Analyse de la prise en charge communautaire des orphelins et enfants rendus vulnerables (OEV) par le VIH/SIDA : experience de l'organisation communautaire de base (OCB) Jammixale yi Thies (Senegal)

Introduction: le VIH/SIDA ne cesse de provoquer de multiples difficultes avec l'accroissement du nombre d'orphelins et enfants vulnerables (OEV). Au Senegal; 3193 OEV etaient recenses en 2008. L'objectif etait d' analyser la prise en charge communautaire des OEV par l'organisation communautaire de base (OCB) JammiXale Yi (JXY) de Thies afin de mieux apprecier les effets psychologiques du VIH sur les enfants; les parents. Population et methode: Il s'agissait d'une etude transversale faite en 2009 aupres des agents de sante; des OEV et de leurs parents. Des entretiens individuels et des focus groups ont permis de recueillir des donnees. Selon la source et la cible; une triangulation des informations avait ete faite Resultats : 61 OEV etaient suivis. L'age moyen etait de 9;82 ans; variant entre 2 mois et 17 ans. Le sex- ratio etait de 1;08 (filles = 48).Dans cet OCB; 99 des enfants etaient a l'ecole publique; 20 avaient une bourse scolaire ; 92 n'etaient pas depistes. Parmi ceux depistes; 8 etaient seropositifs.Selon la cible; les principaux effets psychosociaux du VIH/SIDA etaient pour les enfants: l'utilisation de l'alcool; de la drogue; la prostitution. Pour les parents venaient au premier rang : la discrimination; le non depistage des enfants; les difficultes d'acces aux soins de qualite; l'attitude d'indiscretion du personnel de la sante. Les agents de sante avaient surtout souligne le manque de formation sur la prise en charge psychologique des OEV. Conclusion : on note l'importance des effets psychosociaux du VIH/SIDA sur les enfants; leurs parents et la difficulte de la prise en charge communautaire de cette maladie dans les pays a ressources limitees

Low-level environmental exposure to lead and renal adverse effects: a cross-sectional study in the population of children bordering the Mbeubeuss landfill near Dakar, Senegal.

This study deals with the health effects within a child population, neighbouring a landfill. After detecting metals in soil and air samples collected in the surroundings of the landfill and in a control site, we have studied: (i) levels of lead (Pb) and exposure biomarkers in blood and urine, (ii) oxidative stress biomarkers and (iii) renal injury by applying a set of early effect biomarkers. Levels of Pb were higher in the exposed site (i.e. 1129 mg/kg and 640 ng/m(3) in soil and air samples, respectively) versus those in the control site (i.e. 14.3 mg/kg and 9.3 ng/m(3) in soil and air samples, respectively). Pb impregnation and levels of delta-aminolevulinic acid in urine were influenced by the living site that shows the prevailingly alarming situation in the Mbeubeuss landfill. Malondialdehyde changes indicated Pb-induced excessive production of reactive oxygen species. Lactate dehydrogenase activities and proteinuria were found to be higher in the children living in the exposed site. These evidences may reveal the usefulness of these two effect biomarkers to monitor the kidney injury entailed by relatively low-environmental exposure to Pb. Overall, these results show that the Mbeubeuss landfill constitutes a real source of environmental and health risk, be it living or working on site, of the surrounding population, predominantly for children.

[Nutritional state of women and children in the rural community of Mpal (District of Saint Louis, Senegal)]. / Etat nutritionnel des femmes et des enfants dans la communauté rurale de Mpal (District de Saint-Louis, Sénégal).

This cross sectional survey carried in april 1995 aimed to assess the nutritional status of the women old enough to procreate++ and the children less than 5 years old in the community of Mpal (District of St Louis). The method of sampling used was the method of stratified poll. The assessment of the nutritional status is carried among the women by measuring the brachial circumference and the corporal mass index. Among the children, the indicators used were the ratios: weight-age, weight-height and the brachial circumference. The results showed a rate of malnutrition very high in comparison to the national averages as well in ythe women old enough to procreate (31% versus 17.4%) as in the children (11% of acute malnutrition versus 8.7% and 24.4% of chronic malnutrition versus 21.7%). The young mothers and the children more than 3 years old were the more frequently reached. It urges to set up in this locality a programme of struggling against malnutrition based on the integration of the economics activities of the communitary groups to their health activities.

[Community nutrition strategy project: an innovation in community health]. / La stratégie du projet de nutrition communautaire: une innovation en santé communautaire.

The strategy of the community nutrition project is based on the utilization of the community development structures to deliver the nutrition services. These structures, represented in Senegal by youth associations, women groups, GIEs and NGOs, are part of the decentralization process, and as such play an important role in health and health development activities in poor urban districts. The Community Nutrition Project (CNP), funded for five years by the World Bank, German Cooperation (KFW), World Food Program (WFP) and the Senegalese government aims to halt further deterioration in the nutrition status of the most vulnerable groups in the poorest urban districts of Senegal. All nutrition services and particularly the IEC services have been entirely contracted out the first year to 76 GIEs involving 323 unemployed persons, operating as micro-enterprises "MIC" and 17 "GIEs" of unemployed physicians, pharmacists, and social workers for a total of 34 persons, organized as "maître d'Oeuvre communautaires "MOC", in charge of the supervision tasks. Each community nutrition center recruits and monitors every six months 460 to 600 beneficiaries composed of women at six months of pregnancy, lactating mother of children under 6 months, and a group of children aged from 6 to 35 months old. An average of 87% of registered children in the nutrition centers are weekly or monthly weighted. Thus the proportion of malnourished children in cohort of children followed from January to July 1996 has decreased from 70% to 25% within six months. The malnutrition rate has been reduced up to 65% after six months.

Une solution de pain de singe pour la prevention et le traitement de la deshydratation aigue due aux diarrhees infantiles

L'objectif de cette etude etait d'evaluer de maniere comparative; les resultats de la therapie de rehydratation par voie orale (TRO) avec la solution standard obtenue avec les sachets de l'OMS et une solution a base de pulpe de fruit de baobab (Adansonia digitata); pain de singe; chez les enfants presentant une diarrhee aigue. Un essai clinique de TRO a ete mene chez des enfants diarrheiques; ages de 6 mois a 57 mois et presentant une diarrhee ou une deshydratation moyenne ; 79 enfants ont recu la solution OMS et 82 la solution de pain de singe ; l'evolution de la diarrhee et le gain de poids ont ete evalues. La solution OMS a eu des resultats legerement superieurs a ceux de la solution a base de pain de singe; quant a l'amelioration de la diarrhee et au gain de poids aux 4eme et 48eme heures; mais cette difference etait statistiquement non significative. La solution a base de pain de singe presente en outre des avantages sur le plan nutritif; economique et socio-culturel ; les auteurs la recommandent; en vue d'une utilisation plus etendue de la TRO a domicile