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PubMed2004

[Participatory mapping as a tool for public health decision-making in nomadic settings. A case study among Dazagada pastoralists of the Bahr-el-Ghazal region in Chad].

Integrating the strategies of the point of view of nomadic breeders of cattle into a geographic information system (GIS) highlights the complexity of the temporospatial context associated with point of view of nding health care seeking by nomadic pastoralists. The method used in this study was based on a combination of participatory mapping with group discussions and semi-structured interviews. The resulting data allowed georeferencing of the pastoral environment in the inner Lake Chad Basin according to the representation of Dazagada pastoralists of the Bahr-el-Ghazal region (Kanem, Tchad). By providing better insight into the day-to-day life of nomadic people determining their capacities to make use of primary health care, this holistic approach provides a tool to assist public health decision-makers in optimizing the use of health care facilities by nomadic communities.

Animal Husbandry↗
PubMed2004

[Indentification of institutional factors affecting the well-being of sedentary and nomadic populations living in the Waza-Logone flood plain along the border between Cameroon and Chad].

This article describes an ongoing research project designed to compile a database to promote pastoral development in the lowlands along the Logone and Chari Rivers in Cameroon. A number of sedentary and nomadic populations depend on these flood plains south of Lake Chad for their livelihood. However the natural resources of the area undergo sharp seasonal variations and sometimes become the property of sedentary groups. As a result nomadic communities experience difficulty not only in gaining access to grazing lands and water but also to quality health care (hospital centers, effective medication). The purpose of this study was to define institutional requirements necessary to ensure access to health care resources for both nomadic and sedentary groups. The main problem for the nomadic population is that, unlike the now defunct pre-colonial structures, today's institutions are not compatible with the subsistence strategies of rural populations. These findings suggest that new institutional frameworks for natural resource management could indirectly improve the health status of nomadic pastoralist.

Cameroon↗
PubMed2004

[First isolation of tuberculous mycobacteria in man and animals in Chad].

This report describes the first successful isolation and identification of mycobacterial infection in humans and animals of Chad. All mycobacterial strains from human specimens were M. tuberculosis and strains from animal specimens (cattle) were M. bovis. None of the 10 of M. tuberculosis strains tested for antibiotic resistance were multidrug resistant. Due to the intrinsic resistance of M. bovis to pyrazinamide and the growing number of tuberculosis cases in HIV-infected people in Africa and elsewhere, more information on the potential of M. bovis for human infection is needed to guide disease control policy.

Animals↗
PubMed2004

[An innovative approach combining human and animal vaccination campaigns in nomadic settings of Chad: experiences and costs].

The purpose of this report is to describe a network of public health care workers, veterinarians and nomadic pastoralists that was set up in Chad to increase vaccination coverage to nomadic children and women who had rarely been vaccinated before. The objectives of the project were to provide human vaccination in conjunction with existing veterinary services, to evaluate the feasibility and limitations of such campaigns, to determine what other services could be provided concurrently, and to estimate the savings for public health care cases in comparison with carrying out vaccination separately. In a series of 12 vaccination campaigns in the Chari-Baguirmi and Kanem districts, more than 2100 children, 2100 women and 52000 cattle were fully immunized. These results confirmed the feasibility of joint campaigns in nomadic settings and provided important experience for improving organization. Information-Education-Communication (IEC) campaigns adapted to the realities of the pastoral setting were an important factor in mobilizing nomadic pastoralists for attendance at vaccination clinics. The savings in logistics costs (i.e., personnel, transportation and cold chain costs excluding vaccine costs) was 15% in Gredaya where 3 out of 6 campaigns were carried out together with veterinarians and 4% in Chaddra/Am Dobak where only 1 out of 6 campaigns was carried out in conjunction with veterinarians. The cost per fully immunized child (FIC) was considerably higher in Chaddra/Am Dobak than Gredaya (EUR 29.2 vs. EUR 11.5). The joint vaccination campaign approach is innovative, appreciated by nomadic pastoralists and less expensive than separate vaccination. By using the mobility of veterinarians in remote zones far from health care facilities, vaccination can be provided to nomadic children and women in countries with limited resources.

Adolescent↗
PubMed1990

[Hyperthyroidism in Chad and its treatment. 16 cases of which 10 were treated surgically in 1984-1985 in N'Djamena].

Sixteen patients with thyrotoxicosis were admitted during a period of eighteen months (1984-1985) in Central Hospital of N'Djamena (Chad). Clinical features, laboratory investigations are reported. Ten patients had a surgical treatment:subtotal thyroidectomy. A review of literature in Africa was made. Whereas thyrotoxicosis was rare among Africans before 1970, there has been an increase of frequency for twenty years. Many hypotheses are proposed, among them the possibility of the role of Epstein-Barr's virus, frequent in Africa.

Adolescent↗
PubMedDate not supplied

[Epidemiological aspects of human African trypanosomiasis in south Chad].

The authors are recording results of a clinical, parasitological and immunological sample survey about african human trypanosomiasis in the South Chad where old focus has been reexplored. In 1988 the situation ever remains as a problem in some areas (Tapol, Ranga) where high prevalence rates are found again.

Adolescent↗
PubMedDate not supplied

[Anthrax in Chad: a zoonosis that still exists today].

An epidemic of human and animal anthrax raged in Chad mainly in the Department of Chari Baguirmi from September to December 1988, infesting more than 50% of donkeys and horses. 716 human cases have been reported, with 88 deaths. Thanks to a geographical distribution of animal and human prevalence, one sees immediately the interdependency between sanitary state of live-stock and public health. An unusual means of transmission from donkey to donkey by insects as the vector is suggested to explain the intensity of animal epidemics. Two strains of B. anthracis were isolated and described. Systematic annual prophylactic inoculation of the live-stock is recommended, and also resumption of research to create a polyvalent vaccine for cattle plague/peripneumonia and anthrax.

Adolescent↗
PubMedDate not supplied

[The focus of human African trypanosomiasis in Moissala (Chad): prospective study of 16 villages using the direct card agglutination test (Testryp CATT) and the ion exchange mini-column (mAECT)].

The authors report on the results of a case finding survey of human African trypanosomiasis (HAT) within the focus of Moissala (Chad). 2,947 agglutination card-tests (Testryp CATT) have been performed and among them, 19 were confirmed by parasitologic test, either in gland juice or with an ion exchange minicolumn.

Adolescent↗
PubMedDate not supplied

[Acute epidemic non-A, non-B hepatitis: clinical study of 38 cases seen in Chad].

An epidemic of acute non-A, non-B hepatitis (NANBH), observed in 38 young French soldiers in Chad, presumed to be waterborne, allowed to describe the clinical picture of the disease. The main features of this entity were compared with those observed during previously described outbreaks of waterborne NANBH encountered in North Africa and in Asia as well as with 85 cases of viral type A hepatitis of various other geographical origins, observed during the same period of time. Similarities between the clinical features of the disease within every water-transmitted NANBH epidemic center were suggestive of a particular nosologic entity among the non-parenterally transmitted cases of NANBH. In young male subjects, the course of the disease proved to be milder than that of type A viral hepatitis. A 5 ml dose of non-specific French-prepared human immunoglobulins had no prophylactic effects on the disease.

Acute Disease↗
PubMed1988

[Epidemiology of Bietti's keratopathy. Study of risk factors in Central Africa (Chad)].

Climatic Droplet keratopathy (synonyms: spheroidal degeneration, Bietti's keratopathy) is a corneal degeneration characterized by an opacification at the level of the Bowman's membrane in the area of the palpebral fissure. It is particularly common in areas of bright sunlight and in Labrador; ultraviolet light thus being thought at its genesis. Two objectives were included in this study: studying the Climatic Droplet Keratopathy (CDK) prevalence by looking for the influence of the climatic factor; looking for possible association with three other degenerative ocular diseases: cataract, open-angle, glaucoma and exfoliation syndrome. A random cluster sampling survey was carried out in different climatic areas in Chad (N = 3,241 people). The resulting analysis showed a significant relation between the CDK prevalence and the kind of climate: the more the climate is dry; the more the higher the frequency: subdesert area = 1.57%, Sahelian area = 0.73%, tropical area = 0.18% (p less than 0.0001, rate standardized to age). The CDK occurs earlier in the subdesert area (mean age = 60.0) than in the Sahelian one (mean age = 66.7) (p less than 0.05). The CDK only exists among people age 40 or older, and is more frequent among males than females (p less than 0.005). The cataract is more frequent among individuals having a CDK than among those without it: relative risk = 4.3 (C.I.: 2.3-7.9 p less than 0.00001) (Mantel-Haenszel's method with adjustment to climate, age and sex). As for open-angle glaucoma, it is more frequent among individuals suffering from CDK: relative risk = 4.2 (p = 0.05). Finally, we noticed that the exfoliation syndrome was 5 times more frequent among chadians suffering from a CDK (p less than 0.02).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMedDate not supplied

[Epidemiological aspects of xerophthalmia in Chad].

An epidemiologic survey by random cluster sampling was carried out in Chad. Its purpose was to evaluate the importance of xerophthalmia. 3.002 children under 10 years of age were surveyed for two different periods: in 1984 after the drought striking the Sahelian zone and in 1985 after a normal crop. Computerization of the results according to nutritional circumstances and geographical distribution demonstrated that avitaminosis is a true Public Health problem, whatever climatic zones, food products and nutritional conditions are. However situation worsens during a drought and calls for an emergency distribution of vitamin A to the most-in-need populations.

Chad↗
PubMed1971

Microfilaruria in onchocerciasis. A clinical and epidemiological follow-up study in the Republic of Chad.

Microfilariae of O. volvulus were recovered from the urine of 11% of the residents of a village in the Republic of Chad where onchocerciasis was holoendemic. A follow-up study of the same population 3 years after the original investigation revealed that microfilaruria was still present and that living microfilariae of O. volvulus could be recovered from small urine samples obtained by high catherization of the ureters. Radiological changes consistent with chronic pyelitis were found in 4 out of 14 persons with microfilaruria who were examined by retrograde pyelography. The recovery of microfilariae in the urine was associated with the intensity of the infection, as determined by counts of microfilariae in skin snips and the number of onchocercomata. A systematic comparison for differences between onchocerciasis patients with and without microfilaruria revealed that the microfilaruria patients had a low weight: height ratio, deficient antibody responses in indirect haemagglutination tests with O. volvulus antigen, elevated serum aminotransferase levels, and reduced systolic blood pressure.

Adolescent↗
PubMed1978

Epidemiology of poly-parasitism. I. Occurrence, frequency and distribution of multiple infections in rural communities in Chad, Peru, Afghanistan, and Zaire.

Parasitic diseases are predominantly rural diseases. They are often associated with poverty, illiteracy, poor sanitation and high risks of exposure to environmental and biological hazards. Because these factors are also essential determinants in the epidemiology of a variety of other infections with quite different etiologies, occurrence of multiple infections in the same people is common. In the tropics, polyparasitism may involve diseases of major public health inportance such as malaria, schistosomiasis, filarial infections, trypanosomiasis, and others. The paper presents data on the frequency and types of multiple infections with different parasitic and other infectious agents for thirteen villages of Chad, Peru and Afghanistan. The age and sex patterns of a number of observed combinations of parasitic and other diseases are shown for different ecological zones. Concomitant infections with up to five species of filarial worms are found in residents of villages in the Congo River Basin of Zaire. The specific types of combinations of these infections vary from place to place and appear to be closely linked to ecological factors.

Afghanistan↗
PubMed1994

[Anemia in infants less than 1 year old in Moundou, Chad: prevalence and etiology].

In order to evaluate the prevalence of anemia in infants under one year of age and ascertain the main etiologic factors, a survey was conducted in Moundou, Chad at the end of the rainy season. Tests were performed in 144 infants to determine hemoglobin levels, mean erythrocyte volume, transferrin saturation coefficient, serum iron level, Plasmodium positivity on blood smears, and nutritional status according to GOMEZ. Using the criteria defined by the World Health Organization, 139 infants were diagnosed as anemic including 19 cases classified as severe (hemoglobin level less than 5 g/dl). In addition, 32 of the 141 infants studied (22.7%) presented iron deficiency confirmed by two positive indicators. Serology demonstrated malaria in 45% of infants. Mean hemoglobin levels were significantly lower in infants with positive blood smears and this lowering increased the higher serum parasite levels. Nutritional status was directly correlated with hemoglobin level. This data suggests that malaria plays a major etiologic role in anemia in infants particularly severe anemia. This finding justifies use of antimalarial chemoprophylaxis in infants and the Centers for the Extended Vaccination Program provide the framework.

Adult↗
PubMed1994

[Improvement of the productivity of goats in the periurban zone of N'Djamena (Chad). Choice of measures following an ecopathological inquiry].

A goat herd follow-up and an ecopathological survey on respiratory diseases were undertaken in Chad. Late puberty and high mortality were highlighted by the follow-up. Diseases were frequent and depended on the season. Few risk factors of respiratory diseases were shown by the ecopathological survey. Mortality was connected with 3 parasitic and infectious factors. Decreasing the age at puberty and the mortality rate are priorities. Measures to achieve these aims are well known. They must be set up within a development program, in interaction with research, for a good use by the goat farmer.

Animals↗
PubMed1993

[Ecopathological survey on pneumopathies in goats during the dry cold season in Chad: methodological aspects].

The authors describe the methodology used in an ecopathological survey of goat pneumopathies in periurban area of N'Djamena (Chad) during the dry, cold season of 1991-1992. The choice of farms was made after a typology survey. A total of 3,500 small ruminants (85% of goats) belonging to 60 farms were identified and the performance and health of the animals examined from August 1991. The protocol used for collecting information and the strategy applied to the analysis of data were based on conceptual pre-models of analysis corresponding to the 3 observations scales used, i.e. goat, concession flock, day flock. The survey took place from December 1991 to March 1992. The difficulties of the statistical interpretation of the data, are emphasized. The biological significance of the risk factors is discussed. Measures for obtaining improvements should take into account the cost/profit ratio and the technical and financial possibilities of the farmers.

Animals↗
PubMed1993

[Effect of 2 vaccination strategies on developments during the epidemic of meningococcal A meningitis in N'Djamena (Chad) in 1988].

From February till May 1988, during an epidemic of group-A meningococcal disease, 4542 cases of meningitis were reported in N'Djamena, the capital of Chad (550,000 inhabitants). A first selective vaccination campaign was carried out between 5 and 14 March; 156,500 vaccine doses (polyvalent: group A and C: Institut Mérieux) were given using jet injectors. The target population for this first campaign consisted of groups such as school-children and the armed forces. As the epidemic continued, a mass vaccination campaign was implemented one month later between 8 and 14 April 1988; this was targeted at the whole population above 1 year of age, not previously immunized, and 266,738 doses of vaccine were injected. One week after the start of the second campaign, the number of reported cases fell sharply and, within four weeks, the epidemic was halted. The vaccination coverage rate, evaluated by a WHO cluster survey method in people above one year of age, was 95.5%. These results show (i) the failure of selective vaccination, restricted to only at-risk groups, to halt the epidemic; (ii) the efficacy of the mass vaccination campaign aimed at the whole population; and (iii) the feasibility in tropical Africa of such a mass campaign which must be carried out in a few days.

Adolescent↗