Structure-activity relationships in platelet-activating factor (PAF). 11-From PAF-antagonism to phospholipase A(2) inhibition: syntheses and structure-activity relationships in 1-arylsulfamido-2-alkylpiperazines.

1-Benzoyl-2-alkyl piperazines are strong inhibitors of Group I and II secreted PLA(2)s. An improvement of their activity was obtained by replacing the amide function by a sulfamide and by introduction of electrodonor substituents on the para position of the benzenesulfonyl moiety. Neither the position on one of the carbon of the piperazine ring nor the absolute configuration of this carbon have an effect on the affinity for one or the other group of PLA(2), but the lipophilicity remains for these series an essential parameter. In addition structure-activity relationships allow new hypothesis on interaction of these piperazine derivatives with the catalytic site of PLA(2)s.

Evaluation of invermectin distribution in Benin, Côte d'Ivoire, Ghana and Togo: estimation of coverage of treatment and operational aspects of the distribution system.

Invermectin distribution by the Onchocerciasis Control Programme (OCP) was assessed in Benin, Côte d'Ivoire, Ghana and Togo, in terms of the proportion of villages which had been treated and the proportion of villagers in each village treated in the last round who had actually received treatment. These proportions were evaluated both for treatment in the last round of ivermectin distribution and for treatment since the beginning of the drug's distribution in each country. During the last treatment round, 97 (74.6%) of the 130 selected villages investigated in the four countries had received ivermectin treatment, and 67.2% of the members of these 97 treated communities had taken ivermectin. In general, higher percentages of the members of treated villages in Côte d'Ivoire and Ghana had been treated [with mean (S.D.) percentage values of 72.0 (5.2) and 71.6 (4.6), respectively] than in those of Togo [61.8 (5.6)] or Benin [64.2 (4.6)]. Overall, 893 (26.1%) of those interviewed had never received treatment since the beginning of ivermectin distribution but 29.4% had received all the annual treatments. The main reason for non-treatment during the last treatment round was absence from village (54.5% of those not treated), followed by non-eligibility (i.e. pregnant women and young children; 12.2%), refusal to take treatment (2.6%), and shortage of drugs (1.9%). Community approval for the programme was demonstrated when all treated individuals, including those who were absent at the last treatment round, said they would take the ivermectin during the next treatment. During the last treatment round, members of the community assisted in the distribution of the ivermectin tablets in 69 (71.1%) of the 97 treated villages which were investigated. Although only 26 (26.8%) of these 97 villages preferred community-based distribution of ivermectin to the 'mobile' method, it is believed that, with good education and efficient organization, the communities could be encouraged to undertake community distribution.

[Status of women and rural-urban migration in Benin: from decision to integration]. / Statut de la femme et migration urbaine dans le Golfe du Benin: de la decision a l'insertion.

Factors affecting the decision to migrate among women in countries around the Gulf of Benin are examined. Using data for Togo, the author notes that "rural-urban migration can be a component of women's status. Women are now better educated, even in rural Africa, and better integrated into the modern way of life, and it is likely that they will be more and more engaged in rural to urban migration in the...future. But...they need to be better skilled and/or have financial capital. Therefore, instead of implementing policies to avoid migration, policy makers must develop comprehensive strategies taking this migration dimension into account, in order to improve women's status." (SUMMARY IN ENG AND SPA)

[Routes of care and health of children in Togo]. / Itinéraires de soins et santé des enfants au Togo.

A character of child health in the tropics is that benign diseases elsewhere become serious and even mortal. Thus, in spite of considerable pediatric care in Togo, diarrhoea, malaria, anaemia, malnutrition, and acute respiratory illness remain prevalent and comprise a formidable "gang of 5" for pediatric pathology. The behaviour patterns of families and the population in general confronted by illnesses may in part be responsible for this situation. A survey was conducted over 3 months and based on a questionnaire given to parents bringing their children for consultation at the hospital (CHU) of Lomé. The following proved important aspects concerning the care of sick children: 1) many communities call upon health centers, only when other avenues of health care have failed. The number of emergency cases presenting themselves is therefore increased markedly, as is the number of deaths; 2) malaria and diarrhoea are the main offenders, while less than half the children affected use chloroquine or RVO; 3) self-medication and traditional medicine dominate alternative health care strategies. As a result, access to official health resources is retarded. In conclusion, the efficiency of prophylactic and curative health care would be improved if simple preventive measures were employed at all levels and based upon cultural values adapted to individual populations.