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Biomedical subjects

D Fassin

Publications and source records attributed to D Fassin.

At least 19 recordsLinked to original sources
PubMed1991

[Physical handicapped, economic practices and matrimonial strategies in Senegal].

Social relations around the handicapped are generally presented in terms of economic dependence and social inadaptation. This point of view leads to give greater importance, especially in Africa, to studying the way in which group and society help the physically or mentally ill. Actually, this approach does not give a complete account about the real situation of the handicapped in social relations of production and reproduction. From a series of in-depth interviews conducted in handicapped families of the suburbs of Dakar, two aspects are analyzed: the economic role of the handicapped, through the circulation of the product of his begging in his household or through the exploitation of his work as apprentice in a workshop; and his value on the marriage market, where invalid persons are given without dowry if they are women, and must pay a much more important amount if they are men. The social situation of the handicapped thus is not only a matter of assistance or charity, but as well of strategies that the handicapped and above all his circle implement in order to take advantage of the stigma or on the contrary try to erase it.

Persons with Disabilities↗
PubMed1991

[Utilization of health statistics in peripheral structures in developing countries].

Health information in developing countries serves mostly to diseases notification and activity registration, but rarely is it used for analyzing the health status of populations or the results of health intervention. Moreover, it is stored at a national level, mainly to fill monthly or yearly reports, and very seldom at a peripheral level where it would be probably more helpful. On the basis of experiences realized in Senegal and Nepal, we try to answer the two following questions: how to make health statistics utilizable, i.e. which criteria of relevance and quality recommend and how to utilize them concretely where they are produced, taking into account their well known limits?

Data Interpretation, Statistical↗
PubMed1989

Immunization coverage and social differentiation in urban Senegal.

We studied sociocultural factors associated with immunization coverage among a random sample of 500 mothers in the underprivileged suburbs of Dakar, Senegal. Factors associated with immunization of children under age 5 were maternal educational level and socioeconomic conditions (especially husband's regular salary); maternal age on arrival in town was more influential than total number of resident years in town; no effect of ethnicity was evident.

Age Factors↗
PubMed1989

Risk groups and risk areas.

The risk approach to health management usually relates to groups of people. An alternative method is to concentrate on the areas at risk, which may sometimes be more useful in decision-making.

Health Planning↗
PubMed1989

[Q fever in Guinea-Bissau. 1 case].

Q fever is seldom reported in West Africa. The case of a man returning from Guinea Bissau who presented an acute lobar pneumonia with fever, headache, hematuria and hepatitis was confirmed by high titers of antibody in Phase II indirect immuno-fluorescence which appeared on the twelfth day of fever. Treatment with erythromycin was continued by doxycyclin, and complete resolution of all signs was promptly obtained. Coxiella Burnetii might thus be responsible of cases of unexplained fever with respiratory or hepatic manifestations in West Africa.

Antibodies, Bacterial↗
PubMed1988

Traditional medicine and the stakes of legitimation in Senegal.

Traditional medicine has been recently confronted by a new phenomenon in Senegal: the quest for new sources of legitimation. The cases presented here--an association of traditional practitioners, an encyclopedia of traditional knowledge and a controversy on a traditional leprosy center--illustrate the three following points: healers who are the most inclined to search for official recognition are also those who have the weakest traditional legitimacy; actors who claim for official recognition of healers reinforce at the same time their own legitimacy; and these new principles of legitimacy necessitate authorities for legitimation situated outside the scientific world. This Weberian analysis seems more accurate than usual descriptions of traditional medicines to explain the work of redefinition of social boundaries in the medical field. Far from being limited to Senegal, these stakes of legitimation can also be observed in other African countries and even in industrial ones with the question of parallel medicines.

Attitude to Health↗
PubMed1988

Who consults and where? Sociocultural differentiation in access to health care in urban Africa.

Sociocultural differentiation in health behaviour was studied among 500 mothers randomly chosen in the suburban area of Dakar, Senegal. Variables were age, marital status, educational level, socioeconomic conditions, urban experience, town integration, village attachment, social insurance, ethnic group and disease categories. Access to health care was considered for the last illness of the mother and her youngest child under five. Town integration and disease category (and social insurance for children) were the only variables correlated with the number of consultations. Socioeconomic level and social insurance (and educational level for mothers) were associated with preference for private rather than public health systems.

Adult↗
PubMed1988

[Venous thrombosis in Behçet's disease].

Venous lesions in Behçet's disease (BD) were defined by Adamantiades and represent one of the most suggestive signs of the disease. They are occasionally the first sign of the disease and are frequently the basis for the diagnosis in a case of recurrent thrombosis in a young subject, the preferential context of BD. Involvement of superficial vessels is virtually constant. Venous vasculitis is responsible for non-specific hypersensitivity and erythema nodosa, which constitute some of the major diagnostic criteria. Ocular periphlebitis is one of the elements responsible for posterior uveitis. The originality of the venous involvement is due to the involvement of deep territories. Any vein may be affected, but the remarkable features are the size of the thrombosed vessels: superior and inferior vena cava, iliofemoral veins and the unusual site of the involvement: supra-hepatic veins, cerebral vessels, etc. Inferior vena cava thrombosis may be associated with aneurysms of the pulmonary arteries in the context of Hughes-Stovin syndrome. Cerebral phlebitis, which can now be identified more easily by means of digital angiography, is responsible for a typical picture: headaches, bilateral papilloedema and raised CSF pressure. The classical pictures of optic chiasmatic arachnoiditis and so-called benign intracranial hypertension actually correspond to unrecognised phlebitis. They may also be associated with other neurological lesions. In one half of cases, phlebitis cutaneous manifestations. However, they may precede the diagnostic signs or may occur very late in the course of the disease. They are recurrent and affect a number of different territories.(ABSTRACT TRUNCATED AT 250 WORDS)

Anti-Inflammatory Agents↗
PubMed1988

[Is Behçet's disease associated with characteristic abnormalities of coagulation and fibrinolysis? Apropos of 70 case reports].

The frequency of thrombotic episodes in patients with Behçet's disease prompted us to study their hemostasis. Seventy patients were investigated and 27 of them (38%) had history of venous thrombosis; they were compared to 27 healthy subjects and to 16 hospitalized patients in whom the diagnosis of Behçet disease was ruled out. Fibrinolytic activity after a 10 minute venous occlusion was significantly decreased while fibrinogen, factor VIII and von Willebrand factor was increased as well as the tPA inhibitor (PAI-I): the last 3 proteins are synthetized by the endothelial cell. No significant difference was observed between patients with or without history of thrombosis. Coagulation and fibrinolysis changes observed are not specific of Behçet disease since they were also found in a population of patients without Behçet disease and without history of thrombosis.

Adolescent↗
PubMed1988

Illicit sale of pharmaceuticals in Africa: sellers and clients in the suburbs of Dakar.

Illicit drug sale seems to be increasing in developing countries, but it has received little scientific interest from research workers and health planners. A study was carried out in the underprivileged suburbs of Dakar. 10 sellers selected on two markets and a street corner were observed during one week day each: 144 buyers were thus seen on the spot. Age and sex distribution reveals differentiation in customers' patterns: women are more present on markets while men usually buy on street corners; young children are often sent by their parents when the location of the sale is near the house. The closer the seller is to his clients, the more regular they are. This suggests a differential integration in social life. Pharmaceuticals are bought for symptomatic treatment, especially pain or fatigue (77%). Aspirin is part of 58% of drugs sold; antidiarrhoeals (mainly tetracycline) and antimalarials (4-aminoquinolines) represent 12% and 7% of sales, respectively. Prices are low, as pharmaceuticals are sold as individual tablets. Total cost of drugs thus sold by 102 sellers on the 13 main markets of Pikine is 100,000 $ per year - 11 times the Ministry of Public Health expenditure for pharmaceuticals in this area. Better accessibility to drugs in primary health care structures would give an alternative choice to populations and be more effective than mere repression against illicit sellers.

Adolescent↗
PubMed1986

[The good mother: rural and urban practices related to measles in Haalpulareen women in Senegal].

Anthropologists usually describe the village as a place of tradition, and the town as a place of modernity. In order to question this opposition, a study was carried out among 100 Haalpulaaren mothers (Tukulors and Fulas), 50 from a village in the Sahelian area along the Senegal River and 50 from an underprivileged suburb of Dakar. They were asked about their representations and practices related to measles, which is the first cause of mortality under 5 years of age in the urban group, and second in rural group. Although fatality rates were equivalent in both groups and even higher among village children who had been staying in town at the time of the illness, measles seems much more feared in the village where it comes by epidemics than in town where it is endemic. Moreover, causal interpretations seem to be changed by the different environment of the city where the mechanistic explanation by winds has lost its material basis and is changed into the metaphoric and magical interpretation of wind-spirits. As for therapeutic practices, the study reveals a more traditional behaviour (judged on use of local remedies and immunization coverage) in the urban group than in the rural group. This paradoxical result can be explained by the existence of a subgroup of migrant women (seen in town more than in the village) who appear to resist to change and reinforce their traditional behaviours. Finally influence of castes seems to disappear in town, where therapeutic practices vary according to the level of integration into urban society (measured by use of the vehicular language).(ABSTRACT TRUNCATED AT 250 WORDS)

Child, Preschool↗
PubMed1986

Acute respiratory infections: a longitudinal study of 151 children in Burkina-Faso.

A longitudinal study of 151 children under five years of age was performed in a rural village of Burkina-Faso (West Africa). During systematic examinations by a physician during the rainy season, 44% of the children were found to be ill and 59% of these had an acute respiratory infection (ARI). During the dry season, the rates were 48% and 73% respectively. Weekly interviews by a field worker showed 6.2 attacks of ARI during the six months of the rainy season and 7.0 during the six months of the dry season. Risk factors for ARI were malnutrition assessed by arm circumference, and a high birth rank. At the 'field-dispensary', ARI accounted for 41% of the visits; lower respiratory infections (LRI) accounted for 24%, similar to the proportion of LRI among illnesses found during the systematic examination.

Acute Disease↗
PubMed1986

[Illicit sales of drugs in Senegal. Consequences for community health].

The relatively recent development of parallel drug markets in the Third World has not yet been specifically studied. A research on illicit drug sale was carried out in Pikine, a 600,000 people suburb of Dakar: all items provided by all sellers observed on the markets of the town were inventoried; their indications and posologies were given by a sample of 20 among the 100 identified sellers; complementary information was obtained from the official structures of drug distribution. The list of all medications available shows 23 items--12 directed at [symptoms], and 11 at [causes]. The indications and posologies are remarkably similar for the 20 sellers, whose training was done in well-structured channels outside the official network. Evaluation of the potential consequences of these parallel markets for community health shows: 1) a probably beneficial impact of some medications, such as analgesics, antimalarials, antibiotic eye ointment; 2) exposure to individual risks (tetracyclines, sulfamids) and collective risks (antibiotics, not widespread yet, but capable of selecting resistant germs). Moreover, this illicit sale must be understood in its social context where buying drugs on the markets is the least expensive and most accessible solution for underprivileged people, because of scarcity of resources in the dispensaries. Thus, rather than to automatically condemn illicit drug sale, it seems more appropriate and urgent to evaluate the risks of medications available in each of the countries involved, to develop health information in the population, and meanwhile to make access to drugs in primary health care structures easier.

Costs and Cost Analysis↗