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Introduction: Constituting a new body to contribute to improving the health of populations, community health professionals trained at Alioune Diop University in Bambey (Senegal) must integrate into a medicalized health system where curative medicine occupies a place preponderant. Objectives: to appreciate the level of understanding of the concept of community health and the challenge of integrating graduates in community health into the health care system. Methods: This was a qualitative study conducted from February 1 to April 15, 2020, targeting community health professionals and employers. Two tools were used: semi-structured interviews for employers and the focus group for community health professionals. Results: Community health professionals are assimilated by healthcare professionals and by patients to community health workers, although the latter have no professional qualification. The actions used by employers are more akin to public health than to community health. Community health professionals reported the existence of jurisdictional conflicts within the core team of the medical region or health district. The community health professionals greatly appreciated the establishment of the community health program, which according to it should be extended to hospitals and urban populations. Moreover, they would like their recruitment into the public service to strengthen the human resources of the health system. Conclusion: Recommendations have been formulated for an appropriation of this concept by healthcare professionals and decision-makers.

Introduction: Health training community is based on a professionalizing approach which consists of placing on the job market community health professionals with know-how and able to meet the needs of the populations. Goals: Assess with community health professionals the level of adequacy of theoretical and practical training in the field of their training and with employers, the quality and relevance of the skills retained within the framework of the teaching / learning program of these professionals. Methods: This is a qualitative study carried out from February 1 to April 15, 2020, targeting community health professionals (semi-structured interviews) et employers (focus group). The content analysis of the speeches illustrated by the words put in quotation marks by the people surveyed was carried out. Results: Community health professionals have affirmed that there is an adequacy between theoretical and practical training in the field and internships in care and community settings have greatly contributed to making this training professional. The professionalizing nature of this training is confirmed by the employers, that is to say the officials of the Ministry of Health and Social Action but also by non-governmental organizations. They underlined the usefulness of these professionals in the health system. The training model is co-constructed between teachers and employers and the latter's concerns are taken into account. Community health professionals consider it essential to revisit the training model and adapt it to the context of the country. So, it has been proposed to eliminate certain teaching units, to strengthen others, but above all to integrate certain topical issues. With regard to professional integration, it was noted that it is more easily done at the level of non-governmental organizations (NGOs) than at the level of the Ministry of Health and Social Action. Conclusion: Recommendations were formulated for a revision of the model in order to make the training more adapted to the needs of the market, as well as the recruitment of graduates by the Ministry of Health and Social Action.

Introduction: Over the past years, efforts have been made to expand access to antiretroviral combinations (cART) in low-income countries. However, major concerns are noted with drug resistance emergence, as treatment failure result and need to introduce a second line treatment, more expensive and difficult to implement. The objective was to study the incidence of switch to second line, reasons for switch and risk factors using a cohort of people living with HIV in an Ambulatory Treatment Center in Dakar. Methodology: This was a cohort study of people living with HIV under cART from January 2004 to December 2013. Naive patients monitored for at least six months, regardless of their profile and regimen with baseline CD4 counts 3 were included in this study. Results: The median age of the 827 patients included was 44 [IQR = 18 - 78]. The switch to second-line treatment was observed in 72 patients (8.7%) after an average of 38.5 months of follow-up. The overall incidence rate of switch to second line of antiretroviral treatment was 1.59 per 100 persons-years. Most of changes in first-line treatment were motivated by virological failures (n = 60, 83.3%) under treatment with AZT/3TC/NVP (n = 25, 34.7%) or AZT/3TC/EFV21 (29.2%). 9.7% of switch occurred after immunological failure, 1.4% after clinical failure, 4.2% after severe toxicity and 1.4% was not documented. Predictive factors identifying failures at the end of the multivariate analysis were age 3. Conclusions: In total, CTA identified a low incidence rate of treatment failure of the first line of treatment. Associated risk factors were age 3 and high viral load at treatment initiation.

To cope with the aging of the population on the horizon in Africa and in particular in Senegal, it is important to set up geronto-geriatric policies adapted to our socio-economic and health context. Thus, in the field of health, the medical and health protection of the elderly, should have a double requirement which consists on the one hand, to prevent the loss of autonomy and on the other hand, in case of illness, even minor, to early diagnosis and appropriate treatment before cascading lesions occur. The main principles or guidelines for a geriatric strategy in Senegal in particular and in Africa in general could be articulated around a policy of home care; the integration of geronto-geriatrics with primary health care, specialized consultation, psychomotor rehabilitation, traditional medico-surgical hospitalization and housing for the elderly. However, any medical and health action in favor of the elderly must first give priority to prevention without neglecting the curative aspect. Thus, this action to be effective should focus on maintaining the home and the family of the elderly, through an urbanization policy that should make possible the cohabitation of ages. On the other hand, the creation of services exclusively reserved for the elderly should for the moment be excluded, since it is culturally inappropriate and economically difficult to implement. It should be emphasized that this medical and health protection for the elderly will require the provision of additional financial resources. However, the organization that will have to cover the cost of this care has yet to be defined.

The objective of this work was to study among former Senegalese footballers their state of health and their socio-economic situation, an expression of appreciation of their professional retraining. This was a cross-sectional descriptive study from October 2015 to April 2016. Our population consisted of former footballers who played in the Senegalese national championship in the first division or were expatriates, honoring or not a selection in the national team. The cohort consisted of 100 retired footballers, the average age was 57, the average age of sports retirement at 31.8 years, the average duration of sport at 25 years; 56% of respondents had at least one risk factor, 28% reported sports-related conditions, 77% said they did not have reconversion and / or economic difficulties, but only 18% actually expressed the wish that their children become footballers. Older age was the main reason for sports retreat (49%) but 67% of subjects continued to play sports. However, it was noted that the number of risk factors increased with advancing age and longer sporting life and that lean body mass decreased with both indicators. In addition, subjects who engaged in regular physical activity had fewer risk factors and had more lean body mass. This study confirms the positive impact of sports practice in the prevention of risk factors and recommendations have been made to improve the living conditions of former athletes.