Search

Nosocomial Infection (NI) is also observed in healthcare facilities in non-Western countries. The purpose of this report is to describe the findings of a survey undertaken to evaluate hygiene procedures implemented at the "Hopital Principal" in Dakar, Senegal and to assess perception and awareness of nosocomial risk among the hospital staff. A total of 264 healthcare workers were interviewed. Mean age was 39 years (range, 18-60) and the sex ratio was 1.3 (150 men/114 women). Sixty (22.7%) had university degrees, 106 (40.2%) had secondary school diplomas, 50 (18.9%) had attended middle school, and 13 (4.9%) had no schooling. Analysis of interview data showed that 56.1% (157/264) defined NI as infection acquired at the hospital but that only 9.8% (n=26) knew that a minimum 48-hour delay was necessary to distinguish nosocomial from community acquired infection. While understanding about NI was correlated with education level, data showed that 1 out of 3 physicians (13/39) failed to give the exact definition. Hand contact was cited as the second route of transmission. Isolation precautions were understood by 22.7% of personnel (60/264). Systematic handwashing was reported by 363% (96/264) but observation demonstrated that it was not performed properly regardless of the category of personnel. Care protocols were understood by 54.6% of persons interviewed (144/264). A hygiene-training course had been attended by 52.2% (n=138). Two thirds of the staff (69.7%: 54/264) was able to identify the hygiene nurse. Ninety-eight health care providers (37.1%) were familiar with the CLIN (Comités de Lutte contre les Infections Nosocomiales).

The purpose of this study was to analyze self-destructive behavior in adolescents in Senegal. Based on four case reports the authors stress the central importance of family breakdown in the process leading to this behavior as opposed to the first descriptions implicating an offense against the honor of the group. The vulnerability of teenagers in the absence of structural initiation is also advanced. Systematic intervention may be recommended in such cases.

The World Health Organization has proposed the syndromic approach for management of sexually transmissible diseases (STD) in countries where diagnostic laboratory tests are not consistently available. The purpose of this study was to evaluate the effectiveness of this approach for treatment of ureteral discharge in Senegal. Twenty seven men presenting ureteral discharge underwent two-week treatment using a combination of cotrimoxazole plus tetracycline for suspected gonococcal and a chlamydial infections. Ureteral samples were collected before and after treatment to detect Neisseria gonorrhoeae by culture and Chlamydia trachomatis by direct immunofluorescence and ELISA. Results demonstrated successful treatment of all patients presenting gonococcal and chlamydial infections i.e. 84.6% of cases. Neither germ was detected in 15.4% of cases. Before treatment, Neisseria gonorrhoeae, Chlamydia trachomatis or both were found respectively in 53.9%, 5.1% and 25.6% of samples respectively. Based on these findings we conclude that the syndromic approach was effective in 84.6% of cases but treatment was in adequation with STD biologically documented only with 25.6% of cases.

This report describes a case of mental confusion associated with ongoing adenitis and pulmonary tuberculosis in a 20-year-old man with no history of psychiatric disorders. Diagnosis was based on clinical and laboratory findings. Tranquillizers improved mental status and antituberculosis treatment was administered before referring the patient to an internal medicine department. The authors emphasize the rarity of these cases in the Senegalese medical literature and discuss possible diagnostic pitfalls.

Frequency of cranio-encephalic traumatisms in Senegal raises rapidly, mostly as a consequence of the development of motor circulation (54 p. 100 of the cases). Main features observed in other countries are recalled as well as the relation between high mortality and polytraumatisms. Original aspects are related to the conditions prevailing in developing countries, poor public health facilities, delays for transportation and emergency cares. Consequently many fatal cases are not recorded.

In Senegal, traumas of spinal column are characterized not only by their high frequency and their etiology, but also and mainly by the extreme severity of their neurological lesions. A review of 120 traumas of cervical spine revealed: The importance of the neurological lesions (75%). The influence of the factors of severity and of the treatment. Global mortality rate of 35% raises to 46.46%, consequent on neurological lesion and to 85.71% consequent on total tetraplegia.