[Access to health care in Dakar (Senegal): frequency, type of provider, and non-communicable chronic diseases]. / Accès aux soins à Dakar (Sénégal): fréquence, type de soignants et maladies chroniques non transmissibles.

OBJECTIVES: (1) To describe access to health care in the population of Dakar; (2) to analyze the influence of socioeconomic and demographic characteristics on access to health care; (3) and to describe the fraction of consultations accounted for by chronic non-communicable diseases. METHODS: These data come from a 2009 survey of 600 individuals aged 20 years and over. Socioeconomic and demographic characteristics and information about access to health care were collected. Chi-square tests and binary logistic regressions were used for the statistical analyses. RESULTS: Men, people with no schooling, and poor people were underrepresented among users of health care services. Moreover, the majority of Dakar residents who sought health care during the year preceding the survey went to see a doctor (as opposed to a traditional healer, pharmacist, nurse, midwife, or dentist). Finally, chronic diseases accounted for the smallest fraction of reasons for medical consultations; they were mentioned most often by those aged 50 years or older who consult more than 5 times a year. CONCLUSIONS: Dakar residents have an access to health care similar to that of people in other African countries, but this conclusion hides major inequalities. Moreover, at the same time that Senegal is undergoing an epidemiological transition, chronic non-communicable diseases are not a major reason for consultations. The epidemiological projections made for Africa for the next 15 years indicate that the development of strategies to avert the development of these diseases in Senegal must be a priority objective.

[Ageing and chronic diseases in Senegal. A comparison between rural (Ferlo) and urban (Dakar) populations]. / Vieillissement et pathologies chroniques au Sénégal. Comparaison entre des populations vivant en milieu rural (Ferlo) et urbain (Dakar).

The objectives of this study were: to compare the prevalence of hypertension, overweight and obesity in rural (Ferlo) and urban (Dakar) Senegalese populations aged 50 and over. The survey was conducted on individuals aged 50 and older living in the rural area (N=478) and in the urban area (N=220). We have collected data about age, gender, marital status, education level, and knowledge, treatment of hypertension, height, weight and blood pressure. We have observed that overweight and obesity were more prevalent in the urban area (Dakar) than in the rural one (Ferlo). The risk of overweight or obesity decreased when age increased, and women had weight problems more often than men. The prevalence of arterial hypertension was lower in rural area (55.86%) than in Dakar (66.36%), but increased at an older age. However, the logistic regression showed that these increased proportion of hypertension in Dakar is linked to the more important proportion of overweight and obese people in this area. Moreover, rates of knowledge, treatment and control of hypertension are particularly low in the rural area of Senegal. In conclusion, age-associated diseases should be better managed in Senegal, particularly in rural areas.

[Arterial hypertension in Dakar: Prevalence, awareness, treatment, and control]. / L'hypertension artérielle à Dakar : prévalence, connaissance, traitement et contrôle.

The aim of this study was to determine prevalence, awareness, treatment, and control of hypertension, and its risk factors in Dakar. Six hundred people aged 20 and older, living in the city of Dakar were interviewed. This sample was constructed using the combined quota method in order to strive to representativeness of the target population. Prevalence of hypertension was 27.50%. Quarter of those suffering from high blood pressure were aware of their problem, and among the latter, 61% said they were on treatment. However, of these, only 32% had controlled arterial blood pressure, that is less than 6% of those suffering from hypertension. Two factors were associated with hypertension, awareness, and treatment: age and the frequency of doctor visits. These results indicate that hypertension already constitutes a major health concern in the Senegalese capital. Detection can be considerably improved given that only a quarter of the hypertensives are aware of this problem. Compliance with treatments also appears particularly problematic. Public health policies should be quickly set up to minimize the consequences of this emerging burden.

Hypertension prevalence, awareness, treatment and control in Dakar (Senegal).

The prediction of risk profile trends associated with non-communicable diseases in developing countries is among the greatest global health challenges. The aim of this study is to estimate prevalence, awareness, treatment and control of hypertension in Dakar (Senegal). This study was carried out between January and June 2009 on a population sample of 600 individuals living in the department of Dakar. This sample was constructed using the quota method in order to strive for representativeness. Sociodemographic characteristics, hypertension, hypertension awareness, treatment and control, and body mass index of individuals were collected during face-to-face interviews. Statistical analyses used were χ2-tests and binary logistic regressions. Prevalence of hypertension was 27.50%. Prevalence of awareness, treatment and control among hypertensives were 27.88%, 16.97% and 5.45%, respectively. Logistic regression showed that the prevalence, awareness and treatment of hypertension increased with increasing age. Overweight and obese subjects were more often hypertensive but did not differ from others in awareness and treatment. This could be linked to the social valorization of stoutness in West Africa, which explains that excess weight is not perceived as a risk factor for hypertension. In conclusion, given the very low rates of awareness, treatment and control in our sample, developing strategies for averting a hypertension epidemic must be a priority objective.

Prevalence of diabetes and associated risk factors in a Senegalese urban (Dakar) population.

AIM: The aim of this study was to estimate the prevalence of diabetes in the urban population living in Dakar, Senegal, and to investigate the factors associated with diabetes. METHODS: Data from a 2009 survey of 600 individuals, aged 20 years or above and considered representative of the population of the city of Dakar, were evaluated. Socioeconomic characteristics, hypertension, capillary whole blood glucose, and weight and height measurements of these subjects were collected during face-to-face interviews. The statistical analyses used chi-square (chi2) tests and binary logistic regressions. RESULTS: The percentage of participants with fasting blood glucose levels greater than or equal to 1.10 g/L and/or currently being treated for diabetes was 17.9% (n=107, 95% CI: 14.7-20.8). Observed rates of diabetes were significantly higher among women (chi2 = 6.3; P < 0.05), in subjects aged > 40 years (chi2=33.6; P < 0.001), in those with low educational levels (chi2=11.9; P < 0.05) and in those with hypertension (chi2 = 13.9; P < 0.001), and in those who were overweight (BMI ≥ 25 kg/m2 and < 30 kg/m2) or obese (BMI ≥ 30 kg/m2; chi2=40.3; P < 0.001). After adjusting for gender, age, educational level, BMI and blood pressure, the results showed that gender, age and BMI were associated with diabetes: women, older people and those with a higher BMI had significantly greater chances of being diabetic than the rest of the population, whatever their blood pressure and educational level. CONCLUSION: Diabetes is becoming a pressing public-health problem in Senegal, and the major risk factors for the increasing diabetes prevalence in the city of Dakar are gender, age and body mass index.

[Regular versus lapsed donors: sociodemographic differences and motivational factors]. / Donneurs de sang réguliers ou donneurs occasionnels : différences sociodémographiques et motivationnelles.

AIM: Blood donor retention represents a fundamental objective in public health. Comparison between the sociodemographic characteristics and motivational factors between lapsed and regular donors is then required. The objectives of this analysis were: (1) to compare the sociodemographic characteristics of lapsed donors and current donors; (2) to compare the motivations to donate blood expressed by lapsed and current donors. PATIENTS AND METHODS: Data from a 2008 survey, representative of the population by crossed quotas method, of 1400 individuals questioned by phone were used to reach these objectives. Chi(2) tests and binary logistic regressions were used. RESULTS: Results show that socio-occupational categories and motivational factors are different between lapsed and regular donors. Workers, senior management and higher intellectual professions are more often lapsed than regular donors. Concerning motivations, results show that lapsed donors more frequently mention the first experience with blood donation (with colleagues, friends, and parents) than regular donors, for whom altruistic and community motivations are more frequently cited. CONCLUSION: Workers, senior management and higher intellectual professions should be targeted uppermost, in order to convert them in regular donors. Finally, concerning motivations, the social pressure applied to lapsed donors for their first blood donation appears crucial, whereas regular donors have internalized their motives, more often altruistic and community motivations.

Prevalence, awareness, treatment and control of hypertension among adults 50 years and older in Dakar, Senegal.

BACKGROUND: Older adults are disproportionately affected by hypertension, which is an established risk factor for cardiovascular disease. Despite these facts, no study of the prevalence, awareness, treatment and control on arterial hypertension in Senegal has been conducted, specifically among elderly people. METHODS: Five hundred people aged 50 years and older, living in the city of Dakar were interviewed. This sample was constructed using the combined quota method in order to strive for representativeness of the target population. RESULTS: Prevalence of hypertension was 65.4% in our sample. Half of those suffering from high blood pressure were aware of their problem and among the latter, 70% said they were on treatment. However, of these, only 17% had controlled arterial blood pressure. The only factor associated with awareness, treatment and control of hypertension was the frequency of doctor visits. CONCLUSION: Improving follow-up health checks of older adults are necessary to limit the consequences of hypertension in Dakar.

Prevalence of obesity in Dakar.

The present study is to our knowledge the first to evaluate the prevalence of obesity among both men and women in Dakar. It was carried out on a sample of 600 dwellers of the Senegalese capital. The prevalence of general obesity is 8.3%, and that of overweight is 22.3%. The underweight rate remains high, given that 12.3% of the adults in this sample show a body mass index (BMI) of <18.5 kg/m(2) . The prevalence of central obesity is 41.2% according to waist to hip ratio (WHR), and 21.2% according to waist circumference (WC). These figures mask considerable differences between men and women and between generations. For instance, women are often more obese than men, whether it is a question of general obesity (13% and 3.9% respectively) or central obesity (37.5% and 5.5% by WC respectively). Moreover, prevalence of general and central obesity rise drastically with age, irrespective of gender. Thus, in addition to combating infectious disease and undernutrition, Senegal must now face problems associated with overweight and obesity.

How barriers to blood donation differ between lapsed donors and non-donors in France.

Blood donors are underrepresented in the general population. Thus, comparing barriers to blood donation between non-donors and lapsed donors is crucial to improving their participation in blood donation and to targeting theses groups in recruitment programmes. The aims of this study were to identify barriers to blood donation and to compare their occurrence between lapsed and non-donors in France. Data from a 2008 survey of 1400 individuals were used to evaluate differences in barriers between two subpopulations: 619 non-donors and 567 lapsed donors. Individuals answered questions concerning sociodemographic variables and donation-related variables. Results show that, in decreasing order, individuals cited medical reasons (32%), lack of time (15.12%), fear (12.20%), negligence (10.03%), lack of information (7.69%), no particular reason (7.18%), lack of solicitation (6.18%), lack of opportunity (5.18%) and prior deferral (4.43%) as barriers to blood donation. After adjusted analysis, non-donors mentioned fear, lack of information and no particular reason more often than lapsed donors, who cited lack of time more often than non-donors. This study has pinpointed nine main barriers to blood donation among the French population, the most significant being medical reasons (for both lapsed and non-donors), lack of time, cited more frequently by lapsed donors, and fear of donating blood, most often cited by non-donors. Future studies are needed to gain greater insight into what these barriers represent for individuals to improve awareness and for recruitment of French blood donors.

[Impact of socioeconomic status on blood donation]. / Influence de l'appartenance à une catégorie socioprofessionnelle sur la pratique du don de sang.

AIM OF THE STUDY: Describe and compare the socioeconomic status of regular donors, occasional donors and nondonors, considering the sociodemographic characteristics and self-rated health of individuals. MATERIAL AND METHODS: The survey of this study consists of 1400 individuals, aged from 18 to 65. Sociodemographic characteristics, blood donation, self-rated health and socio-economic status of individuals have been recorded by phone interviews (mean: 15minutes). Statistical analyses used in this study are Chi(2) and multinomial logistic regressions. RESULTS: Socioeconomic status is associated to donor status. However, it only differentiates nondonors and other population categories: intermediary professions, students and retired are more often regular donors than nondonors. And senior management and higher intellectual professions, as intermediary professions and students are more often occasional donors than nondonors. CONCLUSIONS: Even when sociodemographic variables and self-rated health are considered, socioeconomical status stays associated to blood donor status. Thus, this article highlights the importance of socioeconomic status in the blood donors' population structure. This study also shows that occasional donors, that should be resensitized, belong to the same socioeconomical categories than regular donors. Finally, this article provides research and sensitizing clues for some of the socioeconomic status analysed.

[Infant and child mortality and morbidity in the People's Republic of the Congo]. / Mortalite et morbidite infantile et juvenile en Republique Populaire du Congo

PIP: Results of five demographic and medical surveys carried out in the Congo in the 1970s and early 1980s to investigate infant and child mortality and morbidity are presented. The results suggest that infant and child mortality is low in comparison with that in many other African countries. The importance of mortality from infectious and respiratory diseases is noted. (summary in ENG, SPA)^ieng