In this work, we use existing particulate matter (PM) data from Dakar, Senegal, satellite aerosol optical depth (AOD) and the Weather Research and Forecasting (WRF) model to evaluate the role of dust transport from the Sahara and PM concentrations and exposure into other administrative districts of Senegal during 2015 and 2016. We also use data from the Ministry of Health to examine spatial and temporal patterns of acute respiratory infections, asthma, bronchitis, and tuberculosis across Senegal with an emphasis on Northern Hemisphere winter December-February, when air quality is poor, and June-August when there is an improvement in air quality. Measurements in Dakar, Senegal, suggest hazardous PM 10 concentrations associated with Saharan dust storms but lower PM 10 concentrations during the summer. The WRF dust simulations show a similar temporal pattern to the observations in Dakar, Senegal, with notable biases. However, the WRF model suggests that the highest dust concentrations are found across the northern half of Senegal during the winter season where there are no currently PM measurements. Health data during 2015-2016 show the highest prevalence of asthma and bronchitis in Dakar, Senegal, suggesting that other sources of air pollution are important. Acute respiratory infection is prevalent throughout the country with the high prevalence found in rural zones, for children between 12 and 59 months. All measures including real-time monitoring, air quality forecast, and communication should be used to protect the public from potentially hazardous environmental conditions during the winter season. Plain Language SummaryAir pollution is a leading cause of respiratory and cardiovascular disease and may be responsible for a significant fraction of infant mortality in West Africa. We examine observations and simulations of PM 10 and PM 2.5 concentrations using the Weather Research and Forecasting model during 2015 and 2016 in Dakar, Senegal, and the entire country. We also examine monthly and trimester patterns of asthma, bronchitis, acute respiratory infection, and tuberculosis cases across Senegal. Observations from Senegal show that monthly PM 10 and PM 2.5 concentrations are unhealthy from December through March but improve during the summer months. Saharan dust aerosols, which are transported into Senegal are responsible for the poor air quality through attribution studies using the Weather Research and Forecasting model. We also find the largest numbers of cases of asthma and bronchitis in Dakar, suggesting that urban sources contribute to poor air quality. However, these cases occur during the summer season when air quality is improved. Acute respiratory infection is a public concern in Senegal with the highest values occurring away from the capital city.
La fièvre bilieuse hémoglobinurique (FBH) est une forme grave du paludisme; caractérisée par la survenue d'une hémolyse intravasculaire aiguë se traduisant par une anémie hémolytique, une insuffisance rénale aiguë et une hypovolémie. Son diagnostic repose essentiellement sur la clinique notamment la couleur des urines d'aspect rouge porto. Nous rapportons un cas de fièvre bilieuse hémoglobinurique chez un jeune garçon de 10 ans originaire et vivant dans une zone d'endémie palustre, colligé dans un CHU de Dakar (Sénégal). V.G est un garçon de 10 ans qui était hospitalisé pendant 2 jours au service des urgences dans un centre de santé de proximité pour une fièvre associée à des vomissements qui évoluaient depuis 3 jours. Le test de diagnostic rapide (TDR) au paludisme était positif à la présence d'antigènes de Plasmodium falciparum dans le sang. Un traitement à base de quinine injectable (25 mg/kg/j), a été entrepris pendant 03 jours. Au quatrième jour, sont apparues une hémolyse intravasculaire aiguë et une hémoglobinurie avec une insuffisance rénale aiguë anurique. La goutte épaisse était revenue négative et le traitement par la quinine injectable arrêté. Le relais a été fait avec les dérivés de l'artémisinine. Trois (03) séances d'hémodialyse ont été réalisées. L’évolution était favorable, par la reprise de la diurèse et la normalisation de la fonction rénale. La FBH existe encore dans notre pratique quotidienne. Il faut y penser devant l'apparition brutale d'une hémolyse avec insuffisance rénale aiguë et urines rouges porto au cours du traitement d'un paludisme.
Les malformations artérioveineuses (MAV) sont des anomalies vasculaires congénitales à haut débit très rares chez l'enfant. Leurs localisations atypiques et leurs manifestations cliniques variables rendent leur diagnostic et leur prise en charge souvent tardifs. Nous rapportons le cas d'un enfant pris en charge au Centre Hospitalier National d'Enfants Albert Royer de Dakar. Un garçon âgé de 9 ans nous a été adressé d'une structure sanitaire en milieu rural pour la prise en charge d'une insuffisance cardiaque. L'examen clinique à l'admission montrait une altération de l'état général, un syndrome d'insuffisance cardiaque globale et une volumineuse masse inguino-crurale droite, chaude, étendue à la paroi abdominale latérale droite (fosse iliaque et flanc droit), à limites mal définies. L'auscultation de cette masse objectivait un thrill et un souffle diffus. L'échographie cardiaque montrait une HTAP sévère avec retentissement important sur les cavités cardiaques, sans atteinte structurelle du cœur. Le diagnostic de MAV a étè confirmé par une échographie doppler de la masse complétée par un angioscanner. Ils mettaient en évidence des fistules artérioveineuses multiples au sein de la masse. Le diagnostic d'une MAV complexe de la racine de la cuisse droite au stade IV de Schöbinger a étè retenu. La prise en charge médicale a consisté au traitement de l'insuffisance cardiaque à base de furosémide, de spironolactone, et de captopril, en vue d'une stabilisation hémodynamique pour une éventuelle cure chirurgicale. Les malformations artérioveineuses des membres, en particulier de l'extrémité proximal du membre inférieur sont encore méconnues chez l'enfant, d'où les erreurs et retards diagnostiques fréquents. Leur évolution est imprévisible d'où la nécessité d'un diagnostic précoce et d'un suivi attentif impliquant une collaboration pluridisciplinaire entre pédiatres, chirurgiens et radiologues.
Introduction: Purulent pleurisy refers to the presence in the large pleural cavity of a purulent, cloudy or lemonyellow liquid, but containing altered polynuclear cells. It is a frequent pathology, the epidemiology of which is constantly changing in Africa and throughout the world. This is why we conducted this study with the aim of updating epidemiological, clinical, bacteriological and therapeutic data. Methods: This is a retrospective, mono-centric, descriptive study including the records of children aged 0 to 15 years old hospitalized during the period from 20 May 2014 to 26 March 2019 at the Children's Hospital of Diamniadio for purulent pleurisy. The data were entered and analyzed using sphinx, Excel under Windows 8 and SPSS software. Results: We counted 42 cases of purulent pleurisy, i.e. a hospital frequency of 0.7%. Most of the patients were aged between 2 and 12 years (48%). The average age at diagnosis was 46 months. The sex ratio was 2.5. Most of the children came from parents with a low socio-economic status (64%); fever was the most frequent reason for consultation (50%), followed by cough (33%) and respiratory difficulty (29%). In all cases, a liquid effusion syndrome was objectively diagnosed (100%), tachycardia in 36% of cases and a pulmonary condensation syndrome in 33% of patients. X-rays showed a predominantly right-sided effusion (62%) which was very abundant in 71% of cases. In bacteriology, staphylococcus aureus was the most frequently isolated germ (75%), followed by streptococcus pneumoniae (20%) and group D streptococcus (5%). Biology showed an average hemoglobin level of 9.2 and there was a predominantly neutrophilic hyperleukocytosis in 98% of cases. All patients had received antibiotic therapy and pleural drainage in 76% of cases. Mortality was 10%. Conclusion: In the light of this work, we insist on the importance of early diagnosis and adequate management of purulent pleurisy in order to avoid complications and after-effects. Thus, antibiotic therapy should be more closely monitored, and its administration better codified to reduce bacterial resistance and germ selection.
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