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PubMed1993

Modeling technology transfer in health information systems. Learning from the experience of Chad.

Health information systems are complex combinations of methods of organization and computer technologies. They are idiosyncratic to each country. Chad's design of a national information system followed a process that can serve as a model for sustainable technology transfer--using consensual decision making and reinforcing administrative reforms while providing strong Ministry leadership and using technical assistance.

Chad↗
PubMed1995

Priorities in global measles control: report of an outbreak in N'Djamena, Chad.

In N'Djamena, capital of Chad, measles vaccination coverage of 12-23-month-old children fell from 61% in 1990 to 15% in 1993. A community survey of measles after an outbreak in 1993 showed that among children < 5 years of age, the mean monthly attack rate was 37 per 1,000 (95% CI, 32-43) and the mean case fatality rate was 7.4%. Measles incidence was highest (77/1,000/month) in children aged 9-11 months and fell among children > 3 years of age. Incidence rates were high (56/1,000/month) among 6-8-month-old children, but only 3 deaths occurred in this age group. Measles vaccine efficacy, estimated by comparing attack rates in unvaccinated and vaccinated children, was 71% (95% CI, 59-80%). Extrapolation of the results to the city population indicated that an estimated 19,000 cases and > 1,000 measles-associated deaths occurred in 1993. This preventable morbidity and mortality, in a city where coverage was formerly among the highest in Africa, shows the need for sustained global commitment to preventive health care.

Age Distribution↗
PubMed2006

Species identification of non-tuberculous mycobacteria from humans and cattle of Chad.

In Chad, during a study on tuberculosis in humans and cattle, 52 non-tuberculous mycobacteria (NTM) strains were isolated. By means of INNO-LiPA, PRA-hsp65 amplification and sequencing of 16S rDNA, NTM species of 25/52 isolates were identified. M. fortuitum complex (8) was the most frequent species, followed by M. nonchromogenicum (4) and M. avium complex (4). PRA method could identify M. fortuitum 3rd variant among isolates derived from cattle specimens. This finding could confirm the existence of farcy in the Chadian cattle population as M. fortuitum 3rd variant and putitative pathogen M. farcinogenes can't be distinguished by the methods used in this study. Half of the NTM isolates could not be specified and we considered them as contaminants from the environment.

Animals↗
PubMed2002

A new hominid from the Upper Miocene of Chad, Central Africa.

The search for the earliest fossil evidence of the human lineage has been concentrated in East Africa. Here we report the discovery of six hominid specimens from Chad, central Africa, 2,500 km from the East African Rift Valley. The fossils include a nearly complete cranium and fragmentary lower jaws. The associated fauna suggest the fossils are between 6 and 7 million years old. The fossils display a unique mosaic of primitive and derived characters, and constitute a new genus and species of hominid. The distance from the Rift Valley, and the great antiquity of the fossils, suggest that the earliest members of the hominid clade were more widely distributed than has been thought, and that the divergence between the human and chimpanzee lineages was earlier than indicated by most molecular studies.

Animals↗
PubMed2002

Geology and palaeontology of the Upper Miocene Toros-Menalla hominid locality, Chad.

All six known specimens of the early hominid Sahelanthropus tchadensis come from Toros-Menalla site 266 (TM 266), a single locality in the Djurab Desert, northern Chad, central Africa. Here we present a preliminary analysis of the palaeontological and palaeoecological context of these finds. The rich fauna from TM 266 includes a significant aquatic component such as fish, crocodiles and amphibious mammals, alongside animals associated with gallery forest and savannah, such as primates, rodents, elephants, equids and bovids. The fauna suggests a biochronological age between 6 and 7 million years. Taken together with the sedimentological evidence, the fauna suggests that S. tchadensis lived close to a lake, but not far from a sandy desert, perhaps the oldest record of desert conditions in the Neogene of northern central Africa.

Animals↗
PubMed2004

[Three new species of Myxosporidia (Myxozoa: Myxosporea) parasites of Citharinus citharus (Geoffroy Saint-Hilaire, 1809) (Citharinidae) in Chad (Central Africa)].

The study of Citharinus citharus (Geoffroy Saint-Hilaire, 1809) (Teleost, Citharinidae) captured in the Chari river in Chad revealed the presence of three new myxosporidian which are described in the present paper: Thelohanellus taguii sp. nov., a systematic parasite; Myxobolus mbailaoi sp. nov., which affects operculum, skin and intestine, Myxobolus charii sp. nov., a parasite of the skin.

Animals↗
PubMed1976

Blood polymorphism frequencies in the Sara Majingay of Chad.

Blood samples of 258 Sara Majingay of Ndila (Southern Chad) were analysed. Phenotype and allele frequencies are given for 22 polymorphisms. For each of these, the Majingay are compared to a number of other African populations. Then they are included in a set of 8 African populations between which multivariate distances for 25 alleles at 9 loci are computed. A two-dimensional representation is derived from the matrix of distances, and is discussed. It bears the stamp of gene flow in central Ethiopia, where an Arab admixture is evident, and in Southern Africa, where a reciprocal gene flow has marked the gene pools of Khoisan and Bantu speakers to a varying degree. The Majingay stand relatively near to the Bedik, another population of West-Central Africa. The non-Arab or non-Khoisan components of the gene pool of the other populations do not seem to differ largely from the gene pools of the West-Central African populations.

Acid Phosphatase↗
PubMed2004

Costs attributable to AIDS at household level in Chad.

This paper assesses the economic costs of AIDS at the household level in Chad, one of the poorest countries in the world. One hundred and ninety-three AIDS patients living in four different regions were found by case identification at hospital level and through community based organizations providing psycho-social relief. They were matched by age, sex, professional category and zone of residence with controls. Costs were evaluated through a standard questionnaire. Costs at household level attributable to AIDS up to death were US$836 per case. Costs related to productivity losses made up 28% of total costs. More than half of total costs (56%) were health care related expenditures and funeral costs contributed 16%. AIDS cases relied more often on borrowing and the selling of household assets than controls for treatment. Household expenditures of AIDS cases were much higher than control households mainly due to health related expenditure. The response of concerned families to HIV/AIDS implies high costs and for most households, especially in low-income settings, the consequences of AIDS are devastating. Innovative strategies on how best to assist households are thus requested and may include the strengthening of care and treatment services being offered to AIDS cases.

Acquired Immunodeficiency Syndrome↗
PubMed1999

Caregiver behaviors and resources influence child height-for-age in rural Chad.

The purpose of this study was to identify caregiver characteristics that influence child nutritional status in rural Chad, when controlling for socioeconomic factors. Variables were classified according to the categories of a UNICEF model of care: caregiving behaviors, household food security, food and economic resources and resources for care and health resources. Sixty-four households with 98 children from ages 12 to 71 mo were part of this study. Caregivers were interviewed to collect information on number of pregnancies, child feeding and health practices, influence on decisions regarding child health and feeding, overall satisfaction with life, social support, workload, income, use of income, and household food expenditures and consumption. Household heads were questioned about household food production and other economic resources. Caregiver and household variables were classified as two sets of variables, and separate regression models were run for each of the two sets. Significant predictors of height-for-age were then combined in the same regression model. Caregiver influence on child-feeding decisions, level of satisfaction with life, willingness to seek advice during child illnesses, and the number of individuals available to assist with domestic tasks were the caregiver factors associated with children's height-for-age. Socioeconomic factors associated with children's height-for-age were the amount of harvested cereals, the sources of household income and the household being monogamous. When the caregiver and household socioeconomic factors were combined in the same model, they explained 54% of the variance in children's height-for-age, and their regression coefficients did not change or only slightly increased, except for caregiver's propensity to seek advice during child illnesses, which was no longer significant. These results indicate that caregiver characteristics influence children's nutritional status, even while controlling for the socioeconomic status of the household.

Aging↗
PubMed2000

Assessment of hospital morbidity, mortality, and cost-effectiveness of a nutritional program for children under 5 years of age in Pala, Chad.

This paper analyses the effectiveness of case management at referral level for malnourished sick children in a rural district health system in the south of Chad (Pala district). The methodology followed was based on a cohort study of malnourished children as well as a cost-effective analysis of alternative options for nutritional rehabilitation strategies. Results show that effective case management at hospital level is possible with few resources as long as the nutritional rehabilitation programme is implemented on an integrated basis including early diagnosis of malnutrition for all children admitted to hospital and not to wait for a normal weight-for-height but discharge when the hospital is no longer the best place to avoid further mortality.

Case Management↗
PubMed2006

Cost-description of a pilot parenteral vaccination campaign against rabies in dogs in N'Djaména, Chad.

In the discussion about policies and strategies for rabies prevention in developing countries, intervention costs arise as a major issue. In a pilot mass vaccination campaign against rabies in N'Djaména, Chad, 3000 dogs were vaccinated. We assessed vaccination coverage and cost, showing the cost per dog vaccinated for the public sector and for society. An extrapolation to city level calculated the approximate cost of vaccinating all 23 600 dogs in N'Djaména. In the pilot mass campaign with 3000 dogs the average cost per dog was 1.69 euro. to the public and the full societal cost was 2.45 euro. If all 23 600 dogs in N'Djaména were vaccinated, the average cost would fall to 1.16 euro to the public and 1.93 euro to society. Private sector costs account for 31% of the cost to vaccinate 3000 dogs, and 40% of the cost to vaccinate 23 600 dogs. Mass dog vaccination could be a comparatively cheap and ethical way to both control the disease in animals and prevent human cases and exposure, especially in developing countries. The cost-effectiveness of dog vaccination compared with treating victims of dog bites for prevention of human rabies should be further assessed and documented.

Animals↗
PubMed2006

Antibiotic susceptibility and molecular diversity of Bacillus anthracis strains in Chad: detection of a new phylogenetic subgroup.

We genotyped 15 Bacillus anthracis isolates from Chad, Africa, using multiple-locus variable-number tandem repeat analysis and three additional direct-repeat markers. We identified two unique genotypes that represent a novel genetic lineage in the A cluster. Chadian isolates were susceptible to 11 antibiotics and free of 94 antibiotic resistance genes.

Anthrax↗
PubMed1997

The deterioration in children's nutritional status in rural Chad: the effect of mothers' influence on feeding.

OBJECTIVES: This study examined how maternal influence on child feeding modified the deterioration of child nutritional status in Chad. METHODS: The pattern of height with age was examined in 98 rural Chadian children aged 12 through 71 months from 64 households randomly chosen. RESULTS: Younger children were more stunted than older ones, probably reflecting secular deterioration in weanlings' nutritional status from 1982 to 1987. Children of mothers with influence over child feeding were taller than children of mothers with less influence, but this held only for the youngest children. CONCLUSIONS: Height-for-age can be a useful indicator of recent changes in social and environmental effects on child health. The mother's influence may have buffered the negative impact of socioeconomic conditions on child growth.

Aging↗
PubMed2004

Rift Valley fever in Chad.

To evaluate the importance of human exposure to Rift Valley fever virus in Chad, investigations were carried out to determine specific antibody prevalence in domestic ruminants during the 2002 rainy season. Results highlighted recent, substantial, active transmission of this virus.

Abattoirs↗
PubMed2006

O'nyong-nyong Virus, Chad.

We report the first laboratory-confirmed human infection with O'nyong-nyong virus in Chad. This virus was isolated from peripheral blood mononuclear cells of a patient with evidence of a seroconversion to a virus related to Chikungunya virus. Genome sequence was partly determined, and phylogenetic studies were conducted.

Adult↗
PubMed2003

Light and electronic observations on Henneguya ghaffari (Myxosporea, Bivalvulida) infecting the gills and intestine of Nile perch Lates niloticus (Pisces: Teleostei) from Chad and Senegal.

Henneguya ghaffari Ali, 1999, described for the first time in Egypt, has been found on gills and intestine of Nile perch Lates niloticus L. from Chad and Senegal (Africa). It formed plasmodia which induced lesions of infected tissues. In fresh state, the spore body was ovoid and its size was 11.07 +/- 0.7 (range 11 to 13) x 7.7 +/- 0.4 (range 7 to 8) microm. The length of the caudal appendages was 44.2 +/- 1.7 (42 to 48) microm. The polar capsules were pyriform, of equal size, with the polar filament showing 4 coils, and measuring 3.17 +/- 0.1 (range 3 to 4) x 2.2 +/- 0.1 (range 1 to 2) microm. The total length of the spore was 55.73 +/- 1.7 (range 53 to 61) microm. At ultrastructural level, our results confirm that in Henneguya species, the sporoplasm is binucleate and the pansporaoblast is disporous.

Animals↗
PubMed2003

Coverage of pilot parenteral vaccination campaign against canine rabies in N'Djaména, Chad.

Canine rabies, and thus human exposure to rabies, can be controlled through mass vaccination of the animal reservoir if dog owners are willing to cooperate. Inaccessible, ownerless dogs, however, reduce the vaccination coverage achieved in parenteral campaigns. This study aimed to estimate the vaccination coverage in dogs in three study zones of N'Djaména, Chad, after a pilot free parenteral mass vaccination campaign against rabies. We used a capture-mark-recapture approach for population estimates, with a Bayesian, Markov chain, Monte Carlo method to estimate the total number of owned dogs, and the ratio of ownerless to owned dogs to calculate vaccination coverage. When we took into account ownerless dogs, the vaccination coverage in the dog populations was 87% (95% confidence interval (CI), 84-89%) in study zone I, 71% (95% CI, 64-76%) in zone II, and 64% (95% CI, 58-71%) in zone III. The proportions of ownerless dogs to owned dogs were 1.1% (95% CI, 0-3.1%), 7.6% (95% CI, 0.7-16.5%), and 10.6% (95% CI, 1.6-19.1%) in the three study zones, respectively. Vaccination coverage in the three populations of owned dogs was 88% (95% CI, 84-92%) in zone I, 76% (95% CI, 71-81%) in zone II, and 70% (95% CI, 66-76%) in zone III. Participation of dog owners in the free campaign was high, and the number of inaccessible ownerless dogs was low. High levels of vaccination coverage could be achieved with parenteral mass vaccination. Regular parenteral vaccination campaigns to cover all of N'Djaména should be considered as an ethical way of preventing human rabies when post-exposure treatment is of limited availability and high in cost.

Animals↗