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Biomedical subjects

I Wone

Publications and source records attributed to I Wone.

At least 19 recordsLinked to original sources
PubMed2006

[Allergy to latex gloves among healthcare workers in Dakar].

BACKGROUND: The prevalence of latex allergy is high (to 17%) among groups at risk such healthcare workers. Our aim was to determine the prevalence and severity of allergy to latex gloves among health workers in Dakar. PATIENTS AND METHODS: The study was conducted in three of the five hospitals in Dakar (Senegal). A randomized sample was constituted. All healthcare workers required to use latex gloves in their work were included. A questionnaire was administered. The analysis was performed using the Epi-info software package (6.0). RESULTS: One hundred and forty cases were included. The median age was 39 years and the sex-ratio was 0.57. Sixty-six (47%) cases had familial atopic dermatitis, 13 (9.6%) had atopic dermatitis, and 4 (2.9%) indicated food allergy (banana, avocado). Irritant dermatitis was found in 40.7% of cases, 112 healthcare workers (81.2%) used bleach and water to clean their hands. Antiseptics were used frequently: 75.5% of those interviewed used them more than three times a day. None of the healthcare workers indicated any allergy to latex condoms. Otherwise surgical procedures and bladder/rectal catheters were noted respectively in 24% and 18% cases. Fifteen healthcare workers (10.7%), of whom 12 were women, indicated appearance of clinical signs when using latex gloves. The clinical manifestations were: contact urticaria or immediate pruritus (8 cases), combined contact dermatitis and contact urticaria (2 cases), allergic conjunctivitis (1 case), allergic rhinitis (2 cases) and asthma (2 cases). We also noted 6 cases of contact dermatitis. Rechallenge tests were performed in 7 cases and were positive, 2/3 prick-tests and 1/4 patch-tests (standard European battery). The statistical analysis shows that allergy to latex gloves was significantly associated with atopy and irritant dermatitis (p<0.03). DISCUSSION: We found a prevalence of allergy to latex gloves of 11% among healthcare workers in Dakar, reflecting reports in the literature. The classical risk factors such atopic dermatitis and irritant dermatitis were found. The correlation between irritant dermatitis and frequent use of bleach and water mean that these practices should be eradicated since they play an important role in the development of contact urticaria and anaphylactic reactions.

Adult↗
PubMed2006

[Prognosis of stroke in department of neurology of Dakar].

INTRODUCTION: The general objective of this study was to determine the morbid-mortality of stroke followed in the Department of neurology of Dakar. MATERIALS AND METHODS: This prospective and longitudinal studywas carried out from August 2003 at May 2005 and concerned 170 patients hospitalized or seen in external consultation for cerebral vascular accident confirmed by the cerebral tomodensitometry. All the patients were subjected to a protocol allowing determining the sociodemographic data, the therapeutic itinerary, the nature and the mechanism of stroke. The follow-up was monthly for 12 months. RESULTS: The patients were old 25 to 90 years. The mean age was 61 +/- 13 years. The sex-ratio is 0.68. The ischemic cerebral vascular accidents represented 64.7% against 35.3% for the hemorrhagic vascular accidents. In 71.7 the AVCH was related to arterial hypertension. For the AVCI, a cardiopathy emboligene was objectified in 16.36% of the cases. The HTA constituted the principal factor of risk and was observed in 63.53% of the cases. The mortality rate was 28.8% (between j0 and j30) and 50.6% at one year. The age constitutes a factor of bad prognosis. For the sex the statistical analysis shows a no significant difference (p = 0.703). The repetition of stroke constitutes a factor of bad prognosis. 52.4% of the patients having an antecedent of stroke had died precociously. Mortality was higher in the AVCH with p = 0.043. The existence of disorders of conscience of start constituted a factor of bad vital prognosis. Among the 84 survivors after one year of follow-up, 49 had found their functional autonomy and 35 kept after-effects. CONCLUSION: Stroke is responsible for a strong mortality. The advanced age, the repetition of cerebral vascular accident, the hemorrhagic nature of the cerebral vascular accident constitutes factors of bad vital prognosis.

Adult↗
PubMed2005

[Monitoring and evaluation of health care programs in Subsaharian Africa].

The monitoring and evaluation is usually the weakest component of health programs in sub-Saharan Africa, what is undermining the sustainability of funding. The problems are complex and the weaknesses of the health systems are reflected on the monitoring and evaluation of specific programs. This paper gives an insight of the problems faced during field missions for monitoring and evaluation. The steps for building the M&E system have been reviewed and keys points for implementation have been provided.

Africa↗
PubMed2002

[Barriers in the community management of child malaria in the city of Mékhé (Senegal)].

In Senegal, governmental fight plan against malaria emphasizes the need to community actions, particularly for early treatment of child malaria at home. So, we carried out a cross sectional survey, to determine factors linked with treatment of child malaria at home. During February 2001, we had an interview with persons taking care of a child under five years. These persons were randomly chosen among population of a rural town. Their median age was 32 years, 90.5% of them were women, 77.8% were the mother of the child. Their level of knowledge about malaria was fair (hightest transmission period, promoting environmental factors); 85.1% quoted children as vulnerable group; for 85%, fever was chief sign of malaria. When the child had fever, 45% of them brought him to a health center and 44% gave him chloroquin; 67.5% related no harmful effects. But at the time of the survey, only 28.8% had chloroquin at home. Literacy was very linked with home care: literate persons knowed most frequently the way of transmission by mosquito bites (72.4% versus 52.9% p<10-4 OR=2.3[1.5-3.6]); they considered most frequently chloroquin as the malaria treatment (74% versus 60.1% p=.003 OR=1.8 [1.2-2.9]) ;they had more often chloroquin at home (35.4% versus 22.6% p=.004 OR=1.8 [1.1-2.9). In conclusion, chloroquin might be available at home. The high ratio of illiterate persons in the population taking care of children in Mekhe emphasizes the need to organize information, education and communication strategies, using persons coming from the same community. The real impact of literacy on knowledges, behaviours and practices of persons taking care of malarial child at home emphasizes the need of reinforcing it, especially for women.

Adolescent↗
PubMed2002

[Chronic low back pain at a public transportation company in Senegal].

The aims of this study were to appreciate the prevalence of chronic low back pains in a public transport's company, to state characteristics and to identify categories of workers involved and medico-legal consequences. It is a cross sectional study. which used medical records of the occupational clinic. All workers who complained of low back pain in the past three years following the study were selected. Characteristics of workers, types of injuries, occupational and medico-legal consequences were looked out. Sixty nine cases were collected, they were exclusively males. 54 % of them were bus drivers, and 29% conductors. X rays abnormalities were found in 31.64%. Exposure to vibration due to damaged roads and decayed vehicles seems to be main etiologic factors. From a occupational and medico-legal standpoint, two patients were reported for workers compensation, three patients were reclassified in another job. Undamaged roads, ergonomic design of bus' seats, and medical screening during placement and routine medical examination are key issues in preventing low back pains.

Adolescent↗
PubMed2001

[Smoking habits among physicians in Dakar].

A prospective cross-sectional study was conducted in March 1999 on the prevalence of smokers and smoking habits among physicians practicing in the Dakar region. The study population was composed of 163 physicians; 128 male (78.5%) and 35 female (21.5%). The prevalence of smokers was 27.6%. The average age of the smokers was 40.5 (+/- 6.2) years (extremes between 30 and 61 years) and an average duration of 18 (+/- 6.6) years in smoking. Men smoked more than women (93.9% versus 6.7%) with 56.4% of heavy smokers. Specialists represented 63.3% and generalists 36.4%. Initiating factors were stress (28.9%), circle of friends/acquaintances (24.4%), fashion (24.4%), pleasure (20%) and advertisements (2.2%). A little over 82% smoked in public places, 68.9% in their work places and 49.5% before children. The average time duration smoking was stopped followed by relapse was 15.7 (+/- 9.7) months. 97.7% of smokers manifested their intention to stop. Nicotine dependence according too the Fagerström questionnaire was average (37.9%), high (39.6%) and very high (12.6%). Smoking is a reality in the medical environment in Dakar. Specific campaigns aimed at physicians will be necessary to hope for a sustainable change in behavior and for a much more pronounced implication in the fight against tobacco addiction.

Adult↗
PubMed2001

[Cost analysis of psychiatric health care at the University Hospital of Fann (Senegal)].

In the current senegalese context, marked by a political will of autonomisation of health services, is proves very important to study the costs of the services provided in hospitals. Our study, which consists in a retrospective analysis of accounting archives of the psychiatric department of Fann Hospital during the year 1998, had the following objectives: determine the costs related to the functioning of the service of psychiatry, according to the source of financing, determine the average cost of the main services provided by the psychiatric department, analyze the recovery of the cost of these services. The operating costs of the psychiatric department came to 86.824.477 FCFA in 1998. 88% of the total amount were brought by the State and the remaining 12% came from community participation. The average cost of hospitalization in Clinique Moussa Diop was 91.398 F CFA. For the former patients the visit cost 6.664 F CFA; for the outpatients the price was 12,886 F CFA. The average cost of a child psychiatric visit was 8.140 F CFA and 28 days of hospitalization in the same service cost 354.825 F CFA. The share supported by the community participation is in general largely covered by the current fees in spite of the high cost of these services.

Costs and Cost Analysis↗
PubMed2000

[An innovative training experience in public health at the Cheikh Anta Diop University of Dakar].

The Institute for Health and Development (ISED) at the University of Dakar, was created in 1987. Its mission is to fulfill the public health training needs of Senegalese health care professionals. ISED is responsible for a training program entitled "Certificat d'études Spéciales" (CES), the equivalent of a Masters of Public Health degree. The "CES" is a two-year program comprised of six modules, which last four months each. The ISED training approach stresses trainee responsibility above all. It is based on the trainee's professional tasks and is oriented toward the problems identified by the trainees themselves. In this sense it is highly adaptive and flexible. Each module is implemented in the same way; initially there is a 15 day residential phase for intensive theoretical courses, followed by an application period of 75 days in the trainee's work place, and then a final residential phase of 15 days for writing and presenting a technical report on the work in the field. This model allows trainees to bring together the theoretical and the practical. The trainers directly supervise each of these three phases. The two residential phases are conducted in the ISED training center, located in Mbour, 80 Km south of Dakar. 103 trainees are enrolled in the program in seven different classes. Of these trainees, 93 are health care specialists (85 physicians 7 pharmacists, 1 dentist). Ninety percent of previous graduates have been civil servants who work for the Ministry of Health in Senegal and the remaining 10% were from Burkina Faso and Togo. The training program is considered by all stockholders, beneficiaries, and relevant financial institutions, to be appropriate, beneficial and successful.

Certification↗
PubMed2000

[Prevalence of the use of skin bleaching cosmetics in two areas in Dakar (Sénégal)].

The use of skin bleaching cosmetics is an increasingly widespread phenomenon in Africa. If the negative sanitary effects of this practice are today well known, reliable statistics on the importance of the problem within the global population are rare. Our study, conducted in two popular areas in Dakar, Usine bene taly and Usine Niary Taly, had 2 objectives: to determine the prevalence of the use of skin bleaching cosmetics in the studied zones, to describe the prevalence according to the following variables: age, matrimonial situation, level and/or type of instruction, job, type of agents used. For that purpose, we conducted a transverse study on a representative sample of 600 women from 15 to 55 years old. This study reveals a prevalence of the use of skin bleaching cosmetics of 67.2%. The agents found are hydroquinone derivatives (61%), topical corticosteroids (37%) and agents from unknown origin (2%). The use of skin bleaching cosmetics is more important among young women between 30 to 44 years (72.5%), married (72.2%), analphabets (75%), working (77.6%). Studies conducted in Mali and Togo gave comparable results, which give perspectives for a prevention based on education an awareness.

Administration, Cutaneous↗
PubMed1998

[Prevalence of malnutrition in the Mbao Health District].

Protein-energy malnutrition is a real health priority in developing countries specially in african ones. So, a cross-sectional study was conducted, from April 14 to July 28 1995, in the health district of Mbao in Senegal, to determine the prevalence of protein-energy malnutrition (PEM) in a population of children 0-5 year old utilizing the health center, for a curative care, an immunization, a growth monitoring. Anthropometric and sociodemographic data were collected and analysed using a microcomputer with WHO/CDC Epi Info 6.0. The index weight/age expressed on Zscore was used with comparison to NCHS/CDC/WHO population's international reference. Among 204 children, 89 (43.6%) present a PEM.51 (57.3%) are male. More than 60% of the children with PEM are 6-29 months old. 74 (83.2%) live in the surroundings of Mbao. They all come from different ethnic group. 67.4% utilize the health center for a curative care and 7.9% for growth monitoring. There is no relation statistically significant between protein-energy malnutrition and the parameters we studied. To overcome such problem, it is necessary to strengthen the management of malnourished children in specialized centers, to educate families in the nutritional properties of local products and to improve the socioeconomic status of the population for better access to these products.

Anthropometry↗
PubMed1997

[Drug management at the level of the Psychiatry Department of the Fann University Hospital Center: problem and perspectives].

Health system in developing countries is facing difficulties due to lack of resources and poor management of the available ones reinforced by the economic crisis and the structural adjustment program since 1980. The situation will be worsened by the recent devaluation of the France CFA. The consequences are a permanent shortage of drugs, a decreased motivation of the health personnel with at the end the decrease of health services reliability. Teaching Hospitals, which are essential for the implementation of PHC, are facing such situation. Thus, a study was conducted at the Department of Psychiatry, Fann Hospital to analyse the process of drug management and to find out suitable solutions. The study, qualitative, showed that that the main problems encountered are: inexistence of management tools with inexploitable health information systems, insufficient budget allocated for drug purchase, selection of drug exclusively on brand name with a standard list unrenewed since 1986, weak drug delivery system, frequent stock-outs. Prescribers are unaware of available drug at the pharmacy. Patients are not informed about their diseases and the use of drugs prescribed. Therefore, adopting the EDP in Teaching Hospitals will help for better management of drug delivery.

Drug Costs↗
PubMed1997

[A baobab solution for the prevention and treatment of acute dehydration in infantile diarrhea].

OBJECTIVE: The purpose of this study was to compare the clinical efficacy of a local solution based on "pain de singe", fruit of baobab (Adansonia digitata), and the WHO standard solution in the treatment of children with acute diarrhea and resulting mild to moderate dehydration. METHODOLOGY: A prospective clinical trial comparing the local solution to the standard WHO solution was conducted; in children of 6 months or older (mean age = 16.6 +/- 8.8 months), 79 received the WHO solution and 82 the local solution, and were followed for a period ranging from 4 to 48 hours. Evolution of diarrhea and weight gain were evaluated as variables of interest. RESULTS: WHO solution was found to be superior, but not statistically significant in term of duration of diarrhea and weight gain. DISCUSSION: The pain de singe based solution presents additional advantages: nutritional, economic and cultural; we recommend it to promote use of TRO at home.

Bicarbonates↗
PubMed1997

[Technical quality of prenatal visits in Senegal].

The objective of this study is to estimate the quality of antenatal care in Senegal. A survey was conducted in 49 health centers near 70 health workers practising antenatal cares for pregnant women. The quality of cares was assessed on 13 essential actions, which were classified in 4 components. The global score of quality and the specific score of each component were calculated and analysed according to the qualification and the duration of time in the work of the health workers, the location and the equipment of the centers. Global quality of prenatal cares was linked with the qualification of agents. The component "screening for risk factors" had low and worse score and "reception of pregnant women" also. These 2 components were not linked with the qualification of agents, contrary to the 2 others, pregnancy and mother health surveillance. The duration of time in service and the equipment had no influence in global and specific scores. The health workers qualification was linked with many components of quality, but a good basic training is not sufficient to provide prenatal care of high quality. It must be define a framework with screening for unfavorable ends of pregnancy.

Adult↗
PubMed1996

Bamako boost for primary care.

In Senegal the generation of funds from the users of public health services in accordance with a strategy based on the Bamako Initiative is proving to be an extremely effective means of cost recovery and, in conjunction with management changes, is helping to improve the standard and scope of primary care.

Community Health Services↗
PubMed1995

[Evaluation of the financial participation of the users of 102 health services in 3 districts of Senegal].

Primary Health Care (PHC) financing is today one of the major concern of public health system managers in developing countries. Their governments never allocated appropriate and sufficient resources to the sector of PHC. The external donors' funds are mostly allocated to short term PHC projects. They stop with the end of the projects. The undesirable consequences of that situation are well known. They are mainly related to a persistence of high rate of mortality and morbidity due to preventable diseases. To better address that situation the health ministers of the WHO african region adopted in September 1987 in Mali the Bamako alternative, to the country economical situation, for PHC services financing. It permitted to finance up to 80% of the recurrent costs of health system of Pikine department in 1980. In the three pilot districts where the Bamako initiative strategy has been tested: Podor, Matam and Bignona, all of the one hundred and two (102) health posts are self financed for their recurrent costs, since 1992.

Adult↗
PubMed1993

[Dental cavities in the urban, suburban, and rural environment among school children from the region of Dakar].

An epidemiological survey on 2.067 children from 7 to 12 years old in average carried in three urban, suburban and rural school environments, has shown that dental caries prevalence is not yet alarming in the district of Dakar, and that the caries index remain more high in the urban environment than in the rural environment. However face to the urbanization and the industrialization of this region, the modification of the alimentary habits appear to be facilitating factors of the raising of the dental caries prevalence in the coming years if nothing is done. It's why preventive measures have to be taken based over all on dental health education and dental health information in organized structures like school.

Child↗