Search

From January 2001 to May 2002, 300 chicken carcasses from retail shops in Dakar were examined for prevalence of Salmonella and Campylobacter. Of these, 146 were fresh products, 58 were refrigerated and 96 were frozen. Salmonella was isolated from 96 (32%) of the carcasses analyzed. The most prominent Salmonella serovars were Salmonella Hadar (41.6%) and Salmonella Brancaster (20.8%). Campylobacter spp. was isolated from 168 (56%) of the samples. C. jejuni was more frequently isolated (59%) than C. coli (27%). The contamination rates for Campylobacter were significantly different in relation to the type of carcass: 76% for fresh, 53% for chilled and 28% for frozen.

Campylobacter resistance to antimicrobial agents appears as an emerging public health problem in industrialized countries, but, on the other hand, only few data on the subject are available in developing countries. To assess antibiotic susceptibility of Campylobacter strains in Senegal, skin samples were collected from 250 chicken carcasses from January 2001 to October 2002. Among 204 Campylobacter strains isolated, two species were identified: C. jejuni (59%) and C. coli (41%). In vitro susceptibility to five antimicrobial drugs (amoxicillin, amoxicillin-clavulanic acid, erythromycin, nalidixic acid and ciprofloxacin) was determined by the E-test method. Minimum inhibitory concentrations (MICs) showed 34% of Campylobacter isolates were ciprofloxacin resistant with a high level of resistance (MIC ≥ 32 mg/l) in 25% of both species. Cross-resistance between nalidixic acid and ciprofloxacin was found in 96% of quinolone-resistant strains. The level of amoxicillin resistance was statistically higher for C. coli than for C. jejuni (20.2 versus 10.8%), but all the strains were susceptible to amoxicillin combined with clavulanic acid. Both species showed low resistance to erythromycin. Multiresistant phenotype to three of the drugs tested was found in 9.8% of the strains: 15.5% of C. coli strains and 5.8% of C. jejuni strains. No strain was resistant to four or more of the drugs studied. Further studies appear necessary to evaluate antibiotic resistance of Campylobacter isolated in human and animal samples in order to control the emergence of new multidrug-resistant strains in Senegal.

Microbiological analysis of a broiler chicken carcass revealed the presence of a new Salmonella serotype. It is characterized by two genes that express resistance to antibiotics, except to the very last quinolones. This serotype poses a threat as it has been found in human samples in association with high temperature and diarrhea. The onset of this Salmonella may result from the anarchic use of antibiotics in poultry production.

Fire and Gas (F&G) detection is an essential part of the mitigation system in facilities handling and storing flammable and toxic materials. While detector reliability might be very high, safety performance of a F&G system strongly depends on layout and coverage. Current reference standards for on-shore applications do not define the plant areas to be mapped, the coverage targets, and the reference hazardous scenarios to be considered. In the present study, a methodology aimed at the F&G coverage mapping was developed. The procedure is applicable in the Front End Engineering Design phase (FEED), where limited data is typically available. The development of the methodology considered the main aspects that define F&G system performance. Coverage targets for detection were set considering risk reduction goals and actual detector capabilities. Simple strategies were developed for the determination of the reference hazardous scenarios to be considered. A Matlab code for 3D F&G coverage mapping was developed. The proposed procedure was demonstrated by a simplified case study. The methodology proved itself a valid instrument to assist detector layout assessment.

Accidental fires in Oil&Gas facilities have a significant potential for severe consequences, endangering personnel safety, environment, asset integrity, production continuity and company reputation. Moreover, in-plant accident propagation (domino effects) may further increase the outcomes of fires. Fireproofing is a crucial safety barrier in preventing the escalation of fire scenarios. Maintenance and cost considerations require the application of such protection only where an actual risk of severe fire scenarios is present. Available methodologies for the identification of fireproofing zones in on-shore installations are based on simplified assumptions and do not consider the effect of jet-fire scenarios. Experience has tragically shown though the importance of including such scenarios (e.g. Valero accident in 2007). In the present study, a risk-based methodology for the identification of fireproofing zones was developed. The procedure addresses both the prevention of domino effect and the mitigation of asset damage due to the primary fire scenario (pool and jet fires), taking into account the specific issues of on-shore applications. Specific criteria were introduced to assess escalation hazard. A risk-based identification of the reference accident scenarios was developed, allowing a more detailed definition of the plant items that should be considered for fireproofing application. The method is mainly oriented to early design application, allowing the identification of fireproofing zones in the initial lay-out definition. The potential outcomes of the methodology are investigated by applying them to case-studies of industrial interest.

In December 2023, we observed through hospital-based surveillance a severe outbreak of enterovirus D68 infection in pediatric inpatients in Dakar, Senegal. Molecular characterization revealed that subclade B3, the dominant lineage in outbreaks worldwide, was responsible for the outbreak. Enhanced surveillance in inpatient settings, including among patients with neurologic illnesses, is needed.

In 2022, many regions around the world experienced a severe respiratory syncytial virus (RSV) epidemic with an earlier-than-usual start and increased numbers of paediatric patients in emergency departments. Here we carried out this study to describe the epidemiology and genetic characteristics of RSV infection in patients hospitalized with severe acute respiratory infections in 2022. Samples were tested for RSV by multiplex real time reverse transcription polymerase chain reaction. Subsequently, a subset of RSV positive samples was selected for NGS sequencing. RSV was detected in 16.04%, among which RSV-A was confirmed in 7.5% and RSV-B in 76.7%. RSV infection were more identified in infants aged ≤ 11 months (83.3%) and a shift in the circulation pattern was observed, with highest incidences between September-November. Phylogenetic analyses revealed that all RSV-A strains belonged to GA2.3.5 genotype and all RSV-B strains to GB5.0.5a genotype. Three putative N-glycosylation sites at amino acid positions 103, 135, 237 were predicted among RSV-A strains, while four N-linked glycosylation sites at positions 81, 86, 231 and 294 were identified in RSV-B strains. Globally, our findings reveal an exclusive co-circulation of two genetic lineages of RSV within the pediatric population in Senegal, especially in infants aged ≤ 11 months., (© 2023. The Author(s).)

The study aimed to analyse the challenges and solutions for maintaining the continuity of essential health services during the COVID-19 pandemic in Francophone West Africa. A cross-sectional study involving the managers of Reproductive, Maternal, Neonatal, Child and Adolescent Health (RMNCAH) and vaccination programmes in Francophone West Africa was designed. The challenges that limited the supply and use of RMNCAH services included: lack of standardized guides and procedures for appropriate care, limited knowledge of health workers on the new coronavirus disease, lack of diagnostic materials and kits, ineffective organization of services, anxieties of health workers and populations, and postponement of immunisation mass campaigns. The solutions proposed to address these challenges, included better organization of services to respect the physical distance, provision of adapted guides and care procedures, enhanced communication, training of health workers, effective use of social media and information and communication technologies. This study showed that the managers of RMNCAH programmes are aware of the challenges that could limit the supply and use of essential services during the COVID-19 pandemic.

Background: Increasingly, WHO recommendations are defined by context-specific factors and WHO is developing strategies to ensure that recommendations are successfully adapted and implemented at country level. This manuscript describes the development of a toolkit to support governments to adapt the WHO recommendations on antenatal care (ANC) for a positive pregnancy experience for their context in a systematic manner., Methods: The toolkit was developed in three steps. It was created with input from methodologists and regional implementation experts (Step 1) followed by a user-testing phase (Step 2), implemented during country stakeholder meetings. User testing consisted of stakeholder interviews that were transcribed, and data was categorised according to the content analysis method. Suggestions for toolkit improvement and issues identified during the interviews were assessed as serious, moderately serious or minor/cosmetic., Results: A total of 22 stakeholders - comprising five Ministry of Health (MoH) consultants, four MoH policy-makers, and 13 advisors/implementers - from Burkina Faso, India, Rwanda and Zambia participated in user-testing interviews during stakeholder meetings held in each country between August 2018 and February 2019. Most stakeholders had a medical or nursing background and half were women. Overall, responses to the toolkit were positive, with all stakeholders finding it useful and desirable. User testing interviews highlighted four serious, four moderately serious and five minor/cosmetic issues to be managed. These were addressed in the final step (Step 3), an updated version of the WHO ANC Recommendations Adaptation Toolkit, comprised of two main components - a baseline assessment tool with spreadsheets for data entry and a Slidedoc ® , a dual-purpose document for reading and presentation, outlining the qualitative data that shaped the women-centred perspective of the guidelines, accompanied by an instruction manual detailing the components' use., Conclusions: The WHO ANC Recommendations Adaptation Toolkit was developed to support countries to systematically adapt the WHO ANC recommendations for country contexts. Using this approach, similar tools can be developed to support guideline implementation across different health domains and the continuum of care.

Problem: In Burkina Faso, the coverage of services for family planning is low due to shortage of qualified health staff and limited access to services., Approach: Following the launch of the Ouagadougou Partnership, an alliance to catalyse the expansion of family planning services, the health ministry created a consortium of family planning stakeholders in 2011. The consortium adopted a collaborative framework to implement a pilot project for task sharing in family planning at community and primary health-care centre levels in two rural districts. Stakeholders were responsible for their areas of expertise. These areas included advocacy; monitoring and evaluation; and capacity development of community health workers (CHWs) to offer oral and injectable contraceptives to new users and of auxiliary nurses and auxiliary midwives to provide implants and intrauterine devices. The health ministry implemented supportive supervision cascades involving relevant planning and service levels., Local Setting: In Burkina Faso, only 15% (2563/17 087) of married women used modern contraceptives in 2010., Relevant Changes: Adoption of new policies and clinical care standards expanded task sharing roles in family planning. The consortium trained a total of 79 CHWs and 124 auxiliary nurses and midwives. Between January 2017 and December 2018, CHWs provided injectables to 3698 new users, and auxiliary nurses or midwives provided 726 intrauterine devices and 2574 implants to new users. No safety issues were reported., Lessons Learnt: The pilot project was feasible and safe, however, financial constraints are hindering scale-up efforts. Supportive supervision cascades were critical in ensuring success., ((c) 2019 The authors; licensee World Health Organization.)

We used the multilocus sequence typing (MLST) method to study the genetic diversity of Campylobacter coli isolated from chickens in Senegal, and to check the presence of genetic exchange with Campylobacter jejuni. In addition, we assessed the resistance of the isolates to ciprofloxacin and nalidixic acid, and their gyrA sequences. MLST revealed a low level of diversity and the absence of lineages among C. coli isolates. In addition, an exchange of alleles with C. jejuni was found. Twenty percent of the ciprofloxacin-resistant isolates lacked mutations within the quinolone resistance-determining region (QRDR) of GyrA. There was no link between quinolone resistance and sequence type (ST).

We used the multilocus sequence typing (MLST) method to evaluate the genetic diversity of 46 Campylobacter jejuni isolates from chickens and to determine the link between quinolone resistance and sequence type (ST). There were a total of 16 ST genotypes, and the majority of them belonged to seven clonal complexes previously identified by using isolates from human disease. The ST-353 complex was the most common complex, whereas the ST-21, ST-42, ST-52, and ST-257 complexes were less well represented. The resistance phenotype varied for each ST, and the Thr-86-Ile substitution in the GyrA protein was the predominant mechanism of resistance to quinolone. Nine of the 14 isolates having the Thr-86-Ile substitution belonged to the ST-353 complex. MLST showed that the emergence of quinolone resistance is not related to the diffusion of a unique clone and that there is no link between ST genotype and quinolone resistance. Based on silent mutations, different variants of the gyrA gene were shown to exist for the same ST. These data provide useful information for understanding the epidemiology of C. jejuni in Senegal.

Objective: To identify factors predicting uptake of voluntary HIV counselling and testing in pregnant women., Methods: All pregnant women receiving ante-natal group health education at St Camille Medical Center, Ouagadougou, Burkina Faso from 1 May 2002 to 30 April 2004 were offered voluntary HIV counselling and testing. If they consented, the women were pre-test counselled, tested by two rapid tests giving immediate results and post-test counselled., Results: Less than one-fifth of pregnant women [1,216/6,639 (18.3%, CI 17.4-19.3%)] accepted voluntary HIV counselling and testing, mainly at the first ante-natal visit (83.4%) and at early gestational age (73.4% before week 24). The HIV seroprevalence rate was 10.6% (8.8-12.5%). The uptake rate was independently associated with age, the number of previous pregnancies and the number of previous miscarriages., Conclusions: Our two-step approach of group education followed by voluntary HIV counselling and testing yielded a low uptake rate in this setting. However, the drop-out rate after enrolling in the programme was nearly zero. The timing of programme uptake would permit implementation of earlier prophylactic courses. Effective scaling-up of voluntary HIV counselling and testing outside the clinical trial requires a mass sensibilization campaign pointing out the programme's benefits and addressing the stigma of HIV. The independent value of age and previous obstetrical episodes show how important social factors are in influencing the voluntary HIV counselling and testing uptake rate.

To assess fluoroquinolone susceptibility of Campylobacter strains in Senegal, skin samples were collected from 250 chicken carcasses from January 2001 to October 2002. Among 205 isolated Campylobacter strains, 59% and 41% were identified as Campylobacter jejuni and C. coli, respectively; the overall ciprofloxacin-resistance rate was 34%.

There is accumulating evidence for a role of immunoglobulin G (IgG) in protection against malarial infection and disease. Only IgG1 and IgG3 are considered cytophilic and protective against P. falciparum, whereas IgG2 and IgG4 were thought to be neither and even to block protective mechanisms. However, no clear pattern of association between isotypes and protection has so far emerged. We analyzed the isotypic distribution of the IgG response to conserved epitopes and P. falciparum blood-stage extract in 283 malaria-exposed individuals whose occurrence of infection and malaria attack had been monitored for about 1 year. Logistic regression analyses showed that, at the end of the season of transmission, high levels of IgG2 to RESA and to MSP2 epitopes were associated with low risk of infection. Indeed, IgG2 is able to bind FcgammaRIIA in individuals possessing the H131 allele, and we showed that 70% of the study subjects had this allele. Also, high specific IgG4 levels were associated with an enhanced risk of infection and with a high risk of malaria attack. Moreover, specific IgG2 and IgG3 levels, as well as the IgG2/IgG4 and IgG3/IgG4 ratios, increased with the age of subjects, in parallel with the protection against infection and disease. IgG4 likely competes with cytophilic antibodies for antigen recognition and may therefore block cytotoxicity mediated by antibody-activated effector cells. In conclusion, these results favor a protective role of IgG3 and IgG2, which may activate effector cells through FcgammaRIIA, and provide evidence for a blocking role of IgG4 in malarial infection and disease.

The in vitro sensitivity of P. falciparum drug-resistant isolates was evaluated in the region of Bobo-Dioulasso during the 1995 and 1996 rainy seasons. Two routinely used antimalarials (chloroquine and quinine) and two new antimalarials (mefloquine and halofantrine) were assessed using 24-hour in vitro cultures with tritiated hypoxanthine and a parasite density > or = 4,000/microl of blood. The proportion of chloroquine-resistant isolates was 20% in 1995 and 19% in 1996, whilst in 1996, the proportion of isolates resistant to halofantrine was greater than in 1995 (9.6% versus 1%). No significant differences were seen in the mean IC50 values in relation to the susceptibility of chloroquine-resistant or chloroquine-sensitive isolates to mefloquine and halofantrine. In the case of quinine, the mean IC50 values were significantly higher in chloroquine-resistant isolates than in chloroquine-sensitive ones. A significant positive correlation was found between the following IC50 values: chloroquine versus quinine, quinine versus mefloquine and mefloquine versus halofantrine.

A case-control study was carried out to identify risk factors for neonatal tetanus in rural Burkina Faso. Each of the 31 cases identified prospectively were matched with two controls. Risk factors such as the instrument used to cut the umbilical cord and the qualification of the midwives were only identified in the univariate analysis. The multifactorial analysis identified factors commonly believed to be associated with neonatal tetanus: lack of mother's immunization and place of birth other than maternity clinics. However, applying karite nut butter on the umbilical cord was found to be a strong independent factor associated with neonatal tetanus. Immunization of mothers against tetanus should be enforced. Health education must take into consideration sociocultural realities of these populations.

Objective: To investigate the association between where young children defecate, where stools are disposed of, and the presence of human stools on the ground in the compound and the rate of hospital admission with diarrhoea., Design: This was a case-control study with two control groups., Setting: The study took place in Bobo-Dioulasso, the second city of Burkina Faso in West Africa., Participants: Three groups of children aged 36 months and under, and living in Bobo-Dioulasso were studied. Cases were 757 children admitted to hospital with symptoms of diarrhoea or dysentery. The first control group comprised 757 neighbourhood control children approximately matched on age and date of recruitment, and the second, 631 children admitted to the same hospital without symptoms of diarrhoea or dysentery., Main Results: There was no evidence of any association between where the child was reported to defecate and hospital admission with diarrhoea or dysentery (odds ratio = 1.10; 95% confidence interval (CI) 0.78, 1.57, cases v neighbourhood controls; odds ratio = 0.84; 95% CI 0.60, 1.18, cases v hospital controls). There was evidence of an association between where the mother reported disposing of the child's stools and hospital admission with diarrhoea or dysentery (odds ratio = 1.50; 95% CI 1.09, 2.06, cases v neighbourhood controls; odds ratio = 1.31; 95% CI 0.96, 1.79, cases v hospital controls). Human stools were more frequently observed in the yards of cases than controls (odds ratio = 1.38; 95% CI 0.98, 1.95, cases compared with neighbourhood controls; odds ratio = 1.33; 95% CI 0.96, 1.84, cases compared with hospital controls)., Conclusions: The findings suggest that it is not where the child defecates that matters but how the mother then deals with the child's stools.

Reported are our findings from a case-control study of the association between prolonged breast-feeding and clinical malnutrition in an urban setting in West Africa. The cases were children aged 12-36 months who had been hospitalized with a diagnosis of clinical malnutrition. Children of a similar age who lived in neighbouring courtyards were recruited as controls. For 152 case-control pairs in which both children were receiving solid foods, non-breast-feeding was associated with an increased risk of clinical malnutrition (crude odds ratio = 2.37; 95% confidence interval = 1.24, 4.55). This association remained statistically significant after controlling for various potentially confounding variables (P = 0.03). Our findings suggest that either prolonged breast-feeding may offer substantial protection against clinical malnutrition in the study population or malnutrition leads mothers to stop breast-feeding. These results are inconsistent with those of a number of workers who have reported that prolonged breast-feeding is associated with an increased risk of malnutrition. This inconsistency might have arisen because of differences in the definition of malnutrition used or because of variations in the quantity and quality of weaning foods available in different settings. We found no evidence to support the hypothesis that prolonged breast-feeding may be detrimental to children.