[Medical certificates for intentional wounds and blows in medico-legal practice in Dakar]. / Certificats médicaux pour coups et blessures volontaires en pratique médico-judiciaire à Dakar.

Drawing up the medical certificate is a crucial step in the judicial process. This judicial document should be drafted during a medical legal consultation. This study aims to evaluate the quality of medical certificates in a medico-judicial consultation and to study interpretative criteria of medical certificate validity. We conducted a retrospective study of patient's victims of intentional wounds and blows receiving a medico-judicial consultation at the Grand Yoff General Hospital, from April 2012 to February 2015. The whole of medical certificates were recorded on a survey form analyzed by Epi Info Version 6.04. The whole of the 249 certificates studied was printed in legible and understandable "Arial police 12". All the studied medical certificates included complete identification of the physician and the victim. The date and the time of aggression were written in 248 certificates (99.6%). The type of abuse suffered was specified on the whole of the 249 certificates: 164 brawls (65.9%), 64 unilateral aggressions (25.7%). The precise description and nature of the lesions was written in 246 certificates. The site of the lesions was established based on fixed anatomical landmarks in the various body plans. Medico-judicial consultation, coordinated by the forensic physician, helped to significantly improve the quality of the documents issued. The dissemination of these drafting practices and of the practices concerning the issuing of certificates is essential in particular in the regional hospital as part of an ongoing training or postgraduate training.

[Causes of death in Dakar and health policy]. / Causes de décès à Dakar et politique de santé.

The study of mortality enables to identify the major public health problems in the countries under consideration. It can give an indication on the preventive and "medico-curative" measures as well as on the investments in research that could increase life expectancy of the population. This study aims to evaluate the causes of death in the general population based on the informations contained in the register of deaths in Dakar. Our specific aim was to determine the causes of death, to identify the socio-demographic factors influencing death and to identify the kinds of death and types of death. We conducted a retrospective study on the cases of death in the general population who underwent an autopsy in Dakar, from 2003 to 2012. Data were taken from the autopsy registers from the Aristide Le Dantec Hospital (HALD) and the General Hospital of Grand Yoff (HOGGY), which are the only hospitals in Dakar where autopsies are made. The informations contained in the different data sources were recorded on a survey form and analyzed using Epi-Info 6.04. During the study period, 985 patients died among whom 693 of violent death (70.3%), 261 of natural death (26.5%), and 14 of unspecified cause (1.4%). There was a predominance of traffic accidents (394; 40%). With respect to the kind of death, more than half of the cases were due to traffic accidents (violent deaths). Traffic-related deaths most often occurred during the pre-hospitalization period or on arrival to the hospital. The Ministry of Health should continue to promote measures for preventing and managing communicable diseases. The two priorities should be as follows: cardiovascular diseases and traumas.

Autopsy following death by homicide in 644 cases.

The objectives of this study are to determine the cause of death and based on the wounds, to analyze the different epidemiological variables on homicide in Dakar. Included were all homicides cases where an autopsy was performed and these results recorded in the autopsy register. The data collected in our work included, identity, sex, age, place of crime (location), the cause of death (the causative agent and the anatomical region injured) and the mechanism of death (the pathophysiological phenomenon causing death). On average 56 cases of homicide a year are reported, ranging from 44 cases in 2005 to 80 cases in 1999. Extrapolated to the population of Dakar this corresponds to 1.9 homicides per 100,000 inhabitants. Victims aged over 55 years represented only 4.03% of all victims. 6.52% of cases were infanticide. The crimes mainly took place in the suburbs of Dakar (51.42% of cases). Hand held weapons were used in 578 cases (89.7%) followed by firearms in 44 cases (6.8%). The study of the age of the victims has some interesting points. The homicide of elderly people in Senegal was relatively low in contrast to what is found in a developed country. The youthfulness of our population also explains the large number of homicide victims between 21 and 25. Infanticide is a particular problem in Senegal. In our study, 50.6% of homicides were found in the suburbs of Dakar followed by the peripheral area which accounted for 29.3% of homicides. The incidence of homicide can be directly correlated with the level of economic development. This frequency is much higher where incomes are low and particularly affect young males. The study of this phenomenon should lead to better prevention. The victim-type in Dakar is a young man, aged 20-25 years, killed by an instrument with an injury to the skull, neck, heart or main arteries, causing bleeding and death.

Detention provisoire des jeunes femmes accusees d'avortement clandestin ou d'infanticide au Senegal

Introduction: L'activite sexuelle chez les jeunes les expose a un accroissement du risque de contracter des grossesses non desirees. Le recours a l'avortement clandestin avec son corollaire de complications peut entrainer le deces de la jeune femme. Avortement et infanticide sont interdits et sanctionnes par la loi senegalaise. Comment ces jeunes femmes vivent-elles leur detention ? Existe-il des alternatives a la detention pour eviter leur desocialisation ? Methodes: Cette etude retrospective portait sur la maison d'arret des femmes de Dakar situee a Liberte 6; un quartier deDakar. Nous avons procede a des entretiens avec des femmes detenues a la maison d'arret des femmes de Dakar et suspectees d'infanticide ou d'avortement clandestin. Resultats: Les femmes de notre echantillon ont une moyenne d'age inferieure a 25 ans avec parmi elles une fille mineure de 16 ans. Nous avons trouve 18;51 de femmes suspectees d'infanticide ou d'avortement. Dans notre etude 50 des femmes sont originaires de la peripherie et de la banlieue de Dakar et presque 44 proviennent des autres regions du pays. La duree moyenne de detention provisoire est de neuf mois. Conclusion: Malgre leur qualification distincte dans le code penal : l'infanticide est un crime et l'avortement un delit; les femmes suspectees d'avoir commis ces actes sont soumises a de longues detentions preventives