Ethics of health research partnerships in Global South : PhD students in learning.

In view of the worldwide epidemic processes that require and result in simultaneous research in several countries and in an increasingly more structured scientific community, especially in countries of Global South, it is essential to establish partnerships between researchers, policy-makers, local supervisors, and communities in both the North and the South. The objectives of this essay are to: 1) present the context and issues linked to research in the framework of a North-South partnership; 2) describe the development of appropriate responses to improve consideration of ethical aspects; and 3) discuss the current role of young researchers in this era of multiple partnerships and share the observations and thoughts of PhD students in one research unit.

[Hospital care for a child living with HIV in Dakar. What is the cost for the family?]. / Hospitalisation d'un enfant vivant avec le VIH à Dakar. Quel coût pour la famille ?

In sub-Saharan Africa, hospitalization is one of the main gateway for testing and care of children living with the HIV. The aim of this study is to estimate the direct costs of the hospitalization of children living with the HIV in Dakar (Senegal). The various expenses were collected daily with the medical file and by interview from the accompanying persons in 30 children. Median age was 9 years (1-17) with a sex ratio of 1.3. Siteen children were orphan and 7 died during the sur- vey. The median duration of the hospitaization was 20 days (3-71). Children older than 5 years had longer hospitalization duration than those under 5 years (p = 0.0001). The average full cost was 175,701 FCFA (268 €), distributed as follow: cost in the hospital 36%, cost of drugs 31%, cost of medical care 20% other non-medical expenses 13%. This survey explores an underdocumented aspect of HIV pediatric care : cost of hospitalization. It also addresses the issue of non-medical expenses resulting from the hospitalization, with regards to the families' income.

[Relations between ethnicity and child malnutrition in rural Benin]. / Liens entre appartenance ethnique et malnutrition infantojuvénile en milieu rural béninois.

UNLABELLED: Relations between ethnicity and child malnutrition in rural Benin. RATIONALE: In a therapeutic feeding center in northern Benin, we found disparities between the three main ethnic groups in the proportions of children hospitalized; undernutrition seemed more frequent and severe in the Gando than in the Bariba and the Fulani groups. This survey sought to identify risk factors for malnutrition. METHODS: We used a standardized questionnaire to interview women from these three groups, all with a child aged 5 years or younger. RESULTS: The study included 165 mothers from the three main ethnic groups, 62 of whom had weaned a child. Children from the Bariba group seemed to have access to better sanitary and nutritional conditions than those from the Gando and Fulani groups: higher quality water (from boreholes), more frequent access to latrines, higher usage of bed nets, higher likelihood of birth in a medicalized environment, early breastfeeding, and progressive and voluntary weaning. During and after weaning, children from the Fulani group received more milk-based food than the other groups. In the Fulani group, therefore, the supply of milk of animal origin may compensate for some less favorable practices related to childbirth and breastfeeding. CONCLUSION: We identified several factors, probably influenced by socioeconomic and cultural conditions, that probably affect child undernutrition. Sanitary and nutritional education programs should be conducted to target specific ethnic groups of this region.

[Pitfalls in phlebography]. / Les pièges en phlébographie.

Despite the progress in functional investigation procedures, phlebography remains the standard test in venous disease of the lower extremities. The development of better quality contrast media has significantly improved patients tolerance. After a review of the regular, routine procedure, the authors stress the technic's pitfalls. Uncomplicated pitfalls are air bubbles, Venturi's effect, venous malformations, and superimposed venous axes or gases. This type of problems is easily circumvented. Flow images caused by confluent axes of high-flow veins (internal iliac veins, renal veins) or layer courants (gutter effect) are presented as a reminder. Compression images are often more treacherous: related to normal veins: compression of left iliac vein by aortic junction; of inferior vena cava by enlarged aorta or by osteophyte; tourniquet too low, iliac vein compressed by a dilated bladder; or compression due to intramuscular hematoma,... related to pathological veins: to be mentioned are bridle-caused obstruction of the popliteal vein (Klippel-Trénaunay syndrome), and retroperitoneal fibrosis. Although the present description of phlebography-related pitfalls is neither new, nor exhaustive, it should be reconsidered, as phlebography of the lower limbs, while being currently better tolerated, is still an update technic that needs to be rendered more reliable.

[Percutaneous angioscopy of the iliac and femoral arteries]. / L'angioscopie percutanée des artères iliaques et fémorales.

Very few papers about peripheral angioscopy are reported in literature. Percutaneous angioscopy (P.T.A.) of 25 peripheral arteries (21 iliac and 4 femoral arteries) have been performed by the authors without surgery and without anesthesia. Three observations are selected. The first one demonstrates an eccentric stenosis altering its diameter during pulsations; an irregular ulcerated atheroma is observed. The second case shows the signs of a centric atheroma with an intimal fragment. The last one is an intimal dissection due to PTA. The prospective aspects of this new technique are discussed.