Santé (Montrouge, France)
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Santé (Montrouge, France) · Oct 2004
Review[Familial Mediterranean Fever (FMF): from diagnosis to treatment].
Familial Mediterranean Fever (FMF), also known as paroxysmal polyserositis, is an autosomal recessive disease affecting mainly Mediterranean populations (Jews, Armenians, Arabs, Turks). It is characterised by recurrent crises of fever and serosal inflammation, leading to abdominal, thoracic or articular pain. Erysipela-like erythema affecting mainly feet and legs and effort-induced myalgia are less frequently encountered symptoms. ⋯ The alpha/alpha genotype of the serum amyloid A or SAA1 gene is associated with an increased risk of amyloidosis in FMF patients, especially in patients homozygous for M694V, whereas the MICA (Major Histocompatibility Complex, MHC class-I-chain-related type A) gene seems to have an effect on disease course but not its clinical manifestations. The most effective treatment for FMF patients is colchicine, which should be taken regularly on a life-long basis. It decreases the frequency and severity of crises and prevents renal amyloidosis.
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Santé (Montrouge, France) · Oct 2004
Comparative Study[Epidemiology of eye injuries in Abidjanian children].
Eye injuries, most of them preventable, are particularly severe in Africa, because of the risks of infection and delay in treatment. We report a 16-month (March 1997-June 1998) prospective observational survey of eye injuries in children up to the age of 15 years at Treichville-Abidjan University Hospital. During this period, 62 children were treated for these injuries. ⋯ Eyeball phthysis (14.5%) was secondary to 8 open wounds of the eyeball and one postcontusion retinal detachment. Eye injuries remain a major cause of monocular blindness in children in Cote d'Ivoire. Most of them can be prevented by relatively simple measures including supervision of children and rapid hospitalisation when injury occurs.
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Santé (Montrouge, France) · Apr 2004
[Blood transfusion safety in a limited resources setting: the elaboration of a rational National Blood Policy in Togo].
The demand for blood transfusion is high in subSaharan Africa because of the high prevalence of the anemia especially due to malaria and obstetrical damage. Providing a safe and confident system of transfusion requires more and more resources when, in developing countries, these are in fact limited. With a double view to improve the coverage in blood transfusion and ensure the security of blood products, the Ministry of Health of Togo launched in 1999 a series of operations for setting up a rational National Blood Transfusion Policy. ⋯ It was validated during a three-day multidisciplinary workshop and an ultimate validation was made by an international consultant in order to assess the adequacy of the options considered to the country's specific setting. The options retained for developing the Togolese blood transfusion sector development and which are consigned in the National Blood Transfusion Policy are as follows: development and implementation of blood transfusion regulations; reorganisation of the National Transfusion System by reducing it to 3 blood unit production centres: one in Lomé (the capital town), one in the centre of the country (Sokodé, 480 km from Lomé), and one in the Northern part (Dapaong, 870 km from Lomé); setting up of a system of blood collection, storage and distribution around these centres; promotion of voluntary and anonymous blood donation; promotion of quality assurance in the system and of good blood prescription practice; development and implementation of an appropriate and simple information system for better management; identification of a sustainable and equitable financing system in which the State must play a key role. The implementation of the National Blood Policy; and in particular the achievement of its goals requires: i) permanent State commitment; ii) the building of a rational action plan - with a financing framework for all blood transfusion partners; and iii) regular program evaluation.
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Santé (Montrouge, France) · Jan 2004
[Effect of iron supplementation among pregnant women at mother-and-baby clinic of Sidi Bel Abbès, West Algeria].
Iron deficiency is the most prevalent nutritional disorder worldwide, especially in developing countries. It occurs when iron absorption does not equal iron requirements plus iron loss. Because iron requirements are especially high in pregnant women, infants, young children, and adolescents, these groups run a high risk of iron-deficiency anemia. ⋯ The prevalence of anemia fell from 34.1% in the first trimester, before supplementation, to 6.3% in the third trimester. This finding suggests that the supplementation prevented the fall in hemoglobin and serum iron that occurred among the women without anemia. We think that iron supplementation is a good strategy for treating and preventing anemia during pregnancy.
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Santé (Montrouge, France) · Oct 2003
Review[Evolution and new perspectives of health care financing in developing countries].
Over the last twenty five years, the perspective of health care financing has dramatically changed in developing countries. In this context, it is worth reviewing the literature and the experiences in order to understand the major shifts on this topic. During the sixties, health care policies focused on fighting major epidemics. ⋯ In this early millenium, there is a general agreement on some major aspects of health care financing such as: Lack of resources for financing health care; cost recovery as a part of any sustainable health care system; health as a public good needing some extended subsidies; protecting people from the burden of disease as a part of financing schemes; equity in relation with the public private mix at the center of many debates; financing as a key mechanism for the regulation of the whole health care system and not only as a resource mobilization; HIV in bringing up new problems clearly shows how all these matters are related. Health care financing is at the heart of ongoing questions on health care reforms. Although developing countries have low insurance coverage and weak modern medical care, they share the same questions as developed countries: How to promote technical and allocative efficiency? What place for incentives? What role for the public sector? How can market and contracting bring results? What progress through stewardship and better governance?