem encountered in the study was the reduced availability of standardized collected data. The results suggest that GIS constitutes a useful tool in assessment of urban health problems in order to identify fokontany in particular need of additional health care support.

Systeme d'Information Geographique et Sante :application a la ville d'Antananarivo

Geographic Information System and Health in Antananarivo : a new approach : The general health status of the population in the capital; Antananarivo; is determined by anumber of different socio-economical and environmental factors. A study was undertaken in 1998 by which the Geographic Information System (GIS) was implemented in order to describe characteristics in town areas (fokontany) suffering from a high disease burden. It was observed that there was a heterogeneous distribution of health care supporting facilities in comparison to population density in the different areas of the capitol. A risk-score system by use of an image-technique was elaborated. The most important problem encountered in the study was the reduced availability of standardized collected data. The results suggest that GIS constitutes a useful tool in assessment of urban health problems in order to identify fokontany in particular need of additional health care support

[Epidemiological aspects of acute pelvic pain of gynecologic origin at the maternity of the Befelatanana Hospital Center, Antananarivo]. / Aspects épidémiologiques des algies pelviennes aiguës d'origine gynécologique à la Maternité du Centre Hospitalier de Befelatanana Antananarivo.

Acute pelvic pains of pregnancy (APPP) generate a lot of social and professional problems to pregnancy. A retrospective study was carried out in 1996 at the Maternity Hospital of Befelatanana, Antananarivo in order to specify epidemiological feature of APPP suffering pregnancy and to search favourising factors and determinative causes of this disease so that a strategy will be drawn up to reduce its frequency and to organize correct cares. 1,612 APPP were registered for the study period, i.e. an annual incidence of 15.5 per cent. Non periodic APPP were the most frequent clinical forms (99.6 per cent). The average age of pregnancy was 26 years old. Risk factors and determinative causes are infections, hormonal diseases, nulliparity and primiparity, low standard of living. APPP had been associated to hemorrhages (37.4 per cent), circulatory shock (14.5 per cent), and hyperthermia (63.5 per cent). 83 deaths were noted. Deaths are provoked by abortion infectious complications, hemorrhages, hepato-nephric lesions due to abortifacient plants. The authors conclude that prevent measures remain as the best therapy. They are based on Information-Education-Communication program drawn towards sexual education, Reproduction Health and improvement of genital infections cares.

[Leprosy situation in the southeastern region of Madagascar from 1996 to 1998]. / Situation de la lèpre dans une région du Sud-Est de Madagascar de 1996 à 1998.

Leprosy is endemic in Madagascar. The authors report the results of an epidemiologic study performed between 1996 and 1998 in Farafanguna, localized in the South-Eastern of the country. During this period, 217 new cases have been diagnosed. Of the 130 cases included in the study, 69.23% were children aged lower than 15 years and 76.91% suffered from a multibacillary form. More than 50% of the cases belonged to a large family (6 persons or more) and at least one family case was found in more than 60% of cases. These results enhance the severity of the disease in the country and show the presence of multiple risk factors (promiscuity, family cases and multibacillary forms).

Liquid chromatographic analysis of monosaccharides with phenylisocyanate derivatization.

Because of the lack of sensitivity in carbohydrate analysis, HPLC pre-column derivatization techniques which give strongly UV absorbing compounds have been reported. These techniques have the disadvantage of leading to several chromatographic peaks from each reducing sugar. To enhance both the sensitivity and the selectivity of such specific separation problems, a simplex procedure was applied to optimize the phenylisocyanate derivatization of monosaccharides: a major and stable derivative was formed under the optimal conditions established. The method was extended to deoxysugars and methylglycosides. The limit of detection was 0.2-1 ng for all sugars tested.

[Family planning and the mothers of the town of Toamasina (1988)]. / Planification familiale et les meres de la ville de Toamasina (1988).

PIP: 172,000 people live in Toamasina, where 22.5% of the total population is comprised of reproductive-aged women. 5 centers in the city provide family planning (FP) services. Results are presented from a study conducted to determine the attitudes of mothers and their husbands toward FP. For this study, FP is defined as couples¿ conscious efforts to control the number and spacing of births. 85.5-95.3% of mothers favored FP, with the level of approval increasing with their level of formal education received. Although 33.7% of the mothers had never heard of FP, 87.2% of these women stated their approval of the concept once it had been defined and explained. It was especially women aged 20-29 years who had never heard of FP. 13.4% of the mothers were actually using a FP method. Among these latter women, 37.7% used a hormonal method, 34.0% used a natural method, 22.6% used a surgical approach, and 5.7% used either an IUD or a barrier method. Side effects, the desire to procreate, method failure, and financial problems were noted as reasons for method discontinuation. 21% of women opposed to effective methods of FP believe that such methods cause disease, while 11.9% of husbands present in the household oppose FP, with the highest degree of opposition found among men aged 25-29 years and 40 years and older.^ieng

Simultaneous determination of gluconolactone, galactonolactone and galactitol in urine by reversed-phase liquid chromatography: application to galactosemia.

A reversed-phase liquid chromatographic assay was developed for the specific evaluation of metabolic by-products in the urine of galactosemic patients and based on the simultaneous determination of gluconolactone, galactonolactone and galactitol. The procedure involved a lyophilization step and the formation of phenylisocyanate derivatives, followed by injection directly into the chromatograph. Analytical results showed good selectivity, linearity, precision and accuracy. The method enabled the detection of levels as low as 0.05-0.1 ng, and compared favourably with other published techniques for the estimation of aldonic acids in biological fluids.

[Demographic data about mothers of the town of Toamasina I (1988)]. / Donnees demographiques sur les meres de la ville de Toamasina I (1988).

PIP: Approximately 28,125 women aged 15-49 years live in Toamasina, comprising approximately 22.5% of the city¿s 172,000 inhabitants. 385 mothers under 50 years old were surveyed in a study of selected demographic data. 68.4% of the mothers were 20-34 years old, while the mothers¿ mean age was 31.5 years. 63.2% of the surveyed women married before reaching 20 years old, while the median marriage age in the city was 17.6 years. Approximately 8.6% of the mothers were single. 57.7% of women in Toamasina bear their first child before reaching 19 years old. 61.8% of single mothers are 15-19 years old, and 55.9% of them have completed high school. 80.5% of the mothers know how to read and write. Fathers of the most recent child in households were of median age 36 years. 38% of households had at least 7 people living under the same roof and 34.4% of mothers have only 2 rooms available, including the kitchen. An average of 6.1 people per household reside in a mean 2.5 rooms. These findings can help shape the delivery of family planning and primary health services to these residents, and also help to define an appropriate housing policy.^ieng