Obstacles to the Integrated Care of Children Aged 6 to 59 Months Suffering from Acute and Severe Malnutrition at the Chu-Me and HATC of N’Djamena/Chad

Introduction: the problem of Severe Acute Malnutrition (SAM) and its consequences concern and challenge all social actors worldwide. The objective of the study was to identify the real obstacles that actors face in the integrated management of children aged 6 - 59 months suffering from SAM at the University Hospital of Mother and Child (CHUME) and the Chad-China Friendship Hospital (HATC) of N’Djamena. Methodology: this is a cross-sectional descriptive and interpretative study conducted from January to October 2023 at the CHUME and HATC of N’Djamena. It is based on questionnaires and direct observation of two hundred and thirty-six (236) parents or guardians of malnourished children admitted to these health facilities. All 236 agreed to participate freely in this study. Results: it appears from this study that the obstacles to the integrated management of malnourished children were: poor care-care relationship (26.7%) permanent product breaks (22.9%), the direct costs of services ranged from 30,000 to 60,000 FCFA (41.53%), drugs used for the treatment of patients came from the street (66.10%), malaria and anemia occupy an important place (27.5%), 57.2% respondents had monthly income below 60,000 CFAF. Conclusion: the present study carried out has identified the real bottlenecks to the integrated management of children suffering from SAM in the therapeutic nutritional units of the city of N’Djamena. .

Laxative Effect of Some Plants Extracts Used in Traditional Pharmacopoeia on the Intestine of Rabbit

Constipation is a condition in which a person or animal has difficulty in eliminating solid waste from the body and the faeces are hard and dry. It is mainly characterized by a difficulty in defecation. The aim of the study is to assess the laxative effect of some plants such as Adansonia digitata , Ziziphus mauritiana and Psidium guayava traditionally used in Chad to treat the problems of constipation. The Microdynamometer method (Biomecatronics) is used to carry out this study. The outcomes show that the extracts’ leaves of Psidium guayava and barks of Ziziphus mauritiana did not lead a significant contraction of duodenum of rabbit until a maximum concentration of 1000 μg, but the extracts’ leaves of Adansonia digitata had a significant effect (P < 0.05) on the intestinal motility of rabbit. This effect of the extract of Adansonia digitata varies with the increase of its concentration (dose dependent) with a maximum of 500 μg and the minimal effect is inferior to 10 μg. On the other hand, the extract of Adansonia digitata has a musculotrope effect because the results have shown that inhibitive molecules such as the atropine and the naloxone do not have to inhibit the action of Adansonia digitata on the intestinal motility of rabbit. Thus, the extract of this plant would reduce significantly the time of intestinal transit and it will be an important laxative drug candidate as described traditionally in Chad.

Assessment of the Physicochemical Quality of Unrefined Shea Butter Produced in the Localities of Sarh and Koumra (Chad)

Introduction: The shea tree (Vitellaria paradoxa) is one of the plant species supplying Non-Timber Forest Products (NTFPs) in Chad. His edible fruits containing almonds are used as a raw material in butter processing. This processing activity is carried out by both informal units and cooperatives. Aim: The aim of the study is to contribute to the improvement of the physicochemical quality of unrefined shea butter produced in the localities of Sarh and Koumra (Chad). Methodology: The methodology consists of conducting surveys in these units and cooperatives to identify production stages and sample butter. The samples taken were analysed for seven (7) physicochemical parameters to assess their quality. The tests are carried out in the laboratories of the Food Quality Control Center (CECOQDA). The results take into account for seven (7) physicochemical parameters that are: 1) Criteria Organoleptic: 50% black and fondant butter;50% yellow and compact butter;28.57% strong smell, 28.57% low odour, 21.43% medium odour and 21.43% rancid;2) Water Content: 0.14% ± 0.020% for yellow butter and 0.25% ± 0.040% for black (p = 0.002);3) Insoluble Impurities: 3.49% m/m ± 0.27 for yellow butter and 3.88% m/m ± 0.38 black;4) Acid Index: 5.11% ± 0.090% for yellow butter and 3.57% ± 0.130% for black;5) Iodine Index: 21.12 g I2/100 g ± 0.670 for yellow butter and 20.67 g I2/100 g ± 0.62 for black;6) Peroxide Index: 11.86 mEq/Kg ± 0.42 for yellow butter and 3.65 mEq/Kg ± 0.28 for black (p = 0.008);7) Saponification Index: 182.64 mg KOH/g ± 0.80 for yellow butter and 193.45 mg KOH/g ± 0.70 black (p = 0.037). Conclusion: This study evaluated the quality of the two varieties of unrefined shea butter. The yellow variety proves to be better in view of the results. However, efforts still have to be made on the processes to connect to the values required by the Codex Alimentarius.

Effectiveness of Enriched Flour in the Recovery of Children Aged 6 to 59 Months with Moderate Acute Malnutrition

Introduction: In Chad, malnutrition is a silent emergency. Yet the use of local products in the fight against malnutrition is essential. The purpose of this study was to compare the efficacy of locally sourced enriched flour in the recovery of children 6 to 59 months of moderate acute malnourishment compared to Ready-to-Use Therapeutic Foods (Plumpy’ Sup) in the city of Abéché-Chad. Methodology: This study took place from 1 October 2021 to 31 January 2022 in the city of Abéché, capital of the province of Ouaddaï. It was conducted in eight (8) urban health centers in the city of Abéché and concerned eighty (80) children with moderate acute malnutrition. It was based on a consumption assessment of two complementary foods by two groups of children. The assessment of nutritional status was made through anthropometric data such as weight, height and brachial perimeter. Results: All 80 children were tested for moderate acute malnutrition. Two complementary foods have been used which are locally produced flour and the Ready-to-Use Therapeutic Food. The study showed that the group 1 who consumed the locally produced flour had an average weight gain of 1100 g and the group 2 who consumed the Plumpy sup had an average weight gain of 400 g. Conclusion: The present study carried out in Abéché allowed us to compare the effectiveness of locally produced weaning flours with Ready-to-Use Therapeutic Foods on moderate malnourished child weight growth in the nutritional units of the town of Abéché.

Anti-Obesity Effect of Boscia senegalensis in Rabbits

Introduction: Obesity is defined as excessive and abnormal accumulation of fatty tissue with significant somatic, psychological and social consequences on quality of life. Obesity has long been considered a simple aesthetic problem linked to excessive gluttony. It is however recognized today as a real pathology, so much so that the WHO has declared it as “the first non-infectious epidemic in history and a major problem of the century”. In addition, many studies have been carried out aimed at the production of less fatty foods and, scientifically, at the development of anti-obesity drugs. Thus, the objective of this study is to evaluate the anti-obesity effect of the extract of Boscia senegalensis (Capparaceae) used in Chad to fight against type II diabetes and metabolic syndrome. Methodology: A bromatological study of Boscia senegalensis extract was carried out at the Food Quality Control Centre (CECOQDA) in Ndjamena (Chad), followed by an in vivo study of rabbits carried out at the IRED Biotechnop&#244;le laboratory (Chad). Results: The results obtained from the 100 g bromatological study of the dry extract of Boscia senegalensis are as follows: protein content (20.24% ± 0.007%), fat content (5.92% ± 0.21%), carbohydrate content (35.16% ± 1.05%), fibre content (2.11% ± 0.26%), moisture content (5.7% ± 0.14%) and ash content (2.90% ± 0.03%). No aflatoxin was detected in the dry extract of Boscia senegalensis. A significant decrease (p = 0.04) in body weight was observed in rabbits treated with Boscia senegalensis extract compared to controls. In addition, histological sections of the various organs (liver, spleen, kidneys) of treated rabbits showed no lesions following the incorporation of the extract of Boscia senegalensis. Conclusion: This study showed the anti-obesity effect of Boscia senegalensis. It also made it possible to verify the harmlessness of the product with regard to the results on chronic toxicity.

Comparison of the Effectiveness of Different Traditional Soaking Processes on the in Vitro Digestibility of Taro(Colocasia esculenta L.SCHOTT)Flour

A traditional process used by farmers in Chad consists in soaking slices of taro (Colocasia esculenta L. SCHOTT) in tamarind infusion, or in corn solution or in water over a 24-hour period to reduce the acridity of taro and facilitate cooking. The aim of this study was to assess the effect of traditional soaking on the in vitro digestibility of taro flour using or not using an α-amylase enzyme. The digestion without the enzyme has shown that the soaking processes improve the digestibility of taro flour (from 39.30% for the control sample to 75.11% (after tamarind infusion) and 78.67% (treatment with water) after 24 hours of soaking). Soaking over a 6-hour period and preferentially in tamarind infusion or in corn solution obtains highly digestible flour (around 95% of digestibility rate after 3 hours of enzymatic digestion).