RESUMEN
Since 2004 the West African countries of Burkina Faso, Mali and Niger have implemented national schistosomiasis and soil-transmitted helminthiasis control programmes with financial and technical support from the Schistosomiasis Control Initiative (SCI). In the first three years of the control programmes, nearly 13.5 million doses of praziquantel and albendazole have been administered against schistosomiasis and soil-transmitted helminthiasis with coverage rates varying between 67.0% and 93.9%. These treatments have resulted in a reduction of the prevalence and intensity of Schistosoma infection in the sentinel cohorts that were set up to monitor and evaluate the national control programmes. The challenges currently faced by these national control programmes are the ability to maintain the reduction in morbidity achieved thus far due to the mass treatment campaigns and ensuring sustainability. For reinforcement of surveillance, the establishment of a geographical information system is suggested in order to contribute towards enhanced sustainability of these programmes. Our new working hypothesis is that targeted control accompanied by periodic mass treatment campaigns (every two to three years) can contribute to maintaining the low levels of morbidity achieved thus far. The implementation of integrated neglected tropical disease control programmes in these countries will provide means to ensure the financial sustainability of control activities for the years to come.
Asunto(s)
Control de Enfermedades Transmisibles/organización & administración , Programas Nacionales de Salud/organización & administración , Esquistosomiasis/epidemiología , Esquistosomiasis/prevención & control , Adolescente , África del Sur del Sahara/epidemiología , Niño , Control de Enfermedades Transmisibles/métodos , Educación en Salud , Humanos , Cooperación Internacional , Programas Nacionales de Salud/economía , Salud Pública/métodos , Esquistosomiasis/tratamiento farmacológico , Esquistosomicidas/administración & dosificación , Esquistosomicidas/uso terapéutico , Factores de TiempoRESUMEN
In the framework of HIV serosurveillance, serosurveys in pregnant women are a good alternative to population-based surveys, which are more difficult to implement. In 2002 and 2006, surveys were conducted in Niger to assess the HIV seroprevalence in pregnant women and to evaluate the trend of the HIV epidemic. The overall seroprevalence was 0.96% (95% CI 0.5-1.7%) and 1.3% (95% CI 0.9-1.8%) in 2002 and 2006, respectively, showing no significant change. In the 2006 overall sample, women living in urban areas were significantly more infected than those in rural environments, with prevalences of 1.9% and 0.7%, respectively (P=0.006). Women with higher school attainment were more often HIV-positive than other women (4.6% vs. 1.7%; P<0.001). The 2006 prevalence, which is among the lowest of the sub-Saharan region, was not significantly different from the national seroprevalence measured in adults in 2002 (0.87%, 95% CI 0.5-1.3%). Close monitoring of the epidemic must be continued.
Asunto(s)
Infecciones por VIH/epidemiología , Seroprevalencia de VIH/tendencias , Complicaciones Infecciosas del Embarazo/epidemiología , Adolescente , Adulto , Recolección de Datos , Femenino , Infecciones por VIH/prevención & control , Humanos , Niger/epidemiología , Embarazo , Complicaciones Infecciosas del Embarazo/diagnóstico , Estudios SeroepidemiológicosRESUMEN
In the framework of the Human Immunodeficiency Virus (HIV) surveillance, seroprevalence and behavioural survey was conducted in 2002 in Dirkou, a place of concentration of female sex workers (FSW) in Niger The global HIV seroprevalence found was 50% (CI at 95%: 40.6-59.36%). The behavioural survey revealed that 98% of FSW had heard about HIV whereas 78.7% know at least one HIV transmission way and 76.9% know at least one HIV prevention means. Only 33.3% declared using condom, what show that sensitisation efforts are needed to induce a behaviour change in FSW and their clients.
Asunto(s)
Seropositividad para VIH/epidemiología , Seroprevalencia de VIH , Conductas Relacionadas con la Salud , Trabajo Sexual , Adolescente , Adulto , Femenino , Humanos , Persona de Mediana Edad , NigerRESUMEN
Urinary schistosomiasis is endemic in the Niger river valley. The aim of the present study was to assess the efficacy and side effects of a single oral dose of praziquantel at 40 mg/kg in the treatment of schistosomiasis. The investigation took place between April 5, 1999 and May 25, 1999. A total of 318 primary school children, aged from 6 to 16 years, of a Schistosoma haematobium endemic area were included in the survey. They underwent a macroscopic and parasitological examinations of the urine before treatment and two and six weeks after treatment. Treatment with praziquantel was given at 40 mg/kg of body weight in a single dose. Side effects due to praziquantel were assessed within the first 4 hours, and 24 hours after. Side effects were frequent (53.7%), especially occurring in the first four hours. Their expression was not associated with the sex of the child nor the intensity of the infestation. We noted that elder children expressed more complaints. The most frequent symptoms were abdominal pains, headaches and pruritus. All these signs were without gravity and resolved within the first twenty-four hours. Before treatment, the prevalence of infestation was 98%. Six weeks after treatment, 32% of children remained positive despite a marked reduction of egg excretion. In this survey, the side effects of the treatment were very frequent but without gravity. Using praziquantel, 68% of the subjects were cured completely. Urinary schistosomiasis control programs can continue to use it for mass treatment without risk.