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Background: In 2017, WHO recognized scabies as a neglected tropical disease. The optimal treatment is not well defined in some communities. Objective: This study aimed to compare ivermectin and benzyl benzoate in the treatment of scabies in Koranic schools (or "daara") in Dakar (region). Methods: This was a prospective randomized trial conducted from January to October 2018 in Senegal. Any resident living in the selected "daara" and diagnosed with scabies was included. The administered treatments were benzyl benzoate (BB) or ivermectin. At the outset, if one case of scabies was diagnosed, all residents received treatment. Ivermectin was given at the dose of 200 mg/kg. The same treatment was repeated on day 7 for each group, the endpoint was at D14, and the data were analyzed with STATA 14. Results: Fifteen "daara" were included. Of the 959 residents, 70 were diagnosed with scabies: prevalence of 7.29%. All patients except one were male; the mean age was 9.98 years (4-17). At D14, in the BB arm, cure rate was 42.85% (n = 15) while in the ivermectin arm, this rate was 5.71% (n = 2) with a significant difference (p = 0.01). On D28, the cure rate was still higher in the BB group 57.14 (n=20) versus ivermectin 21.42 (n = 6) with a significant difference (p = 0.004). On D42, all patients except eight were cured. At D14, we found a link between the cure rate, the number of people in the room (p = 0.01), and the number of showers per week (p = 0.01) but no link with the number of people per "daara" (p = 0.163). At D28, we found a link between the cure rate, the number of people sleeping in the room (p = 0.03), and the number of showers per week (p = 0.01) but not with the number of people per "daara" (p = 0.07). Conclusion: In Koranic schools, the cure rate is higher with benzyl benzoate compared to ivermectin.

Climate change and variability pose significant threats to agricultural production, particularly in regions heavily dependent on rainfed agriculture like Senegal. The problem addressed in this study revolves around the impact of climate-related risks on agricultural yields in the Senegalese Groundnut Basin as a key agricultural region. Daily rainfall, temperatures, and yield over 1991–2020 were used. The data were analyzed using multiple regression, trend analysis, and correlation approaches. The results indicate that the overall seasonal precipitation increases over time (98 mm in the north and 103 mm in the south). However, we found that the south Groundnut Basin has a much slower seasonal precipitation rate than the northern zone. Our results also show that the northern zone exhibits a more consistent and predictable growing season, with onset and offset, in contrast with the southern zone, which shows higher variability. The analysis further reveals that both the northern and southern zones are experiencing a warming trend, with the southern zone showing a more pronounced increase in maximum temperatures (+0.7 °C) than to the northern zone (+0.4 °C). Estimates from the regression analysis revealed that total seasonal precipitation and maximum temperature positively and significantly influence groundnut, millet, and maize yields in the northern and southern zones. All the other weather-related parameters have different influences depending on the zone. These findings highlight the heterogeneous nature of the study area and the significant role climatic factors play in crop yield variability in the Groundnut Basin. Understanding these influences is crucial for developing targeted agricultural strategies and climate adaptation measures to mitigate risks and enhance regional productivity. The study provides valuable insights for policymakers and farmers aiming to improve crop resilience and sustain agricultural outputs amidst changing climatic conditions. [ABSTRACT FROM AUTHOR]

Objective To estimate the use of hospitals for four essential primary care services offered in health centres in low- and middle-income countries and to explore differences in quality between hospitals and health centres. Methods We extracted data from all demographic and health surveys conducted since 2010 on the type of facilities used for obtaining contraceptives, routine antenatal care and care for minor childhood diarrhoea and cough or fever. Using mixed-effects logistic regression models we assessed associations between hospital use and individual and country-level covariates. We assessed competence of care based on the receipt of essential clinical actions during visits. We also analysed three indicators of user experience from countries with available service provision assessment survey data. Findings On average across 56 countries, public hospitals were used as the sole source of care by 16.9% of 126 012 women who obtained contraceptives, 23.1% of 418 236 women who received routine antenatal care, 19.9% of 47 677 children with diarrhoea and 18.5% of 82 082 children with fever or cough. Hospital use was more common in richer countries with higher expenditures on health per capita and among urban residents and wealthier, better-educated women. Antenatal care quality was higher in hospitals in 44 countries. In a subset of eight countries, people using hospitals tended to spend more, report more problems and be somewhat less satisfied with the care received. Conclusion As countries work towards achieving ambitious health goals, they will need to assess care quality and user preferences to deliver effective primary care services that people want to use. [phrase omitted] [phrase omitted] Objectif Evaluer l'utilisation des hopitaux pour quatre services de soins de sante primaires essentiels dans plusieurs centres de sante communautaires situes dans des pays a faible et moyen revenu, et examiner les differences de qualite entre hopitaux et centres de sante communautaires. Methodes Nous avons preleve des donnees provenant de toutes les enquetes demographiques et sanitaires menees depuis 2010 sur le type d'etablissement frequente pour obtenir des moyens contraceptifs, des soins prenatals de routine ainsi qu'une prise en charge de la diarrhee d'importance mineure, la toux ou la fievre chez l'enfant. Nous avons employe des modeles de regression logistique a effets mixtes pour examiner les associations entre le recours aux hopitaux d'une part, et les covariables individuelles et nationales d'autre part. Nous avons mesure le niveau de competence des soins en nous fondant sur la realisation d'actes cliniques essentiels lors des visites. Nous avons egalement analyse trois indicateurs d'experience en tant que patient dans les pays ou nous avons pu acceder aux resultats d'enquetes devaluation des prestations de service. Resultats Selon la moyenne etablie sur 56 pays, les hopitaux publics constituaient l'unique source de soins pour 16,9% des 126 012 femmes qui se sont procure des contraceptifs, 23,1% des 418 236 femmes qui ont requ des soins prenatals de routine, 19,9% des 47 677 enfants atteints de diarrhee et 18,5% des 82 082 enfants souffrant de fievre ou de toux. Le recours aux hopitaux etait plus frequent dans les pays plus riches ou les depenses en soins de sante par habitant etaient plus elevees, mais aussi parmi les citadines et les femmes plus aisees et mieux instruites. La qualite des soins prenatals etait meilleure dans les hopitaux de 44 pays. Dans un sous-groupe de huit pays, les gens qui se rendaient dans les hopitaux avaient tendance a depenser davantage, a signaler plus de problemes et a se montrer moins satisfaits vis-a-vis des soins prodigues. Conclusion A mesure que les pays s'efforceront d'atteindre des objectifs sanitaires ambitieux, ils devront evaluer la qualite des soins et les preferences des patients afin de proposer des services de soins de sante primaires efficaces auxquels les gens voudront faire appel. [phrase omitted] Objetivo Estimar el uso de los hospitales para cuatro servicios esenciales de atencion primaria que se ofrecen en los centros de salud de los paises de ingresos bajos y medios, asi como estudiar las diferencias de calidad entre los hospitales y los centros de salud. Metodos Se obtuvieron los datos de todas las encuestas demograficas y de salud realizadas desde 2010 sobre el tipo de instalaciones que se usan para obtener anticonceptivos, atencion prenatal de rutina y atencion de la diarrea infantil leve y la tos o la fiebre. Se evaluaron las asociaciones entre el uso de los hospitales y las covariables a nivel individual y nacional mediante la aplicacion de modelos de regresion logistica de efectos mixtos. Tambien se evaluo la competencia de la atencion basada en la recepcion de medidas clinicas esenciales durante las consultas. Asimismo, se analizaron tres indicadores de la experiencia de los usuarios de los paises que disponian de datos de encuestas de evaluacion de la prestacion de servicios. Resultados En un promedio de 56 paises, los hospitales publicos fueron usados como la unica fuente de atencion por el 16,9 % de 126 012 mujeres que adquirieron anticonceptivos, el 23,1 % de 418 236 mujeres que recibieron atencion prenatal de rutina, el 19,9 % de 47 677 ninos con diarrea y el 18,5 % de 82 082 ninos con fiebre o tos. El uso de los hospitales fue mas comun en los paises mas ricos con mayores gastos en salud per capita y entre los residentes de las zonas urbanas y las mujeres mas acaudaladas y mejor educadas. La calidad de la atencion prenatal fue superior en los hospitales de 44 paises. En un subconjunto de ocho paises, las personas que acudieron a los hospitales tendian a gastar mas, a reportar mas quejas y a estar algo menos satisfechas con la atencion recibida. Conclusion A medida que los paises se esfuerzan por alcanzar objetivos sanitarios ambiciosos, tendran que evaluar la calidad de la atencion y las preferencias de los usuarios para prestar los servicios de atencion primaria efectivos que las personas pretenden usar., Introduction Achieving universal health coverage (UHC) will require affordable, high-quality primary care that is accessible to all people, at every age. (1) Primary care is recognized as an essential platform [...]

In response to the failure of community-based health insurance (CBHI) at the municipal level, some African countries are implementing district or departmental CBHIs to improve universal health coverage. After creating two CBHIs at the departmental level in 2014, Senegal launched a campaign to disseminate the model in 2022. This article presents the stakeholders' perspectives on the factors and challenges of scaling up CBHI departmentalization in Senegal. The study uses a mixed-methods approach, utilizing concept mapping and a focus group to examine scaling up departmentalization. The sample size consists of 22 individuals involved in the process. The quantitative analysis includes hierarchical cluster analysis, multidimensional scaling analysis, and the Pearson coefficient test. The qualitative analysis involves content analysis to triangulate the findings. Participants identified 125 factors to consider for the departmentalization of CBHI. They were categorized into nine clusters according to their degree of importance (I) and ease to organize (F): service package (I: 4.07; F: 2,26), communication (I: 4.05; F: 2.96), governance (I: 3.96; F: 2,94), human and logistical resources (I: 3.94; F: 2,82), financing (I: 3.90; F: 2,31), involvement of the authorities (I: 3.82; F: 2.75), community involvement (I: 3.81; F: 2.76), membership (I: 3.70; F: 2.24, strategic planning and implementation (I: 3.57; F: 2,62). The main challenges faced were a process perceived as precipitous and vertical and needing more negotiation and consultation. The conditions for accompaniment and public funding availability need to be sufficiently considered. The study proposes avenues for action to promote the scaling up of CBHI departmentalization in Senegal. [ABSTRACT FROM AUTHOR]