3 resultados para qualité des soins

em Bioline International


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This paper explores the factors associated with the place of death in Burkina Faso, based on mortality data from the Kaya Health and Demographic Surveillance System (Kaya HDSS). A multilevel logistic regression model with random intercept is used to determine the factors associated with the place of death. More than half of the deaths (55%) occur at home. Age, place of residence, distance to the health care centre and cause of death are statistically associated with the place of death. Seniors (50 and over) are more likely to die at home compared to other age grous (66.81 % against 35.9 % for 5-14 years and 44.9 among children under 5 years, p = 0.001). The multivariate results confirm the effect of age, place of residence, living standards quintile and cause of death. The high proportion of deaths occurring at home challenges policy makers in the health care system and calls for programs to adapt the supply of heath care.

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En Afrique sub-saharienne, les recensements constituent une source de données fondamentale pour estimer la mortalité, en raison de l’incomplétude de l’enregistrement des décès à l'état civil. Afin d’évaluer la fiabilité des niveaux de mortalité qui peuvent en être déduits, nous appliquons différentes méthodes d’estimation à des extraits des recensements sénégalais de 2002 et 2013, couvrant trois observatoires de population situés à Bandafassi, Mlomp et Niakhar. Les taux de mortalité des moins de cinq ans tirés du nombre d’enfants nés vivants et survivants s’avèrent plus bas que les niveaux attendus au vu des données du suivi démographique. Les estimations déduites des déclarations sur la survie des parents sont largement inférieures aux niveaux de mortalité adulte réellement observés selon le suivi. Par contre, les taux de mortalité par âge basés sur les décès récents déclarés dans les ménages sont conformes aux données du suivi, sauf pour la mortalité infantile qui est sensiblement sous-déclarée en 2002. Cette évaluation confirme que les méthodes indirectes procurent des estimations qui ne peuvent être considérées isolément mais doivent plutôt être systématiquement comparées les unes aux autres. Des études d’évaluation directes menées au niveau individuel à l’aide d’appariements sont nécessaires pour mieux identifier les différentes sources de biais.

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The bean bruchids, Acanthoscelides obtectus Say and Zabrotes subfasciatus Boheman (Coleoptera: Bruchidae), are cosmopolitan pests of stored dry common beans ( Phaseolus vulgaris L. ), causing damage through reduction of grain quality and seed germination. Biological resistance to these bruchids was definitively established in non-cultivated bean accessions, and has been introgressed into a range of drybean market classes. However, existing resistance to bruchids in Uganda’s common bean germplasm has not been systematically studied. In this study, 45 bean genotypes from the National Bean-Breeding Programme (25 genotypes) and agroecologically diverse bean growing areas in Uganda (20 genotypes), were evaluated for postharvest bruchid resistance. None of the evaluated bean genotypes expressed resistance to either bruchid species, with all the 45 bean genotypes supporting bruchid development, reproduction and feeding. All genotypes were severely damaged by bruchids feeding, resulting in significant (P<0.05) reduction of seed germination. Reduction in seed germination was related to the number of emergence holes and seed size; small bean seeds damaged by up to 2 bruchid emergence holes had a 7.1% reduction in germination, while large bean seeds with a similar number of emergence holes showed a 25% reduction in germination. Whereas this study further confirms bruchids as important storage pests of beans causing direct loss through consumption of the seed and indirect loss through viability deterioration, the resistance to bruchids in the evaluated range of Uganda’s dry bean germplasm is inadequate for direct exploitation in a breeding programme.