The objective of the present work is to contribute to the study and the numerical modelling of the hydric erosion in the plateau of Thies: through an application to the watershed of Kissane, ...according to the USLE (Universal Soil Loss Equation) model. The establishment of the USLE model requires data on the topography, the land use, the climatology and the pedology. One of the major difficulties in the elaboration of the model was the collection of relevant data. Indeed, the rural commune of Noto more exactly the village of Kissane is relatively little informated by the scientific bibliography. The geographical reference data on the topography, the precipitation, the land use either non-existent, or incomplete or obsolete on a small scale and the geo-referenced digital data are even rarer. The study, the combination of the data and in the modelling were operated in a Geographical Information System (GIS). Every factor is a digital estimation of a precise component that affects the gravity of the soil erosion in a given place. The realization of the land use map from the visual interpretation assisted by GIS, from the satellite imaging Landsat that covers the watershed of Kissane facilitated the extraction of the vegetation cover map, what allowed defining with more precision the most sensitive areas with erosion risk.
Undifferentiated embryonal sarcoma of the liver is rare. It is usually observed in children and adolescents. We report one case of embryonal sarcoma of the liver arising in patient without any ...antecedent. The only symptom was right scapular pain. The liver scan showed a multicystic lesion suspicious for infectious origin or a tumor. Serologies for ecchinococcus, schistosomiasis and brucellosis were negative. The treatment was a right hepatectomy. On gross examination, the tumor was unencapsulated, multicystic and contained large areas of necrosis admixed with gelatinous areas. Microscopically, there were epithelioid and spindle tumor cells in a myxoïd stroma. Lipoblastic-like or rhabdomyoblastic-like, giant cells and PAS positive hyaline globules in the cell cytoplasm were present. The tumor cells expressed vimentin, cytokeratin (KL1), alpha-1-antitrypsin and smooth muscle actin. This observation shows that embryonal sarcoma of the liver may develop in adult patients and should be taken into consideration in any differential diagnosis of cystic hepatic tumor.
To guide the human resources department within the Ministry of Health to optimize their capacities and skills, this study sought to evaluate perceptions and motivations among public sector physicians ...in the Dakar region, in Senegal.
This descriptive study included 246 of the 307 public sector physicians in Dakar (80.1%). They were interviewed by three investigators, using a pretested and revised questionnaire. Three categories of variables were studied: social, demographic and professional (remuneration, work conditions, involvement in decision-making, career perspectives, key motivating factors). Data were entered and analyzed with Epi Info 3.3.2 software, and averages and frequencies were calculated.
The physicians' mean age was 41.7 years, and they had been practicing for a mean of 11 years: 26% were women, 82% married, 74% hospital staff physicians, and 88% general practitioners. 77% considered their remuneration insufficient; all had additional income, which 48% judged insignificant and 19% irregular. Most lived in a rented home (50%); and only 45% had a personal car. Overall, 55% reported the work environmental as poor, and 65% considered the department's equipment and supplies insufficient. Relationships with their supervisors were good for 37%, with colleagues 62%, with subordinates 51%, and with patients 54%. Overall, 23% reported no involvement in decision-making, and 60% no involvement in designing or setting up health programs. Letters of congratulations from supervisors, considered important by 96%, were obtained only by 59%. Ten percent of doctors belonged to a political party, 13% to a syndicate (union), and 25% to an association. Globally, 83% participated in continuing medical education; and 93% wanted specialist training. Their priorities for their professional careers were: management (27%), autonomy (25%), solidarity (23%), security (13%), and creativity (12%). In decreasing order of frequency, the key factors motivating them were: the work environment (41%), remuneration (38%), promotion (12%), and involvement in the planning process (9%).
The primary motivating factors were not satisfactory for public sector physicians in the Dakar region, which the bulk of public sector resources are concentrated. Its performance affects the global results of the national health system. Recommendations for action by the State, by supervisors, and by medical personnel, concerning the work environment and remuneration might help to improve population health in Senegal.
This qualitative exploratory study carried out in November 2000 describes and analyzes health promotion by community participation in the health district of Touba, in Senegal. The committees were ...primarily made up of women with an implication of local religious authorities which represented the moral responsible. The promotional activities regularly carried out were: health education, distribution of insecticide treated nets, police in waste management and hygiene, and cleaning. Theses activities were supported through the development of income generating activities. The success of the communities is based on the favorable socio-religious environment, strengthened by the particular commitment of the women. The diversity of activities undertaken by the committees is a proof that the identification of people's needs was not limited to health care questions. The community leadership was stimulated by the district, to enhance the dynamics of participation. The financial autonomy of the majority of communities is a guarantee of their sustainability within the district health system. Extremely encouraging results obtained, two essential recommendations were made to strengthen the experience of sanitation committees in health promotion.
This study, intended to contribute to the fight against HIV/AIDS infection, sought to identify the factors limiting condom use among the pupils of the El Mina middle school in Nouakchott, in the ...Islamic Republic of Mauritania.
This investigation, conducted in May 2004, concerned 711 students aged approximately 12-16 years. The dependent variable was condom use, and two categories of independent study variables were examined: socio-demographic and HIV information. The data were entered, verified, and analyzed with Epi info 6.04 software.
Overall 40% of the students reported sexual activity; in this group, 41% reported multiple partners and 38% unprotected sexual relations. Condom use was significantly more frequent among boys, married students, students with more than one partner, those who attended educational sessions, those for whom sexuality is a taboo subject, those who knew a source of supply, and those for whom condoms were geographically and financially accessible.
Condom use among sexually active students is insufficient. This underuse is caused by shortcomings in the distribution system and contributes to the multiplication of sexually-transmitted diseases, including HIV, among the pupils. To provide students with the knowledge necessary for the desired behavioral changes, the following steps are necessary: promoting social marketing of condoms, involving other partners in the fight against STDs and AIDS, using peer educator strategies, and integrating units on HIV/AIDS into secondary education.
Given the seriousness and the increasing extension of the HIV infection, condom use should be promoted to improve the sexual and reproductive health of students and thus of the entire population of Mauritania.
To make the hospital environment healthier for those it serves, the management of biomedical waste (BMW) was studied in the Ziguinchor Regional Hospital Center (RHC) in Senegal from 1 March through ...15 March, 2000. The RHC incinerator had stopped operating in 1993. Problems in BMW management were observed at all levels. Neither identification nor sorting took place during collection. Waste bins were exposed everywhere. Workers, rather than carrying waste bins on their back or head, used rolling tables. BMW ended up in a shallow open pit where they were periodically burned. Workers collected, stored, and transported BMW without any type of protection (gloves, boots, masks, aprons, etc.). The principal determinants of this poor management appear to be inadequate funding and training for the cleaning staff, the staff's failure to realize the dangers, and their use of non-standardized practices, due to the absence of BMW policies. BMW management at Ziguinchor RHC must be corrected. Protective equipment must be used systematically. Similarly, standardized practices must be applied to the decontamination of used objects, the identification and sorting at the source, the recovery and recycling of all objects with any remaining value, and the correct storage of BMW. This waste must be transported under high security from its place of storage to its final disposal site. Deep burial has been selected as the most feasible method of disposal under current conditions. A year-long program has been proposed towards this end. Strategies include training, information, motivation, equipment, supervision and evaluation. The budget to implement this program is CFA 5,423,454 francs, distributed between training (22%), equipment (40%), construction of the pit, and follow-up (38%). The tasks are distributed between a public health doctor, department supervisors, and cleaning staff. The follow-up will include three quarterly inspections, at 3, 6, and 9 months and an evaluation at the end of the program. The effect of the program will be judged by the disappearance of unlawful dumping due to the disposal of all BMW in the RHS's deep burial pit.
