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Objectif : Decrire l’etat de sante psychique et le handicap des enfants confies a l’Aide sociale a l’enfance (ASE) dans les Bouches-du-Rhone (BDR).Methodes : ESSPER-ASE13 (Etude de la sante somatique et psychique des enfants relevant de l’ASE des BDR) est une enquete descriptive transversale menee entre avril 2013 et avril 2014 aupres de 1 092 enfants âges de moins de 18 ans a l’ASE des BDR, places en maisons d’enfants a caractere social ou chez un assistant familial. Les donnees etudiees concernaient l’etat de sante somatique, psychique, le handicap et les modalites du suivi medical des enfants. Cette etude analyse specifiquement l’etat de sante psychique et le handicap.Resultats : Les antecedents psychiatriques concernaient 22 % des enfants confies. Ils etaient domines par les troubles anxieux (44 %), les troubles du comportement (44 %), puis les troubles d’hyperactivite avec deficit de l’attention (16 %). Un enfant sur cinq beneficiait d’une notification MDPH (Maison departementale des personnes handicapees). Les deux principaux types de handicap retrouves etaient les troubles du developpement psychologique (61 %) et les troubles du comportement et troubles emotionnels (20 %).Conclusion : La surrepresentation des pathologies psychiatriques et du handicap des enfants de l’ASE rend necessaire une adaptation du depistage et une optimisation de la coordination des soins de ces enfants.

Objectif : Decrire le parcours de sante des enfants confies a l’Aide Sociale a l’Enfance dans les Bouches-du-Rhone et proposer des preconisations pour ameliorer le parcours de sante des enfants confies.Methodes : Cet article presente des donnees issues de l’enquete ESSPER-ASE 13, enquete descriptive et transversale menee entre avril 2013 et avril 2014 aupres de 1 092 enfants âges de moins de 18 ans confies a l’Aide Sociale a l’Enfance en Maison d’Enfants a Caractere Social ou chez un assistant familial dans les Bouches-du-Rhone. Les donnees etudiees concernaient l’etat de sante somatique, psychique et les modalites du suivi medical des enfants. Cet article se centre sur le parcours de sante.Resultats : Un medecin generaliste suivait 82 % des enfants alors que la Protection Maternelle et Infantile suivait 15 % des enfants, essentiellement les enfants de moins de six ans confies a un assistant familial. Le parcours de sante des enfants etait constitue de multiples intervenants et etait domine par le suivi psychologique. En moyenne les enfants etaient suivis par deux professionnels (medecin specialiste ou personnel paramedical) en plus du medecin examinateur. En matiere de prevention, les enfants presentaient des taux de couverture vaccinale superieurs aux taux nationaux.Conclusions : La coordination des nombreux acteurs de la sante des enfants est indispensable, autour notamment de la creation d’un medecin referent.

To describe the mental health and disability of foster children in the Bouches-du-Rhône (BDR) department.ESSPER-ASE 13 studied the physical and mental health of children managed by Child Welfare Services (CWS) of the BDR department. This descriptive cross-sectional survey was carried out from April 2013 to April 2014 and included 1,092 children placed in foster homes or in the custody of child care assistants. This survey explored the physical and mental health of the children and the characteristics of their medical follow-up. This article focuses on the mental health and disability of foster children.Psychiatric disorders were identified in 22% of foster children, predominantly consisting of anxiety disorders (44%), behavioural disorders (44%), and attention deficit hyperactivity disorders (16%). 20% of children received MDPH (French Departmental Home for Disabled Persons) notification. The two main types of disability were psychological development disorders (61%) and emotional disorders (20%).The over-representation of severe psychiatric disorders and disabilities among foster children calls for enhanced diagnosis and optimization of care.

To describe the care pathway of children managed by the Bouches-du-Rhône Child Welfare Services and to propose ways to improve this care pathway.ESSPER-ASE 13 survey is a descriptive and cross-sectional survey carried out between April 2013 and April 2014, which included 1,092 children under the age of 18 years placed in a Bouches-du-Rhône Child Welfare Services children's home or foster care. This survey studied the physical and mental health and the medical follow-up characteristics of these children. This article focuses on care pathway data.82% of children were followed by general practitioners, while 15% of children, essentially children under the age of 6 years in child care, were followed by Maternal and Infant Protection (Protection Maternelle et Infantile). The care pathway of these children involved multiple actors and was dominated by psychological follow-up. On average, the children were followed by 2 professionals (specialist or paramedical professional) in addition to the medical examiner. In terms of prevention, children's immunization coverage rates were better than national rates.Coordination of the numerous actors is essential, including the creation of a referring physician.

Cette etude pilote europeenne avait pour but d’evaluer les connaissances, les attitudes et les croyances du personnel penitentiaire de 5 pays face au VIH et d’identifier les facteurs associes a la discrimination potentielle des detenus seropositifs. Elle a montre des niveaux de connaissances des modes de transmission et de tolerance variant significativement selon les etablissements. Une forte proportion de surveillants surestiment la prevalence du VIH dans leur etablissement et craignent d’etre contamines. Les surveillants qui veulent connaitre le statut serologique des detenus sont peu tolerants mais ont connaissance des modes de transmission. L’etude souligne la necessite d’ameliorer la politique de prevention en milieu penitentiaire en direction des surveillants pour renforcer les bonnes pratiques en matiere de gestion du risque de contamination et pour eviter une discrimination a l’egard des detenus.

Despite the high prevalence of hepatitis C in France ( approximately 1.2%), a large proportion of people infected with hepatitis C virus (HCV) are not known aware of their status. The objective of this study was to investigate the factors related to screening in general medicine.Three hundred and one general practitioners were interviewed by phone in South-Eastern France about their HCV screening practices, knowledge of the epidemic, of the natural course of the disease, and opinions about health care for people infected with HCV.While general practitioners often offered HCV screening to intravenous drug users, screening for people who had received blood transfusion, and identification of risk factors among patients were not satisfactory. Multivariate analysis showed that certain characteristics in general practitioners were negatively and independently related to the frequency of HCV screening, especially: general practitioners older than 40 (odds-ratio: 3.12), general practitioners who did not care for intravenous drug users (odds-ratio: 2.24) and did not prescribe human immunodeficiency virus tests (odds-ratio: 5.55). Other characteristics such as awareness of the course of hepatitis C and health care were also associated with HCV screening. Conversely knowledge of the size of the epidemic was not related to better HCV screening practices.Our study shows that knowledge about the size of the epidemic and the natural history of hepatitis C, HCV screening practices and investigation of risk factors among patients are not satisfactory among South-eastern French general practitioners. Although HCV screening and health care must be improved among intravenous drug users, hepatitis C should not be considered as a disease of injecting drug users only by general practitioners and the population. Efforts should be made so that hepatitis C is recognized as a global public health issue, and training of general practitioners should be improved to investigate risk factors and offer HCV screening instead of merely dramatizing the situation.