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Evaluation and use of surveillance system data toward the identification of high-risk areas for potential cholera vaccination: a case study from Niger
Jose Guerra, Bachir Mayana, Ali Djibo, Mahamane L Manzo, Augusto E Llosa, Rebecca F Grais
BMC Research Notes , 2012, DOI: 10.1186/1756-0500-5-231
Abstract: We evaluated the cholera surveillance data using a standard CDC protocol, through interviews with heads of the system, and a review of cholera data collected between 2006–2009. The surveillance system was found to be sufficiently reliable to be able to utilize the data for the detection of high risk areas for cholera vaccination. Temporal, geographic and socio-demographic analyses of cholera cases indicated that between 2006 and 2009, 433 cholera cases were reported in the Maradi region of Niger. Two deprived neighborhoods of the region’s capital city, Bagalam and Yandaka, represented 1% of the regional population and 21% of the cholera cases, reaching a yearly incidence rate of 3 per 1000 in 2006 and 2008, respectively.The results of this evaluation suggest that the reporting sensitivity of the surveillance system is sufficient, to appropriately classify the region as cholera endemic. Additionally, two overcrowded neighborhoods in the regional capital met WHO criteria for consideration for cholera vaccination.In 2008, Africa accounted for 94% of the cholera cases reported to the World Health Organization (WHO). Niger reported a small fraction of these cases, although certain areas of the country face repeated epidemics [1,2]. From 2000 to 2008, Niger reported cholera outbreaks every year, mainly in the south of the country and totaling close to 6000 cases [2]. The region of Maradi has the highest population density in the country and regularly reports cholera cases [2].Two safe and effective oral cholera vaccines (Dukoral and Shanchol) are now available and prequalified by WHO [3-5], with some evidence of induced herd immunity [6,7]. To optimize implementation in cholera-endemic areas, WHO guidance recommends targeting oral cholera vaccination to areas where culture-confirmed cholera has been detected in at least 3 of the past 5?years; and incidence rates are at least 1/1000 population in any of these years or high-risk areas or groups have been identified using in
Health care seeking behavior for diarrhea in children under 5 in rural Niger: results of a cross-sectional survey
Anne-Laure Page, Sarah Hustache, Francisco J Luquero, Ali Djibo, Mahamane Manzo, Rebecca F Grais
BMC Public Health , 2011, DOI: 10.1186/1471-2458-11-389
Abstract: A cluster survey was done on 35 clusters of 21 children under 5 years of age in each of four districts of the Maradi Region, Niger. Caretakers were asked about diarrhea of the child during the recall period and their health seeking behavior in case of diarrhea. A weighted cluster analysis was conducted to determine the prevalence of diarrhea, as well as the proportion of consultations and types of health structures consulted.In total, the period prevalence of diarrhea and severe diarrhea between April 24th and May 21st 2009 were 36.8% (95% CI: 33.7 - 40.0) and 3.4% (95% CI: 2.2-4.6), respectively. Of those reporting an episode of diarrhea during the recall period, 70.4% (95% CI: 66.6-74.1) reported seeking care at a health structure. The main health structures visited were health centers, followed by health posts both for simple or severe diarrhea. Less than 10% of the children were brought to the hospital. The proportion of consultations was not associated with the level of education of the caretaker, but increased with the number of children in the household.The proportion of consultations for diarrhea cases in children under 5 years old was higher than those reported in previous surveys in Niger and elsewhere. Free health care for under 5 years old might have participated in this improvement. In this type of decentralized health systems, the WHO recommended hospital-based surveillance of severe diarrheal diseases would capture only a fraction of severe diarrhea. Lower levels of health structures should be considered to obtain informative data to ensure appropriate care and burden estimates.Although better sanitation, hygiene and access to care have successfully alleviated the burden of diarrheal diseases in developed countries [1,2], diarrhea remains the second leading cause of death in children under 5 years of age in the world, representing nearly one in five child deaths - about 1.5 million each year [3,4]. In sub-Saharan Africa, the etiology of diarrhea is se
Effect of Mass Supplementation with Ready-to-Use Supplementary Food during an Anticipated Nutritional Emergency
Emmanuel Grellety, Susan Shepherd, Thomas Roederer, Mahamane L. Manzo, Stéphane Doyon, Eric-Alain Ategbo, Rebecca F. Grais
PLOS ONE , 2012, DOI: 10.1371/journal.pone.0044549
Abstract: Background Previous studies have shown the benefits of ready-to-use supplementary food (RUSF) distribution in reducing the incidence and prevalence of severe acute malnutrition. Methods and Findings To compare the incidence of wasting, stunting and mortality between children aged 6 to 23 mo participating and not participating in distributions of RUSF, we implemented two exhaustive prospective cohorts including all children 60 cm to 80 cm, resident in villages of two districts of Maradi region in Niger (n = 2238). Villages (20) were selected to be representative of the population. All registered children were eligible for the monthly distributions between July and October 2010. Age, sex, height, weight, and Mid-Upper Arm Circumference (MUAC) were measured at baseline and two weeks after each distribution; the amount and type of distribution and the amount shared and remaining were also assessed. We compared the incidence of wasting, stunting, and mortality among children participating in the distribution (intervention) of RUSF versus children not participating in the distribution (comparison). The absolute rate of wasting was 4.71 events per child-year (503 events/106.59 child-year) in the intervention group and 4.98 events per child-year (322 events/64.54 child-year) in the comparison group. The intervention group had a small but higher weight-for-length Z-score gain (?0.2z vs. ?0.3z) and less loss of MUAC than the comparison group (?2.8 vs. ?4.0 mm). There was no difference in length gain (2.7 vs. 2.8 cm). Mortality was lower for children whose households received the intervention than those who did not (adjusted HR 0.55, 95% CI: 0.32–0.98). Conclusions Short-term distribution with RUSF for children 6 to 23 months improve the nutritional status of children at risk for malnutrition. Fewer children who participated in the RUSF distribution died than those who did not.
Numerical Modelling and Simulation of Sand Dune Formation in an Incompressible Out-Flow  [PDF]
Yahaya Mahamane Nouri, Saley Bisso
Applied Mathematics (AM) , 2015, DOI: 10.4236/am.2015.65080
Abstract: In this paper, we are concerned with computation of a mathematical model of sand dune formation in a water of surface to incompressible out-flows in two space dimensions by using Chebyshev projection scheme. The mathematical model is formulate by coupling Navier-Stokes equations for the incompressible out-flows in 2D fluid domain and Prigozhin’s equation which describes the dynamic of sand dune in strong parameterized domain in such a way which is a subset of the fluid domain. In order to verify consistency of our approach, a relevant test problem is considered which will be compared with the numerical results given by our method.
Preventing Acute Malnutrition among Young Children in Crises: A Prospective Intervention Study in Niger
Céline Langendorf ,Thomas Roederer,Saskia de Pee,Denise Brown,Stéphane Doyon,Abdoul-Aziz Mamaty,Lynda W.-M. Touré,Mahamane L. Manzo,Rebecca F. Grais
PLOS Medicine , 2014, DOI: 10.1371/journal.pmed.1001714
Abstract: Background Finding the most appropriate strategy for the prevention of moderate acute malnutrition (MAM) and severe acute malnutrition (SAM) in young children is essential in countries like Niger with annual “hunger gaps.” Options for large-scale prevention include distribution of supplementary foods, such as fortified-blended foods or lipid-based nutrient supplements (LNSs) with or without household support (cash or food transfer). To date, there has been no direct controlled comparison between these strategies leading to debate concerning their effectiveness. We compared the effectiveness of seven preventive strategies—including distribution of nutritious supplementary foods, with or without additional household support (family food ration or cash transfer), and cash transfer only—on the incidence of SAM and MAM among children aged 6–23 months over a 5-month period, partly overlapping the hunger gap, in Maradi region, Niger. We hypothesized that distributions of supplementary foods would more effectively reduce the incidence of acute malnutrition than distributions of household support by cash transfer. Methods and Findings We conducted a prospective intervention study in 48 rural villages located within 15 km of a health center supported by Forum Santé Niger (FORSANI)/Médecins Sans Frontières in Madarounfa. Seven groups of villages (five to 11 villages) were allocated to different strategies of monthly distributions targeting households including at least one child measuring 60 cm–80 cm (at any time during the study period whatever their nutritional status): three groups received high-quantity LNS (HQ-LNS) or medium-quantity LNS (MQ-LNS) or Super Cereal Plus (SC+) with cash (€38/month [US$52/month]); one group received SC+ and family food ration; two groups received HQ-LNS or SC+ only; one group received cash only (€43/month [US$59/month]). Children 60 cm–80 cm of participating households were assessed at each monthly distribution from August to December 2011. Primary endpoints were SAM (weight-for-length Z-score [WLZ]<?3 and/or mid-upper arm circumference [MUAC]<11.5 cm and/or bipedal edema) and MAM (?3≤WLZ<?2 and/or 11.5≤MUAC<12.5 cm). A total of 5,395 children were included in the analysis (615 to 1,054 per group). Incidence of MAM was twice lower in the strategies receiving a food supplement combined with cash compared with the cash-only strategy (cash versus HQ-LNS/cash adjusted hazard ratio [HR] = 2.30, 95% CI 1.60–3.29; cash versus SC+/cash HR = 2.42, 95% CI 1.39–4.21; cash versus MQ-LNS/cash HR = 2.07, 95% CI 1.52–2.83) or with the
A rapid screening tool for psychological distress in children 3–6years old: results of a validation study
Caroline Marquer, Caroline Barry, Yoram Mouchenik, Sarah Hustache, Douma M Djibo, Mahamane L Manzo, Bruno Falissard, Anne Révah-Lévy, Rebecca F Grais, Marie-Rose Moro
BMC Psychiatry , 2012, DOI: 10.1186/1471-244x-12-170
Abstract: This study was conducted in Maradi, Niger. The scale was translated into Hausa, using corroboration of independent translations. A cross-cultural validation was implemented using quantitative and qualitative methods. A random sample of 580 mothers or caregivers of children 3 to 6 years old were included. The tool was psychometrically examined and diagnostic properties were assessed comparing the PSYCa 3–6 against a clinical interview as the gold standard.The PSYCa 3–6 Hausa version demonstrated good concurrent validity, as scores correlated with the gold standard and the Clinical Global Impression Severity Scale (CGI-S) [rho?=?0.41, p-value?=?0.00]. A reduction procedure was used to reduce the scale from 40 to 22 items. The test-retest reliability of the PSYCa 3–6 was found to be high (ICC 0.81, CI95% [0.68; 0.89]). In our sample, although not the purpose of this study, approximately 54 of 580 children required subsequent follow-up with a psychologist.To our knowledge, this is the first validation of a screening scale for children 3 to 6 years old with a cross-cultural validation component, for use in humanitarian contexts. The Hausa version of the PSYCa 3–6 is a reliable and a valuable screening tool for psychological distress. Further studies to replicate our findings and additional validations of the PSYCa 3–6 in other populations may help improve the delivery of mental health care to children.The mental health needs of young children in humanitarian contexts often remain unaddressed [1-4]. During the acute phase of a humanitarian emergency, and in humanitarian contexts in general, psychological care of children may come far down on the list of priorities. The limited number of both local and international medical professionals combined with the relative lack of mental health professionals in these settings also hinders the implementation of mental health activities [5]. Further, even when mental health professionals are present, they are rarely specialists in yo
Distance and Visibility: Two Systems in Hausa Deixis
Abdoulaye, Mahamane L.
Linguistik Online , 2008,
Abstract: The current standard account of Hausa deixis claims that Hausa has a linear person-based system with the following four locative adverbs and their interpretations: nan 'here', nan 'there near you', can 'there away from you and me', and can 'over there away from you and me'. This paper shows that in fact one may need two separate deictic systems for Hausa to account for all relevant data. The first system is based on distance with a primary proximal vs. distal contrast. The distance system however also embeds a person subsystem, with one adverb in particular referring to the hearer (second person) position. The second deictic system in Hausa is based on visibility, with a primary contrast between an area comfortably visible and an area visible only with some difficulties. Indeed, in the visibility system, five adverbs range the entire visible area in front of the speaker, from the foreground up to the extreme visible area at the horizon.
Perfect and Perfective in Hausa
Mahamane, L. Abdoulaye
Afrikanistik Online , 2008,
Abstract: In West African languages that have the relative TAM marking, i.e., a system of syntactically conditioned alternating TAM paradigms, it is generally considered that the paradigms in each alternating pair have necessarily the same meaning. This paper shows that in Hausa, the Completive, which appears in pragmatically neutral clauses, and the Relative Perfective, which appears in pragmatically marked clauses (such as relative clauses), have, respectively, a basic perfect and perfective semantics, and that in some marked cases the alternation is not possible. The paper also shows that the two paradigms have acquired derived uses in a way consistent with the results of typological studies in the domain of tense/aspect.
Los usos políticos del cuerpo: los dos cuerpos del rey en la filosofía política de Francis Bacon
Manzo, Silvia;
Kriterion: Revista de Filosofia , 2008, DOI: 10.1590/S0100-512X2008000100011
Abstract: as a prominent intellectual figure in the complex political arena of england, during the transition from tudor to stuart dinasties, francis bacon (1561-1626) assumes the medieval king's two bodies theory in his political and juridical writings. his use of this theory is extremely linked to central concepts of his natural philosphy, which testifies to the deep connection that bacon finds between politics and nature. this paper addresses bacon's use of the king's two bodies theory and its link to the rest of the baconian philosophy. the focus of this study will be his discourse on the naturalization of scots born after james i assumption of power, where bacon deals more deeply with the king's two bodies theory.
Francis Bacon y el atomismo: una nueva evaluación
Manzo, Silvia;
Scientiae Studia , 2008, DOI: 10.1590/S1678-31662008000400002
Abstract: there is no unanimity among recent historians about francis bacon's theory of matter. disagreement exists in particular about bacon's atomist and animistic ideas. my claim is that although bacon changed his views on atomism repeatedly, he never rejected it completely. i shall reconstruct bacon's various opinions in chronological order to establish his final evaluation of atomism and his reasons for it. because bacon never held an orthodox atomist matter theory identical with greek atomism, for this paper i will define atomism in the broadest sense, as a corpuscular matter theory that posits final and indivisible particles. following this semantic delimitation, two successive baconian opinions may be distinguished: the first took the atomism to constitute an ontological and causative-operational principle; the second deprived the atom of its causative-operational ability, but did not touch its ontological priority. furthermore, i will investigate the question of the coexistence of atomism and pneumatism in bacon's theory, a point that has been discussed in the influential interpretations by kargon and rees. however, i shall argue that bacon did not regard these two doctrines as incompatible.
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