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Introduction: Unconjugated bilirubin jaundice is a common symptom in neonatal period. In some babies, excessive serum bilirubin concentrations can place them at risk of acute bilirubin encephalopathy (BE) when the unconjugated pigment crosses the blood-brain barrier. Our study aimed to describe epidemiology, diagnosis and prognosis of BE at the Neonatology Department of Albert Royer Children’s Hospital of Dakar. Materials and Methods: It was a retrospective, descriptive study of cases of BE from January 1, 2015 to June 30, 2019. Obstetric and perinatal data as well as postnatal jaundice data (onset time, associated signs, signs of encephalopathy, treatment and evolution) were collected and analyzed by SPSS software version 2.0. Almost all newborns (27 cases; 90%) were exclusively breastfed. At admission, all children exhibited blunt jaundice and signs of encephalopathy dominated by the abolition of archaic reflexes (76.7%), low suction (22 cases; 73.3%), central apnea (12 cases, 40%). The mean serum bilirubinemia was 322 mg/litre. Neonatal infection (10 cases; 33.3%) and fetal-maternal incompatibility (16 cases; 53.3%) were the main causes. All children received intensive phototherapy and exsanguino transfusion was performed for 7 newborns (23.3%). Nine children died (30% mortality rate). Conclusion: Only better organisation of perinatal care with enhanced postnatal follow-up can reduce the incidence of EB.

Building on the results of Ref. \cite{faye2018phase}, which identified an antiferromagnetic and Kondo singlet phases on the Kondo-Hubbard square lattice, we use the variational cluster approximation (VCA) to investigate the competition between these phases on a two-dimensional triangular lattice with $120^{o}$ spin orientation. In addition to the antiferromagnetic exchange interaction $J_{\perp}$ between the localized (impurity) and conduction (itinerant) electrons, our model includes the local repulsion $U$ of the conduction electrons and the Heisenberg interaction $J_H$ between the impurities. At half-filling, we obtain the quantum phase diagrams in both planes $(J_{\perp}, U J_{\perp})$ and $(J_{\perp}, J_{H})$. We identify a long-range, three-sublattice, spiral magnetic order which dominates the phase diagrams for small $J_{\perp}$ and moderate $U$, while a Kondo singlet phase becomes more stable at large $J_{\perp}$. The transition from the spiral magnetic order to the Kondo singlet phase is a second-order phase transition. In the $(J_{\perp}, J_{H})$ plane, we observe that the effect of $J_H$ is to reduce the Kondo singlet phase, giving more room to the spiral magnetic order phase. It also introduces some small magnetic oscillations of the spiral magnetic order parameter. At finite doping and when spiral magnetism is ignored, we find superconductivity with symmetry order parameter $d+id$, which breaks time reversal symmetry. The superconducting order parameter has a dome centered at around $5\%$ hole doping, and its amplitude decreases with increasing $J_{\perp}$. We show that spiral magnetism can coexist with $d+id$ state and that superconductivity is suppressed, indicating that these two phases are in competition., 7 pages, 5 figures

International audience; Experimental data on precipitation chemistry were collected at a semi-arid savanna in Senegal (Dahra) in 2013, 2014 and 2017. The chemical composition of precipitation was analyzed for inorganic and organic ions, using ionic chromatography. The pH values of precipitation range from 4.50 to 8.50 with 89% of the samples having basic pH. The composition of precipitation was controlled by four source contributions: marine, terrigenous, biogenic, and organic acids emissions from vegetation. The terrigenous contribution was the highest accounting for 42% of the total annual Volume Weighted Mean ionic concentrations, due to the proximity of the Saharan desert, followed by the marine source representing 36%, due to the location of Dahra close to the Atlantic Ocean. Nitrogenous (N) contribution represents 16% of the mean annual total ionic charge, from biogenic sources and livestock crossing the site all year round. Finally, the lowest contribution is from organic acidity (5%), due to the low density of vegetation especially during the dry season. Wet deposition fluxes in Dahra for all compounds show larger values than at other Sahelian savanna sites. Dry N deposition in Dahra was also estimated by inferential method using gas concentration measurements and modeled dry deposition velocities. The total N deposition fluxes (wet plus dry) range from 3.80 to 4.81 kgN ha-1 yr-1 , comparable to fluxes at other semi-arid savannas in Niger and Mali. Wet deposition contributed with 37-53% of the total N flux, suggesting that wet N deposition is equally important to dry deposition fluxes for direct N loading to savanna ecosystems in the Sahel, with a large contribution of reduced compounds. This study shows that Dahra presents a precipitation chemistry composition with characteristics close to those from other Sahelian sites, with however the specificity of being more influenced by the proximity of the Atlantic ocean and the presence of livestock year round.

Resume Introduction La drepanocytose pose un probleme de sante publique au Senegal. Elle concerne principalement les enfants et les adolescents. L’objectif de notre travail etait de determiner les profils epidemiologiques, cliniques et hematologiques de la drepanocytose homozygote SS dans une cohorte d’enfants suivis a l’hopital de la paix de Ziguinchor. Patients et methodes Il s’agit d’une etude retrospective portant sur des dossiers d’enfants drepanocytaires. Etaient inclus dans l’etude, les enfants drepanocytaires SS âges entre deux mois et 21 ans, recus en phase intercritique durant la periode allant du 1er janvier 2015 au 31 aout 2017. La phase intercritique etait definie par l’absence de fievre, de douleur osseuse ou abdominale et d’hemolyse aigue. N’etaient pas inclus dans l’etude les heterozygotes composites (SC, S beta-thalassemie). Les parametres etudies etaient les donnees sociodemographiques, epidemiologiques, cliniques et hematologiques. Resultats Nous avons collige 46 (20 filles et 26 garcons) dossiers d’enfants drepanocytaires SS. L’âge moyen des enfants etait de huit ans [11 mois–21 ans]. Environ un tiers des enfants avaient un âge superieur ou egal a cinq ans. L’âge moyen des enfants a la premiere crise etait de 35,5 mois [7–192 mois]. Plus de un tiers des enfants avaient fait une premiere crise avant le deuxieme anniversaire. Le type de la premiere crise, etait domine par la crise vaso-occlusive (32,6 %) suivi du syndrome pied-main (30,4 %). Les signes cliniques en phase intercritique etaient la pâleur 95,6 %), l’ictere (36,9 %) et la splenomegalie (21,7 %). A l’hemogramme, le nombre de globules blancs moyen etait de 12 465 leucocytes/mm3 [5340–26 900]. L’hyperleucocytose, superieure a 10 000 leucocytes/mm3, etait retrouvee chez 34 malades (soit 73,9 %). La totalite des malades presentait une anemie avec une moyenne de 8,6 g/dL [05,7–11,8]. Le taux d’hemoglobine S variait entre 54,6 % et 98,4 %. Conclusion Le diagnostic et la prise en charge medicale de la drepanocytose SS sont tardifs a Ziguinchor. Le depistage neonatal pourrait ameliorer le diagnostic et favoriser une prise en charge precoce dans la region.

Introduction Cette proposition de communication s’inscrit dans le cadre d’une activite transfrontaliere du programme europeen ProspectSaso en Cerdagne. La Cerdagne est peuplee d’une population franco-catalane caracterisee par son unite physique, culturelle et economique. Dans ce territoire, les Francais et les Catalans sont relies par une multitude de liens sociaux. On y trouve aussi des professionnels et des usagers venus d’autres regions espagnoles et francaises. Le theme relatif a l’acces aux soins et aux services de sante est marque par son actualite, particulierement dans les zones transfrontalieres. En effet, la problematique des effets-frontieres demeure un probleme majeur de sante publique. Les principaux obstacles a la cooperation transfrontaliere en matiere de sante sont administratifs, reglementaires et financiers (Raymonde S., Regis K., 2010). L’impact de la frontiere internationale en Cerdagne est particulierement sensible sur les parcours de sante et sur l’accompagnement social et medicosocial des personnes âgees et tres âgees. Pour ameliorer leur prise en charge a domicile et/ou en etablissement, les acteurs transfrontaliers ont exprime pendant les differentes rencontres un besoin d’harmonisation et/ou d’articulation des pratiques professionnelles. Des conventions cadres existent deja dans ce territoire transfrontalier. Elles visent a ameliorer les conditions d’acces a l’offre de soins de la population transfrontaliere et a simplifier les demarches administratives. Malgre ces avancees, des differences ont ete constatees dans les pratiques professionnelles et dans les approches de prise en charge des personnes âgees. Methode Cette etude s’inscrit dans le champ de la gerontologie. Elle consiste a reperer et analyser les effets frontieres dans les parcours de soins et de sante des personnes âgees a domicile et en etablissement. Comment les professionnels transfrontaliers prennent en charge l’usager dans son parcours de soins et de sante ? Quels sont les effets frontieres qui impactent les pratiques professionnelles et l’accessibilite aux soins ? Quelle conception du vieillissement peut-on partager pour ameliorer la prise en charge des personnes âgees de part et d’autre de la frontiere ? Face a ces interrogations, un groupe de travail pluridisciplinaire et transfrontalier, compose de chercheurs, de professionnels de sante, de responsables d’etablissements, d’associations et de representants des usagers, a ete cree. Son objectif est de realiser une analyse transculturelle permettant de reperer et d’analyser les difficultes rencontrees par les professionnels et les usagers dans les parcours de soin et de sante. Resultats Les resultats obtenus sont classes par thematiques en fonctions des difficultes rencontrees par les professionnels et les usagers : hospitalisation et hebergement, pratiques professionnelles, dimension culturelle et linguistique, flux transfrontaliers, financement des soins, offres de services et acces aux services sanitaires de base. Sur chacune de ces thematiques des effets frontieres ont ete identifies et des reponses proposees pour ameliorer l’accessibilite aux soins des populations de la Cerdagne.

Introduction Les infections respiratoires aigues avaient fait l’objet de nombreuses directives de l’OMS durant la decennie 1980–1990, les pneumonies demeurent toujours la premiere cause de mortalite chez les enfants de moins de 5 ans dans le monde. L’objectif de cette etude etait de decrire les aspects epidemiologiques, cliniques, microbiologiques, therapeutiques et evolutifs des infections respiratoires aigues de l’enfant. Methodes Il s’agissait d’une etude prospective descriptive allant du premier juillet 2017 au 1er juin 2018 au centre hospitalier Albert-Royer de Dakar. Ont ete inclus, les enfants âges 0 a 15 ans hospitalises pour pathologies respiratoires evoluant depuis moins de 10 jours. Des prelevements rhino-pharynges ont ete effectues afin de rechercher le ou les germes en cause. Le recueil a ete fait via un formulaire et l’analyse avec le logiciel EPI info 7.0 et le logiciel R3.4.4. Resultats Au total, 90 patients ont ete inclus. Le sex-ratio etait de 2,2 en faveur du sexe masculin. L’âge moyen etait 23,1 mois avec un ecart type de 28,4 mois. Les hospitalisations les plus frequentes ont ete retrouvees durant les mois de janvier, de mars et d’aout avec une proportion de 17,4 % pour chacun. La dyspnee etait objectivee chez 79,3 % (65 cas). La saturation a l’air ambiant moyenne etait de 88,8 %. Parmi les diagnostics retenus, la pneumonie etait predominante et retrouvee chez 31 des cas soit une prevalence de 37,4 %, suivie de la bronchiolite aigue et de la broncho-pneumopathie avec respectivement 17,3 et 17,2 %. La majorite des tests virologiques etait positive dans 81,1 % des prelevements. Les prelevements presentant un seul germe etaient predominants dans 61,6 % des cas et le virus respiratoire syncytial etait le plus representatif avec 33,3 %. Sur les prelevements avec une bacterie retrouvee, Klebsiella pneumoniae etait la plus representative avec 29,2 %. L’antibiotherapie a ete administree chez 70 % des cas, la corticotherapie chez 42,2 %, l’oxygenotherapie chez 33,3 % et la kinesitherapie chez 18,9 %. Seul 2 deces avaient ete constates, soit 2,2 %. Conclusion Les infections respiratoires aigues de l’enfant posent un veritable probleme de sante publique necessitant une actualisation des donnees microbiologiques. Le traitement doit etre precoce et adapter en fonction du germe retrouve.

Introduction La pollution atmospherique constitue un enjeu planetaire de sante publique. Ces dernieres annees nous avons constate une forte augmentation des cas de crise d’asthme chez l’enfant au CHNEAR. L’objectif de notre etude d’evaluer le role de la pollution particulaire sur la survenue des cas de crises aux urgences du CHNEAR mais egalement d’effectuer une correlation entre les pics de pollutions particulaire et les crises d’asthme aigues chez l’enfant. Methodes Etude retrospective menee du 1er janvier 2011 au 31 decembre 2016. Tous les enfants âges de 0 a 15 ans ayant consulte pour crise d’asthme aigue aux Urgences du CHNEAR etaient inclus. Les donnees particulaires (PM10 et PM2.5) ont ete fournies par le Centre de gestion de la qualite de l’air de Dakar (CGQA). Resultats La prevalence de la crise d’asthme aux urgences etait de 3,6 % (14 347 cas de crise d’asthme sur 5 ans). L’âge moyen des patients etait de 5,2 ans avec une predominance masculine (sex-ratio 1,3). La cartographie des cas montrait que les districts de Dakar-Ouest (21,33 %), de Dakar-Centre (20,60 %) et Dakar-Sud etaient les plus concernes (9,8 %). Les malades provenaient surtout des quartiers des Parcelles Assainies, Guediawaye, de Pikine, Medina et Ouakam. Une augmentation progressive des cas de crise d’asthme etait notee entre 2011 et 2016 passant du simple au double. Les crises d’asthme survenaient surtout pendant la saison seche (64 %) correspondant a la periode de forte pollution particulaire (PM10 et PM2.5), avec des pics en novembre et en mai. Des taux de correlation tres significative de l’ordre de 78,9 % pour les PM10 (R2 = 0,789) et 89 % pour les PM2.5 (R2 = 0,8903) etait retrouvee sur les annees 2011, 2012 et 2013. Donc les PM2.5 joueraient un role plus important dans notre serie que les PM10 du fait de leurs petites tailles. Conclusion L’incidence de la crise d’asthme est en forte augmentation chez l’enfant au CHNEAR. Elles surviennent surtout pendant la saison seche. Cette augmentation est fortement correlee a la pollution atmospherique. Les PM2.5 jouent un role plus important que les PM10.

The study evaluated for the first time the ability of meteorological models of TIGGE to forecast the main features of the West African monsoon rainfall. Seven numerical models were retained over the 2008–2012 period and compared to satellite rainfall estimates. We focused on the seasonal cycle and in particular on the onset of the rainy season and on the intra-seasonal variability that are both of high importance for agriculture, water management and health sectors. We found that the seasonal latitudinal shift of the ITCZ is rather well predicted in terms of amplitude and timing by the different models although there is a systematic northward drift in the ITCZ latitude from the lead-times 1- to 10-day. Although the onset date of rainfall varies a lot according to the different definition in the literature, we also found good performance of TIGGE forecasts in predicting the onset date of the monsoon. The analysis of intra-seasonal variability revealed that the skill of TIGGE forecasts is decreasing with the lead-time from 1- to 15-day and the performance of the ensemble mean of all models overcomes the one of any individual models. Overall criteria used in this study (intra-seasonal fluctuations, onset and seasonal cycles), the skill of UKMO and ECMWF models is better than any other model. Based on such analysis it is likely than an ensemble mean based only on these two models would be more skillful than the ensemble mean based on the seven models. TIGGE forecasts represent a promising step towards the delivery of useful climate information to end-users of key sectors such as agriculture, water management, health and public safety.

The Niayes are the main horticultural production area of Senegal. This paper describes the cultivated and spontaneous biodiversities in two agroecosystems (orchards and market gardens) and some consequences to develop an agroecological approach. Data were collected from surveys on 64 orchards around Thies and from 11 market gardens in the suburb of Dakar. In orchards, cultivated fruit trees are mainly exotic fruit species such as mango, citrus, guyava. More, vegetables (e.g., chilli pepper, cucurbits, etc.) and food crops (e.g., maize, millet, cowpeas) are cultivated as secondary crops between the rows of perennial fruit crops. Plant diversity of the orchard is enriched by the hedges around the plot. These hedges include African species chosen for specific uses. In the Niayes market gardens, the range of crop species has long been known. Vegetable crops are annual plants. They are divided into: (i) African species that are multiplied locally (e.g., onion, okra, African eggplant, peppers, hibiscus), (ii) species that are not multiplied (e.g., carrots, cabbages, turnip, Irish potato), and (iii) species that can be multiplied locally but are yearly introduced (e.g., tomato, watermelon, melon, cucumber, beans). Market gardens also include some fruit species, and are surrounded by living hedges of tree and shrub strata. Horticultural systems appeared to be composed of many exotic species, but rather few local species and few varieties. The cultivation of these species which needs irrigation could be explained by the urban market demand. On the contrary, hedges, that are not watered specifically, are mainly composed by local species resistant to drought during the 8 months dry season. The value of the crop biodiversity as part of an agroecological approach will rely more on African species. (Résumé d'auteur)

Cervical cancer is the second most common cancer and the leading cause of cancer-related death in women in sub-Saharan Africa. It is estimated that more than 200 million females older than 15 years are at risk in this region. This paper highlights the current burden of cervical cancer in sub-Saharan Africa, reviews the latest clinical data on primary prevention, outlines challenges in the region, and offers potential solutions to these barriers. Based on these factors, clinical recommendations for the prevention of cervical cancer from the sub-Saharan African Cervical Cancer Working Group expert panel are presented.

28nm metal 90nm pitch is one of the most challenging processes for computational lithography due to the resolution limit of DUV scanners and the variety of designs allowed by design rules. Classical two dimensional hotspot simulations and OPC correction isn’t sufficient to obtain required process windows for mass production. This paper shows how three dimensional resist effects like top loss and line end shortening have been calibrated and used during the OPC process in order to achieve larger process window. Yield results on 28FDSOI product have been used to benchmark and validate gain between classical OPC and R3D OPC.

The aim of this pilot study was to analyze the Hepatitis C Virus (HCV) genotypes circulating in Senegal among Drug User (DUs), using Dried Blood Spots (DBS) as RNA source for molecular assays. Heroin and/or cocaine users (n = 506) were recruited in Dakar from April to July 2011, using a Respondent Driven Sampling (RDS) method. DBS preparation consisted of five drops of whole blood from finger applied to a Whatman paper card. HCV infection was screened by the detection of anti-HCV antibodies, using a rapid immune-chromatographic test. HCV RNA was quantified on anti-HCV positive DBS, using the Abbott RealTime HCV® Genotyping was performed on DBS with detectable viral load with Versant® HCV Genotype 2.0 Assay (LiPA) and Abbott RealTime HCV Genotype II assay®. Among the 506 participants, 120 were tested as positive for anti-HCV antibodies and their samples were analyzed for HCV RNA viral load and genotype. Out of the 120 DBS tested, HCV RNA was detected on 25 (20.8%). The median viral load was 15,058 IU/ml (ranging from 710 to 766,740 IU/ml). All positive DBS were suitable for the genotyping assay, that showed a predominance of genotype 1 (21/25) including 16 genotypes 1a and 5 genotypes 1b. HCV genotype 1 prevails in a DU population in Dakar. DBS could be useful for HCV RNA genotyping, but optimal storage conditions should required avoiding RNA impairment. Acknowledging this limitation, DBS could be a great interest for detecting and genotyping HCV viremic patients. J. Med. Virol. 89:484-488, 2017. © 2015 Wiley Periodicals, Inc.

Resume Objectifs Evaluer l’evolution des taux et des etiologies de la mortalite neonatale precoce au CHU de Dakar au cours des 10 dernieres annees. Materiel et methodes Il s’agit d’une etude retrospective de tous les deces neonatals enregistres au cours de l’annee 2003. Pour eliminer la part du hasard dans les variations observees pour les differentes periodes etudiees, nous avons utilise comme test statistique la comparaison des proportions avec un seuil de signification inferieur a 5 %. Resultats Nous avons enregistre 364 deces repartis de la maniere suivante : 243 parmi les 4 853 nouveau-nes accouches au niveau de la maternite (221 en periode neonatale precoce et 23 en periode neonatale tardive) et 121 parmi les 213 nouveau-nes transferes des maternites peripheriques. Le taux de mortalite neonatale precoce est de 45 deces pour 1 000 naissances vivantes. Cette mortalite concernait surtout les nouveau-nes pesant moins de 2 500 grammes a la naissance (66 %) et/ou ayant un score d’Apgar inferieur ou egal a 6 a la premiere minute de vie (83 %). La mortalite neonatale precoce a connu une baisse significative depuis 1994, mais la mortalite specifique observee chez les nouveau-nes transferes ne cesse d’augmenter (568 pour 1 000). Les principales causes de deces sont la prematurite (49 % des cas), la souffrance neonatale (23 %) et l’infection neonatale (18 %). L’analyse a montre une baisse significative de la part de la prematurite et de la souffrance neonatale mais une hausse significative de l’infection neonatale. Conclusion La mortalite neonatale precoce a sensiblement baisse, mais elle reste a un niveau encore trop eleve. Pour consolider cette tendance il faut reduire davantage l’incidence de la prematurite, de la souffrance neonatale et de l’infection et parallelement organiser un reseau de perinatalite a Dakar.

Resume Objectifs Determiner la frequence des bassins moderement retrecis, apprecier la valeur diagnostique de la pelvimetrie clinique par rapport a la scano-pelvimetrie et evaluer le pronostic de l’epreuve du travail avec une gestion exclusivement clinique. Materiel et methodes Il s’agit d’une etude prospective longitudinale de type exposees non exposees concernant 296 patientes porteuses d’un bassin moderement retreci et ayant accouche a la maternite du CHU de Dakar entre le 1er fevrier 2001 et le 31 juillet 2002. La capacite du bassin est evaluee par la pelvimetrie clinique et la scano-pelvimetrie. Le bassin est considere comme moderement retreci sur la base d’un des elements suivants : un diametre promonto-retropubien compris entre 9,5 et 10,4 cm ou un indice de Magnin compris entre 20 et 22 ou un diametre transverse median mesurant entre 9,5 et 11,5 cm ou une reduction d’un des diametres sacro-cotyloide de moins de 2 cm. Au total, 148 patientes ont ete exposees a l’epreuve du travail ; pour le groupe temoin, 148 non exposees ont ete selectionnees de maniere raisonnee parmi celles qui ont fait l’objet d’une cesarienne prophylactique et qui n’ont pas presente une pathologie surajoutee pouvant interferer avec le pronostic maternel et perinatal. Les differentes variables sont etudiees en utilisant les tests du Chi 2 de Pearson et de Kappa. Resultats Les retrecissements moderes du bassin representent 5,3 % des accouchements. La moyenne d’âge est de 24 ans, la parite moyenne de 1, la taille moyenne de 161 cm et l’âge gestationnel moyen de 38 semaines d’amenorrhee. L’examen clinique du bassin possede une bonne valeur predictive positive par rapport a la pelvimetrie radiologique (entre 76,5 et 100 % selon le type de bassin). L’epreuve du travail a permis d’obtenir un accouchement par voie basse dans 109 cas (73,6 %), soit un taux global d’accouchements par voie basse de 27 % chez l’ensemble des parturientes presentant un bassin moderement retreci. Cette epreuve du travail n’a pas induit un risque significativement plus important que celui lie a la cesarienne prophylactique. En effet, la mortalite maternelle est nulle dans les deux groupes. La morbidite maternelle est faible, essentiellement d’ordre infectieuse, 4 % des epreuves du travail contre 2,7 % des cesariennes prophylactiques (p = 0,318). La mortalite post-natale est de 7,4 % chez les nouveau-nes apres une epreuve du travail contre 4,1 % chez les nouveau-nes par cesarienne prophylactique (p = 0,579). Conclusion Malgre les contraintes de la pratique obstetricale en Afrique Noire, l’epreuve du travail dans les bassins moderement retrecis doit etre la regle a chaque fois que cela est possible, meme avec une surveillance du travail exclusivement clinique.

Gauge data over North Africa are used to provide an assessment of satellite and blended rainfall products for 1988‐94 and for 1998. A comparison is also made with the Global Precipitation Climatology Center (GPCC) gauge dataset. For the 1988‐94 period, mean fields and latitudinal transects for the June‐July‐August season are presented, based on a 515-station gauge dataset, the GPCC gauge data, the Global Precipitation Climatology Project (GPCP) blended data, the infrared-based Geostationary Operational Environmental Satellite precipitation index (GPI), and the Special Sensor Microwave Imager (SSM/I) microwave estimates. Error calculations are also presented. The mean fields derived from the dense gauge network, the GPCC gauge-only analysis, and the GPCP are remarkably similar. The bias, with reference to the seasonal rainfall field based on the denser network, is about 3%‐4% for either GPCC or GPCP. Agreement is relatively good, even in individual years. The rms error associated with these datasets is 12% for seasonal rainfall totals; thus, the error is largely random. In contrast, there are large systematic errors in the satellite-only analyses of GPI and SSM/I, with biases of 20% and 40% for the mean rain field as a whole and much larger biases in individual years. The rms errors are nearly 2 times as great. For 1998, a 920-station gauge dataset was available for a smaller section of West Africa. The comparison confirmed the superior performance of GPCP and demonstrated the lower level of performance of both GPCP and GPCC at the monthly scale as compared with the seasonal scale. Overall, the results of this study underscore the continued need for extensive gauge networks to describe adequately the large-scale precipitation field over Africa.

Gauge data from a West African network of 920 stations are used to assess Tropical Rainfall Measuring Mission (TRMM) satellite and blended rainfall products for 1998. In this study, mean fields, scattergrams, and latitudinal transects for the months of May‐September and for the 5-month season are presented. Error statistics are also calculated. This study demonstrates that both the TRMM-adjusted Geostationary Observational Environmental Satellite precipitation index (AGPI) and TRMM-merged rainfall products show excellent agreement with gauge data over West Africa on monthly-to-seasonal timescales and 2.5 83 2.58 latitude/longitude space scales. The root-mean-square error of both is on the order of 0.6 mm day 21 at seasonal resolution and 1 mm day21 at monthly resolution. The bias of the AGPI is only 0.2 mm day21, whereas the TRMM-merged product shows no bias over West Africa. Performance at 1.0 83 1.08 latitude/longitude resolution is also excellent at the seasonal scale and good for the monthly scale. A comparison with standard rainfall products that predate TRMM shows that AGPI and the TRMM-merged product perform as well as, or better than, those products. The AGPI shows marked improvement when compared with the GPI, in reducing the bias and in the scatter of the estimates. The TRMM satellite-only products from the precipitation radar and the TRMM Microwave Imager do not perform well over West Africa. Both tend to overestimate gauge measurements.

Resume Objectifs – Il s’agit d’une etude retrospective pour determiner l’epidemiologie des infections bacteriennes neonatales et evaluer l’efficacite des protocoles d’antibiotherapie utilises au CHU de Dakar. Materiel et methodes – Entre le 1er janvier 1997 et le 31 decembre 1998 nous avons enregistre 7 461 naissances vivantes, 2 312 nouveau-nes ont fait l’objet de prelevements bacteriologiques et ont recu une antibiotherapie probabiliste (ampicilline ou amoxicilline + gentamycine) sur la base d’un risque infectieux evalue par des criteres anamnestiques. La duree du traitement est de sept a dix jours, l'antibiotique est ensuite adapte le cas echeant en fonction des resultats de l'antibiogramme. Resultats – Le diagnostic d’infection neonatale est confirme dans 246 cas, soit 33 pour 1 000 naissances vivantes ou 10,6 % des nouveau-nes ayant recu une antibiotherapie. Les facteurs de risque associes les plus frequents sont la rupture prematuree des membranes (85 %) et la souffrance neonatale (87,8 %). Les germes isoles sont : Klebsiella pneumoniae (61,5 %), Enterobacter (11,5 %), staphylocoque (8,7 %), colibacille (6 %), streptocoque β (5,5 %), enterocoque (4,1 %) et Pseudomonas (2,7 %). La majorite d’entre eux sont resistants aux antibiotiques couramment utilises en premiere intention (ampicilline, cefotaxime et gentamycine), en particulier 95 % des klebsielles. Les molecules les plus efficaces sont l’amikacine, la colistine, le ceftriaxone et la ciprofloxacine. L’evolution est mortelle dans 48 cas dont 36 en periode neonatale precoce, soit une letalite de 19,5 % surtout en rapport avec les infections a klebsielles (79 % de la mortalite). Conclusion – L’antibiotherapie, en premiere intention, doit etre adaptee sans cesse a l’evolution de l’ecologie bacterienne et etre plus selective en utilisant des criteres de risque infectieux majeurs. Il faudra surtout promouvoir un diagnostic precoce de l’infection grâce a l’utilisation de marqueurs biologiques dont la reference est representee par la C Reactive Proteine.

Inpatient mortality is an indicator of the quality of care. We analyzed the mortality of under 5-year-old hospitalized children in the pediatric ward of Aristide Le Dantec Hospital for updating our data 10 years after our first study.We analyzed the data of the children hospitalized between 1 January and 31 December 2012. For each child, we collected anthropometric measurements converted to a z-score related to World Health Organization growth data. Logistic regression-generating models built separately with different anthropometric parameters were used to assess the risk of mortality according to children's characteristics.Data from 393 children were included. The overall mortality rate was 10% (39/393). Using logistic regression, the risk factors associated with death were severe wasting (odds ratio [OR]=8.27; 95% confidence interval [95% CI]) [3.79-18], male gender (OR=2.98; 95% CI [1.25-7.1]), dehydration (OR=5.4; 95% CI [2.54-13.43]) in the model using the weight-for-height z-score; male gender (OR=2.5; 95% CI [1.11-5.63]), dehydration (OR=8.43; 95% CI [3.83-18.5]) in the model using the height-for-age z-score; male gender (OR=2.7; 95% CI [1.19-6.24]), dehydration (OR=7.5; 95% CI [3.39-16.76]), severe deficit in the weight-for-age z-score (OR=2.4; 95% CI [1.11-5.63]) in the model using the weight-for-age z-score; and male gender (OR=2.5; 95% CI [1.11-5.63]) and dehydration (OR=8.43; 94% CI [3.83-18.5]) in the last model with mid-upper arm circumference (MUAC). Dehydration and malnutrition were two independent risk factors of death. The protocols addressing dehydration and malnutrition management should be audited and performed systematically for each child's anthropometric measurements at admission.

In developing countries, maternal and neonatal mortality is high. Among the causes of death during the neonatal period, low birth weight is crucial. A dose of fluoride beyond 2mg/L causes enamel damage, possibly affecting the fetus. The aim of this study was to search for an association between dental fluorosis in the mother and low birthweight of the newborn.This was a case-control study performed in an endemic area in Senegal (Diourbel). It included 108 mothers who gave birth to newborns weighing less than 2500 g (cases) and 216 mothers with newborns weighing greater or equal to 2500 g (controls). Data on socio-demographic, lifestyle, history and pregnancy variables were collected. Those related to water consumption during pregnancy and dental fluorosis (Dean's index) were measured. The data were analyzed by R software. Logistic regression was used to identify associations and the statistical significance level was set to 0.05.The proportions of mothers consuming well water were 62% among cases versus 43.5% among controls. The score 4 of Dean's Index was reported for 25.9% of cases versus 6.9% of controls. The water consumed and the modal score of Dean's Index were significantly associated with the occurrence of low birthweight adjusted for gender, consanguinity, anemia and hypertension.Low birthweight was associated with pregnant women living in endemic areas. Defluoridation programs and access for pregnant women and children to high quality water are necessary in areas of endemic fluorosis.

Neonatal mortality is a major public health problem. The main causes are infections, prematurity and asphyxia at birth. In view of reducing this high mortality, primary healthcare facilities were equipped with basic equipment for the care of newborns and their key workers were trained in essential newborn care. Three years after this implementation, the present study assesses the state and conditions of use of this basic equipment intended for taking care of newborns at birth.This assessment was conducted from 16 March to 3 April 2009. It was based on observations and interviews on a sample of healthcare facilities.Healthcare facilities were generally equipped with ventilator bags and masks (87%) (60/69). In more than half of the healthcare centers (20/38), they were not used often because the workers were renewed and not educated in their use. They were practically all in good condition. Eighty-five percent (59/69) of healthcare facilities had at least one aspirator, generally adapted to newborns (negative pressure, 100 mmHg). The maintenance of the material was globally satisfactory because the aspirator bottles were most often clean. As for the aspirator tubes, they were always available but a few cases of supply rupture were observed in some healthcare centers. The warming table was available in only 52% (36/69) of healthcare facilities. Fifteen tables did not comply with initial specifications.This assessment highlights that the basic equipment intended for newborn care was generally available, functional and maintained well after 3 years. This strategy could be scaled up in order to contribute to reducing the newborn mortality.

L\'alimentation hydrique est le principal facteur limitant la productivite du palmier a huile ( Elaeis guineensis Jacq.). Les reponses physiologiques des plantules, soumises a un deficit hydrique, ont ete evaluees sous serre, dans des pots durant 4 mois. En vue d\'identifier des criteres discriminants au jeune âge pour une utilisation en selection varietale, du materiel sensible et un autre tolerant a la secheresse ont ete soumis a un cycle de dessechement - rehydratation. Les parametres tels que : le statut hydrique (taux de transpiration relative, potentiel hydrique foliaire), les echanges gazeux (photosynthese, conductance stomatique) et l\'activite photochimique (fluorescence chlorophyllienne) ont ete etudies. Le regime hydrique a fortement affecte l\'ensemble des parametres etudies. Le taux de satisfaction des besoins en eau a varie de 90 a 4 %, et le potentiel hydrique a atteint une valeur de -3 MPa trois semaines apres suspension de l\'arrosage. Pendant la phase de rehydratation, les plantules ont presente une capacite de reprise satisfaisante. Malgre une bonne correlation, les deux parametres d\'echanges gazeux ne peuvent etre proposes isolement comme criteres de selection dans les conditions de l\'experience. Par contre, la mesure de la fluorescence chlorophyllienne a permis de distinguer le materiel tolerant du sensible au bout d\'une semaine. Ces resultats ouvrent une perspective dans la selection de genotypes de palmier a huile tolerants a la secheresse au jeune âge. Water deficit is the main limiting factor in oil palm production ( Elaeis guineensis Jacq.) in West Africa.Physiological responses to drought plantlets were accessed under green house conditions for 4 months. A drought tolerant species and a sensitive one were subject to one wetting and drying cycle. Parameters such as water status (transpiration rate, water potential), leaf gas exchanges (photosynthesis, stomatal conductance) and photochemical activity (chlorophyll fluorescence) were monitored. Results show that all parameters were affected by watering. Transpiration rate dropped from 90 to 4 %, with a leaf potential close to -3 MPa three weeks after watering was interrupted. Despite a good correlation, the two leaf gas exchange parameters alone were not relevant criteria for the early screening of oil palm material. However, chlorophyll fluorescence data allowed early screening of both genotypes within one week after withdrawal of watering. The latter parameter can offer effective tool to oil palm breeders for screening young oil palm genotypes to drought tolerance. Key-words Keywords : Elaeis guineensis , palmier a huile, deficit hydrique, photosynthese, fluorescence chlorophyllienne, Cote d\'Ivoire. Agronomie Africaine Vol. 19 (1) 2007: pp. 1-12

A case-control study was conducted between September 2003 and January 2004. Fifty four newborn babies born before 37 weeks of gestation resulting from 47 pregnancies including 7 multiple pregnancies were compared to 105 newborn babies born between 37 and the 42 weeks of gestation. Parturient geographical origin, marital status, age, alcohol or tea consumption and height were not significantly associated to premature birth (p0.05). On the other hand, a higher parity or equal to 3, a number of antenatal care lower than 3 were significantly associated with the risk of premature birth (p0.05). But a gestity and a parity lower than 3 and a number of antenatal consultations higher or equal to 3 had a protective effect (OR1; p0.05). We recommend a reinforcement of malarial prevention during pregnancy according to WHO recommendations and the improvement of the quality of the antenatal care in the Ziguinchor medical district.

To evaluate early neonatal mortality at the University Teaching Hospital and assess changes in the rate and causes during the last ten years.We performed a retrospective analysis of neonatal deaths recorded at the Neonatal and Premature Unit (NPU) in 2003. The results were compared with earlier evaluations. Comparison of proportions was used for statistical analysis to eliminate the random element in rate variations. The significance threshold wasor =5%.We registered 364 neonatal deaths: 243 among 4853 newborns in our maternity ward and 121 among 213 newborns transferred from a referring maternity. Early neonatal mortality rate 45.5 per 1,000 live births. Mortality particularly concerned newborns with a birth weightor =2,500 grams (66%) and Apgar scoresor =6. Early neonatal mortality fell significantly since 1994, while overall mortality remained high among newborns transferred from referring maternities. The most frequent causes were premature birth (49%), acute fetal distress (23%) and neonatal infection (18%).Early neonatal mortality has decreased remains at a high level. It could be improved by limiting the number of premature births, neonatal suffering and neonatal infection. In a parallel direction we recommend organizing a perinatal network in Dakar.

Major thrombocytosis associated with severe anemia is uncommon in pediatrics. We report 9 consecutive cases observed in Albert Royer Children Hospital of Dakar. They were 7 boys and 2 girls 4 to 15 years old (mean age = 10 years). Six patients had a history of geophagia and 3 presented recent emission of worms by the stools. Anemia was clinically well tolerated in all cases. In initial blood count platelet levels varied from 800 10(3) to 1180 10(3)/mm3 (mean = 1032 10(3)/mm3), while hemoglobin level varied from 3.4 to 7.4 g/dl (mean = 4.9 g/dl). Anemia was microcytic, hypochromic and associated with low serum iron level in all patients. We considered the diagnosis of reactive thrombocytosis induced by iron deficient anemia in all cases. Platelet count and red cell indices were progressively normalised with iron treatment and no complication of thrombocytosis was observed. Considering published data, iron deficiency is one of the most frequent causes of reactive thrombocytosis in children. The physiopathologic mechanism, still unknown, could involve cytokines of thrombopoiesis. Reactive thrombocytosis induced by iron deficiency or other factors have usually a benign course and need no specific treatment other than that of the etiology.

This report is a retrospective study carried out from records of diseased of asthma, fallowed up in a paediatric national center of reference during the period from 1st of November 1987 to 31 st of august 1993. The goal was to describe the epidemiological and clinical factors linked to that affection in order to better contribute to improve its managment. For all the diseaseds of this report we notice and analysed the socio economical data, the promoting factors the occurring mode of the disease, the main clinical manifestations of the affection and their consequences. The morbid association and the data of the paraclinical exploration particularly the functional breathing exploration. Thus we noticed that the consultation in a specialized center occurs relatively late because of bad orientation of the deseaseds. In effect the mean age of diseaseds at the first consultation is 7.5 years while the disease begins in average at 3.5 years. By elsewhere we notice that 15% of these diseaseds live in an aggressive mesologic medium. With an atopy in 78.4% of the cases, loaded personal case history in 96.6% of the cases and that the releasing factors are not known for most of them (81.9%). Asthma in our diseaseds is not very frequent (77%) in general with a moderate intensity of crises (69%). However disturbances of physical activity are noted among 23% of the sample which corresponds nearly to the number of subjects with severe respiratory obstruction (25%). We quoted that there is an relation ship between the frequency of the cases the intensity of the crisis and the disturbances of physical activities of the diseaseds (x2:25.9, df = 2, p= 0,000002). Tacking count of all these factors may serve to set up a asthma prevention and treatment project in Senegal based on populations education and care providers training.

Rubella is an innocuous illness in adult unless it is contracted by a pregnant woman. We recently observed a case of congenital rubella in the department of neonatology of Abass Ndao hospital in Dakar. It's a female new-born, born after 40 week gestation, with a well followed pregnancy. The first clinical examination shows a severe intrauterine growth retardation and bilateral comeal opacity. Maternal and new-born serologic confirmation is obtained with positive rubella specific IgM and IgG. We also find severe ocular pathology, hearing deficit and associated cardiac disease. This case shows the needs for preventive strategies, such as vaccination against rubella for women of child bearing age.

Hemolytic uremic syndrome (HUS) is an nonexceptional complication of infectious gastroenteritis. No one has already been reported in Senegalese publications. We made a retrospective study of the record of 7 patients with HUS among 256 cases of children with bloody diarrhea presenting to the pediatric unit of Aristide Le Dantec between august 1998 and july 1999. The mean age of the children was 33,14+/-25 months and the weight was -2,29 DS. The diagnosis is supported by the findings of an acute renal failure with urea at 1,28+/-0,51g/ l and creatinine at 41,46+/-25,48mg/l. An hemolytic anemia was constant, the blood film revealed schizocytes. We found a thrombocytemia only in two cases. A hight white blood cell count (more than 50000/mm3) was noted in for cases. Only one child made a good recovery. We insist on preventing gastroenteritis and aggressive and adapted management of the HUS.

The course of sickle cell disease (SCD) may be complicated by neurologic events, mainly bactérial meningitidis and stroke. We retrospectively studied all cases with acute encephalic manifestations (AEM) in a cohort of 461 children and adolescents with SCD followed at Albert Royer Children Hospital of Dakar (Senegal) from january 1991 to december 2000 (ten years). Among them 438 had sickle cell anemia (SCA), 19 SC disease and 4 S-beta thalassemia (3 S-beta+, 1 S-beta0). Seven patients, all with SCA, presented antecedents of AEM revealed by flacid and proportionnal hemiplegia evoking stroke. Prevalence of these AEM was 1.5 per cent among patients with SCD and 1.6 per cent among those with SCA. They were 4 girls and 3 boys (sex ratio = 0.75) aged 4 to 8.5 years when occurred the first accident. We observed no clinical or biological distinctive characteristic of SCA in these patients compared to those without crebrovascular accident. Recurrence was observed once in a boy after a 12 months interval and twice in a girl after 20 and 60 months intervals successively. No transfusionnal program was applied to prevent recurrent stroke because of insufficient conditions for long-term transfusion. Stroke appears to be rare in senegalese children with SCD. However it poses in our context the major problem of applicability of transfusionnal program which constitute the only therapy universally recognised to be effective to prevent recurrence. Nevertheless hydroxyurea could be a satisfactory alternative.

The authors report the results of a retrospective study on the effect of traumatic injuries observed among newborns from forceps deliveries in the maternity ward of Abass Ndao hospital between January 1st, 1995 and December 31, 1996. Forceps deliveries represent 5.89 for 1000 of total deliveries and 47 for 1000 of nursery admissions. Traumatic injuries are found in 44.77 % of the newborn by forceps deliveries. They are dominated by the hematoma of scalp in 23 cases and facial nerve injuries in 6 cases. The were about 76.66 percent of primipare among which 30 percent were adolescents. Maternal age, parity, gravity as well as birth weight for forceps deliveries were not significantly different from those without any injuries (p0.05). However, traumatic injuries of the newborn were more frequent when the forceps were performed by medical resident. The neonatal mortality is 10.44%. We recommend the teaching of the technique for an improvement of technical competence.

To study frequency of moderate pelvic dystocia, to evaluate the diagnosis value of clinical pelvic evaluation and prognosis of trial labor with only clinical monitoring.This is a prospective, exposed and non-exposed study concerning 296 women selected among deliveries presenting moderate pelvic dystocia recorded at Dakar University Teaching Hospital from February 1st 2001 to July 31 2002. Trial labor was undertaken in 148 patients; the control group was chosen among women who underwent prophylactic caesarean section and had no other risk factors of maternal and perinatal complications. Pearson's chi-square test was used or statistic analysis with p value 5% and test of Kappa.Moderate pelvic dystocia was observed 5.3 per 100 deliveries. The most common epidemiological profile was primipara, young age (mean 24 years), height 161 cm (mean), 38-week pregnancy (mean). Clinical evaluation had good diagnosis value comparable with the radiological pelvimetry. Trial labor was undertaken in 148 women, 109 trials (73.6%) were successful; vaginal delivery rate was 27% in women with moderate pelvic dystocia. There were no maternal deaths, maternal morbidity was 4% in trial labor patients and 2.7% in prophylactic caesarean section patents (mainly infection). Post-natal mortality was 7.4% after trial of labour versus 4.1% of newborn child after prophylactic caesarean.These results confirm that trial of labor on moderate pelvic dystocia should be the rule whenever possible, even when only clinical monitoring is available.