Connaissance et attitude pratique des mères vis-à-vis de la vaccination de routine, étude comparative / Knowledge and practice attitude of mothers regarding routine immunization, comparative study

Introduction : La vaccination de routine est une stratégie clé dans la prévention des maladies évitables par la vaccination. L'objectif de l'étude est d'apprécier les connaissances, attitudes des mères vis-à-vis de la pratique de la vaccination en milieu rural et urbain. Méthodes : Il s'agit d'une étude transversale descriptive comparative qui a eu lieu dans deux aires de santé (urbaine et rurale) sur une période de trois (3) mois d'octobre à décembre 2022. Elle a concerné les mères ou gardiennes d'enfants venus pour la vaccination de routine. Résultats : La moyenne d'âge des femmes était de 28, 76±6,85 ans en milieu urbain et 26,51±7,37 ans en milieu rural. Environ72, 00% et 43,00% des femmes respectivement en milieu urbain et rural avaient donné une bonne définition de la vaccination. 88,00% des femmes en milieu urbain connaissaient au moins une maladie cible du PEV contre 55,00% en milieu rural. Le calendrier vaccinal n'était connu que par 31,00% des femmes en milieu urbain contre 12,00% en milieu rural. La majorité des femmes en milieu urbain (97,00%) et rural (67,00%) trouvaient nécessaire de rattraper un rendez-vous de vaccination manqué les séances prochaines. Elles jugeaient majoritairement d'envoyer les enfants au centre de santé en cas de manifestations post- vaccinale (urbain : 80,00%, rural : 53,00%). Conclusion : Une bonne connaissance et pratique de la vaccination permettrait ainsi de protéger les enfants contre les maladies évitables par la vaccination

Background: Routine immunization is a key strategy in the prevention of vaccine-preventable diseases. The objective of the study was to assess the knowledge and attitudes of mothers regarding the practice of vaccination in rural and urban areas. Methods: This is a comparative descriptive cross-sectional study that took place in two health areas (urban and rural) over a period of three (3) months from October to December 2022. It involved mothers or guardians of children who came for routine vaccination. Results: The mean age of the women was 28.76±6.85 years in urban areas and 26.51±7.37 years in rural areas. About 72.00% and 43.00% of the women in urban and rural areas, respectively, had given a good definition of vaccination. 88.00% of women in urban areas knew at least one EPI target disease, compared to 55.00% in rural areas. Only 31.00% of women in urban areas knew the vaccination schedule, compared to 12.00% in urban areas. Majority of women in urban (97.00%) and rural (67.00%) areas found it necessary to make up for missed immunization appointments in next sessions. Majority of them considered it necessary to send their children to the health center in the event of postimmunization symptoms (urban: 80.00%, rural: 53.00%). Conclusion: A good knowledge and practice of vaccination would allow to protect children against vaccine preventable diseases

[Determinants of acute malnutrition among children aged 6-59 months in Menaka health district]. / Facteurs determinants de la malnutrition aigue chez les enfants de 6-59 mois dans le district sanitaire de Menaka.

BACKGROUND: Acute malnutrition continues to be a real public health problem due to morbidity and mortality. The aim of this study was to determine the risk factors related to acute malnutrition among children aged 6-59 months in the health district of Menaka. METHODS: This is a case-control study that was conducted in the health district of Menaka over a period of six (6) months from January to June 2019. Data collection was done for patients in recovery and nutrition education units and for controls, in health centers and in the general population. Subjects were matched on age and sex. Data analysis was done using SPSS software version 20.0. RESULTS: Children with no immunization or incorrect immunization (OR = 18.17 [3.49-94.56]), children not fed exclusively with breast milk before 6 months (OR = 16.44 [3 , 93-68.8]) and lack of compliance with the principle of spacing births (OR = 9.93 [1.65-59.8]) were strongly implicated in the occurrence of acute malnutrition. CONCLUSION: Efforts should be made by the authorities to improve population's living conditions, which would improve the nutritional status of children under five and also reduce acute malnutrition prevalence.

INTRODUCTION: La malnutrition aigue continue d'être un véritable problème de santé publique de par la morbidité et la mortalité. L'objectif de cette étude était de déterminer les facteurs de risques liés à la malnutrition aigue chez les enfants de 6-59 mois dans le district sanitaire de Ménaka. MATÉRIEL ET MÉTHODES: Il s'agissait d'une étude cas-témoins qui a été réalisée dans le district sanitaire de Ménaka sur une période de six(6) mois allant de Janvier à Juin 2019. Le recueil des données a été fait pour les malades dans les unités de récupération et d'éducation nutritionnelle et pour les témoins dans les centres de santé et dans la population générale. Les sujets ont été appariés sur l'âge et le sexe. L'analyse des données a été faite à l'aide du logiciel SPSS version 20.0. RÉSULTATS: La non vaccination ou la vaccination incorrecte des enfants (OR=18,17[3,49-94,56]), le non allaitement des enfants exclusivement au lait maternel avant l'âge de 6 mois (OR=16,44 [3,93-68,8]) et le non respect du principe de l'espacement des naissances (OR=9,93 [1,65-59,8]) étaient fortement impliqués dans la survenue de la malnutrition aigue. CONCLUSION: Des efforts devraient être entrepris par les autorités pour améliorer le cadre de vie des populations, ce qui permettrait d'améliorer l'état nutritionnel des enfants de moins de cinq ans et aussi réduire la prévalence de la malnutrition aigue.

Evolution of quality of life in patients with breast cancer during the first year of follow-up in Morocco.

BACKGROUND: Quality of life has an important place in the future of patients with breast cancer. The objective of this study is to assess the evolution of the patient's quality of life with breast cancer in Morocco after a year of follow-up. METHODS: This study involved the patients with breast cancer with all types of treatment as determined by their physicians. Patient's quality of life was assessed with the Moroccan Arabic version of QLQ- EORTC QLQ C30 and EORTC-BR23 questionnaires. Data were analyzed using SPSS Version 20 software. RESULTS: Regarding EOTRC questionnaires QLQ C-30, there was a significant improvement in global health status and all scales of the functional dimension except the social functional where there was a trend towards improvement and the financial impact of the disease where the situation has deteriorated. Quality of life was improved for most symptom-sized scales dimension of EORTC QLQ- C30 with the exception of diarrhea where it was observed degradation. Most of the EORTC QLQ-scales BR23 questionnaires showed a favorable trend in the quality of life except those of sexual functioning, sexual enjoyment, hair loss and the side effects of systemic therapy. CONCLUSION: The quality of life of the patient is significantly improved after 1 year of follow up. Quality of life instruments can be useful in the early identification of patients whose score low on functional scales and symptoms.

[Place of Malaria in Febrile Illnesses Etiologies In The Community Health Center of Macina central, Mali]. / Place Du Paludisme Dans Les Etiologies Des Affections Febriles Dans Le Centre De Sante Communautaire de Macina Central, Mali.

BACKGROUND: Malaria is a major public health problem because of its morbidity and mortality. The objective is to study the place of malaria in the etiology of febrile access in Community Health Centre of Macina central. METHODS: This is a descriptive prospective study was conducted which covered a period of 12 months from 1 September 2015 to 31 August 2016 at the community health center of Macina central. It concerned all patients admitted to the community health center for febrile with an axillary temperature greater than or equal to 38° C and having agreed to participate in the study. Data collected were analyzed using epi info 7 software version 3.3.2. RESULTS: Febrile accesses represented 13.37% of all consultations during our study period. The majority of patients were men (55.0%). Malaria was the leading cause (64.2%) of febrile accesses followed by respiratory infections (16.2%). In the majority of patients, fever has not exceeded 7 days (89.9%) and the axial temperature was between 38° and 38.9° in 67.6% of cases. Children under five years were most affected by these febrile illnesses (61.3%) and of these, 37.9% had malaria. The most associated symptoms with fever were cough (58.5%), vomiting (48.7%) and headache (47.1%). Co-morbidities were found between malaria and respiratory infections (20.60%) and diarrhea (26.20%). CONCLUSION: Malaria remains a major cause of fever in our study area. However, it is necessary to follow the clinical procedure well in case of fever.

INTRODUCTION: Le paludisme est un véritable problème de santé publique tant de part sa morbidité que par sa mortalité. L'objectif est d'étudier la place du paludisme dans les étiologies des accès fébriles au centre de santé communautaire (CSCOM) de Macina central. MATÉRIEL ET MÉTHODES: Il s'agit d'une étude prospective à visée descriptive qui a été menée sur une période de 12 mois allant du 1er Septembre 2015 au 31 Aout 2016 au centre de santé communautaire de Macina central dans le district sanitaire de Macina. Elle a concerné tous les patients admis au CSCOM pour accès fébrile avec une température axillaire supérieure ou égale à 38° C et ayant accepté de participer à l'étude. Les données recueillies ont été analysées à l'aide du logiciel épi info 7 version 3.3.2. RÉSULTATS: Les accès fébriles ont représenté 13,37% de toutes les consultations durant la période d'étude. La majorité des patients étaient des hommes (55,0%). Le paludisme était la première cause (64,2%) de ces accès fébriles suivi des affections respiratoires (16,2%). La fièvre n'a pas excédée 7 jours chez 89,9% des patients et la température axiale était comprise entre 38° et 38,9° dans 67,6% des cas. Les enfants de moins de cinq ans ont été les plus touchés par ces affections fébriles (61, 3%) et parmi ceux-ci, 37,9% étaient atteints de paludisme. Les symptômes les plus associés à la fièvre ont été la toux (58,5%), les vomissements (48,7%) et les céphalées (47,1%). Des co-morbidités ont été retrouvées entre le paludisme et les infections respiratoires (20,6%) et la diarrhée (26,2%). CONCLUSION: Le paludisme demeure une importante cause de fièvre dans notre zone d'étude. Cependant, il est nécessaire de bien suivre la démarche clinique devant tout cas de fièvre.

[Descriptive study of traffic injuries in the health district of Diema]. / Accidents de la circulation routiere dans le district sanitaire de Diema.

BACKGROUND: Road traffic accidents are major causes of mortality and morbidity. Therefore, we proposed to do a descriptive study of these accidents in the Diéma Referral Health Center during our study period. MATERIAL AND METHODS: This is a descriptive cross-sectional study, which took place in the health district of Diema (Kayes region) from February to July, 2010. It concerned patients victim of road traffic accidents and admitted to the Diema referral health center. Patient information was collected from medical records using a customized questionnaire. Data analysis was done using the SPSS 12.0 software. Quantitative variables were expressed as mean and standard deviation and categorical variables by proportions. RESULTS: A total of 143 patients were admitted. The prevalence of accidents was 8.66%. The mean age of patients was 31.5 ± 12.2 years. The male sex was the most affected 72%. Automobiles were most involved 67.1%. The frequency of these accidents was higher in March at 30.1%. The injuries were the most common lesions with 86.1% of cases and the head was the most affected with 48.3%. Half of these accidents occurred between 8 o'clock and 12 o'clock. We observed 4.9% of deaths. CONCLUSION: Traffic accidents remain true public health problems today because of the serious consequences they generate. To reduce this problem, it is necessary to have well adapted roads and ensure a rigorous application of the rules of the road.

INTRODUCTION: Les accidents de la circulation routière constituent des causes importantes de mortalité et de morbidité. De ce fait, nous nous sommes proposé de faire une étude descriptive de ces accidents au Centre de santé de référence de Diéma durant notre période d'étude. MATÉRIELS ET MÉTHODES: Il s'agit d'une étude transversale descriptive qui s'est déroulée dans le district sanitaire de Diéma (région de Kayes) durant la période de Février à Juillet 2010. Elle a concerné les patients victimes d'accidents de la circulation routière et reçus au centre de santé de référence de Diéma. Les informations sur les patients ont été recueillies à partir des dossiers médicaux à l'aide d'un questionnaire établi à cet effet. L'analyse des données essentiellement descriptive a été faite à l'aide du logiciel SPSS version 12.0. Les variables quantitatives ont été exprimées par la moyenne et l'écart type et les variables qualitatives par les proportions. RÉSULTATS: Au total, 143 patients ont été enregistrés. La prévalence des accidents était de 8,66%. L'âge moyen des patients était de 31,5 ± 12,2 ans. Le sexe masculin a été le plus atteint 72%. Les automobiles seules ont été les plus en cause 67,13% .La fréquence de ces accidents était plus élevée au mois de Mars avec 30,1% .Les blessures ont été les lésions les plus retrouvées avec 86,12% et la tête a été la plus touchée avec 48,32% .La moitié de ces accidents s'est produite entre 8heures et 12 heures .On a observé 4,9% de décès. CONCLUSION: Les accidents de la circulation demeurent de véritables problèmes de santé publique de nos jours du fait des graves conséquences qu'ils engendrent. Pour diminuer ce fléau, il est donc nécessaire d'avoir des routes bien adaptées et veiller à une application rigoureuse du code de la route.

Urinary neopterin in pulmonary sarcoidosis. Relationship to clinical and biologic assessment of the disease.

Neopterin is a metabolite of guanosine-triphosphate, released in vitro by macrophages under the control of gamma-interferon and described as a marker of T cell activation in vivo. We have compared the urinary neopterin/creatinine ratio (mumol/mol) in patients with pulmonary sarcoidosis (n = 66), interstitial lung diseases other than sarcoidosis (nonsarcoid ILD, n = 35), and 45 normal control subjects. For the sarcoid population as a whole, urinary neopterin was higher (496 +/- 52 mumol/mol [mean +/- SEM]) than in control subjects (126 +/- 5 mumol/mol) (p less than 0.001). In patients with nonsarcoid ILD, urinary neopterin was frequently higher in granulomatous and/or lymphoproliferative diseases (hypersensitivity pneumonitis, tuberculosis, primitive Sjögren's syndrome, and malignant lymphomas) (781 +/- 193 mumol/mol, n = 10) but remained normal in other types of nonsarcoid ILD [( 163 +/- 14 mumol/mol, n = 25]: histiocytosis X, idiopathic pulmonary fibrosis, lung collagen-vascular diseases, diffuse neoplasms, pneumoconiosis; p less than 0.001 compared with sarcoidosis). We have also evaluated the relationship between urinary neopterin and the clinical or biologic markers currently used to assess sarcoidosis: alveolar lymphocytosis in lavage fluid (ALY), 67-gallium scan semiquantitative index (67Ga), or serum angiotensin-converting enzyme (SACE). Sarcoid patients with the highest urinary neopterin were those in whom mean values of these markers were the highest (p less than 0.05, all comparisons). Patients with positive markers (i.e., either clinical expression of sarcoidosis-ALY greater than 30%-67Ga greater than 20-SACE greater than 60 U/ml) had significantly higher urinary neopterin levels than did other sarcoid patients (p less than 0.05, all comparisons).

[Malaria in Guiana. I. General status of the endemic]. / Le paludisme en Guyane. I. Situation générale de l'endémie.

Before 1949 malaria was highly prevalent in the whole territory of French Guiana. When malaria control based on house-spraying and drug prophylaxis was implemented in 1950 the disease sharply dropped below 20 cases per year. Since 1976 despite vector control malaria is rising again. In 1987, 3,269 cases have been notified giving an incidence of 37.6 per thousand for the whole country population; only four deaths were recorded. All the age groups were concerned but the transmission was restricted to some foci along the Oyapock river (prevalence rate 25%), along the Maroni river (prevalence 2.3%) and in a few places of the coastal area. The main cities remain malaria free. In vivo resistance to chloroquine was observed in 22% of the cases which could be cleared by amodiaquine or quinine.

Epidemiology of toxoplasmosis among pregnant women in the Paris area.

A survey was performed using a sample of pregnant women selected at one of the biggest test centres in the Paris area. These women were serologically screened for toxoplasmosis between October 1981 and September 1983 (according to the prevention protocol for congenital toxoplasmosis established by the French health ministry). The prevalence rate of specific antibodies for toxoplasmosis was estimated from the 1074 women who were tested for the first time during the study. The prevalence rate among pregnant women in the Paris area was derived by direct standardization according to age and geographical origin. A standardized prevalence rate of 71% +/- 4% among French women, of 51.4% +/- 5% among immigrant women and a global adjusted prevalence rate of 67.3% +/- 3% for pregnant women in the Paris area was found. An incidence rate of 1.6% was estimated for the 2216 non-immune pregnant women included in the sample. There is no significant difference between the probabilities of seroconversion among French and immigrant women (2.3% +/- 1% and 1.6% +/- 0.8% respectively). Comparison of the data with previous study results show a decrease in the prevalence rate of specific antibodies for toxoplasmosis in the Paris area over the last 20 years that cannot be explained by changes in age and geographical origin. No data were available to support an aetiological hypothesis for a decrease in toxoplasma transmission to humans. Since immigration and a decrease in toxoplasma transmission to humans has led to a larger population of women at risk of infection during pregnancy in France, it is therefore important to perform studies to investigate risk factors and markers of acquired toxoplasmosis during pregnancy in order to improve the prevention of congenital toxoplasmosis.