Extension of Chemoprevention of Seasonal Malaria to Five Cycles and to Children from the Age of 6 to 9 Years in Africa: Analysis of Its Acceptability, Feasibility, Cost and Impact A Systematic Review

Introduction: Seasonal Malaria Chemoprevention (SMC) aims at preventing malaria in children during the high transmission season. It has been recommended by the WHO since 2013 for children from the age of 3-59 months. However, despite the impact of this intervention, a peak in the prevalence and incidence of malaria is observed in children from the age of 5-9 years. The aim of this study is to determine from the current literature the feasibility, impact and cost-effectiveness of extending SMC to five cycles and to older children. Methods: A litterature search of PubMed/Medline, NCBI and Google scholar identified 1333 articles. After reading the titles and abstracts by two authors, 24 articles were selected and submitted for full reading. Random control studies on the extension of SMC, malaria, feasibility of SMC, impact of SMC and cost-effectiveness of SMC were selected. A total of 16 articles were included for the qualitative synthesis after excluding 8 studies. Results: Following the summary of the evidence, we conclude that the extension is feasible but will be confronted with the unavailability of older children. The intervention period coincides with field work. SMC is effective in reducing the prevalence and incidence of malaria and the parasite density in children. The financial cost of administering SMC is lower than that of treating a child suffering from malaria. Conclusion: After analysing the information, it was found that the majority of the African population supports the extension of the SMC to the number of cycles and the age group in order to alleviate the high mortality and morbidity rates among children due to malaria.

Monitoring of the Physicochemical and Bacteriological Quality of the Water of the Gounti-Yéna Basin and Assessment of the Impact on the Health of the Populations

The Gounti Yéna valley is the main watercourse that divides the left bank of the city of Niamey into two unequal parts. The area of its watershed is estimated at about 62 km2. The objective of this study is on the one hand to evaluate the current state of the physico-chemical and bacteriological quality of the water of the Gounti Yéna basin and on the other hand to define the risks of water pollution and its origin in the face of the phenomenon of the rise in the water table of this basin by defining some health risks linked to these impacts. In order to properly carry out this work, we carried out a study of the evolution of the physicochemical and bacteriological parameters of the water of the Gounti Yéna basin during the period from November 2020 to October 2021, at three sampling points chosen from upstream to downstream of the basin then entomological surveys and among the health centers of the capital. The results obtained showed that the physico-chemical quality of water in the Gounti Yéna basin is influenced by climatic factors (precipitation and temperature) and anthropogenic actions. This study also highlighted the presence of faecal contamination in the water of the Gounti Yéna basin with a greater degree during the rainy season. This contamination remains worrying and constitutes a health risk causing waterborne diseases. The stagnation of the various bodies of water is also a favorable place for the development and spread of vector-borne diseases.

Physicochemical and Bacteriological Quality of Ground Water in the Basin of Gounti Yena Valley in Niamey City (Niger Republic)

The Gounti Yéna valley, the subject of this study, is a tributary of the Niger River, it is the main watercourse that divides the left bank of the city of Niamey into two unequal parts. The surface area of its watershed is estimated at about 62 Km2. The objective of the present study is on the one hand to evaluate the current state of the physico-chemical and bacteriological quality of the water of Gounti Yéna basin, and on the other hand to define the risks of water pollution and its origin in the face of the phenomenon of rising water table of this basin. In order to carry out this work, we proceeded to a study of the evolution of the physicochemical and bacteriological parameters of the water of the basin of Gounti Yéna during the period going from November 2020 to October 2021, at the level of four points of sampling chosen from the upstream to the downstream of the basin. The results obtained showed that the physico-chemical quality of the water in Gounti Yéna basin is influenced by the lithology of the watershed, climatic factors (rainfall and temperature) and anthropic actions. This study also highlighted the presence of fecal contamination in the water of the Gounti Yéna basin, with a greater degree of emphasis during the rainy season. This contamination remains a concern and may constitute a health risk.

Human Rights Jurisprudence in Hospice Care——Thoughts on the Concept and Boundary of “Death with Dignity”

Death with dignity is the embodiment of the dignity of human life in the context of end-of-life medical care.However,in the development of its concept,it has been alienated into a single way of death and is often confused with the concept of euthanasia.It is therefore a theoretical and practical necessity to re-expand the connotations of death with dignity Death with dignity is the subjective value of dignity reflected in the context of dying.It takes equality,freedom,and virtue as the core,and uses the right to life as its external support.It is projected onto the medical context and incorporates the patient’s right to informed consent.Subject to public interest,legal paternalism,and the principles of public order and good customs,the boundary of the right to death with dignity should be between active treatment and natural death,and active euthanasia in the form of giving up the right to life should not be included in the right to death with dignity.

Rise of Urban Water Table as a Cause of Flooding: Improving Knowledge in the City of Niamey (Niger Republic)

Niamey, the capital of Niger, has experienced continuous demographic growth (+4%), accompanied by rapid urban expansion that is insufficiently controlled. This growth, combined with the effects of climate change as well as a drastic change in land use (urbanization of cultivated fields, deforestation of plateaus and erosion of slopes) disrupts the water cycle, thus leading to the superposition of three types of floods: 1) rain floods (monsoon period);2) river floods (Niger river);and 3) flooding caused by rising water table. In several neighbourhoods, the water table is now out in a sustainable manner and degrades already fragile sanitary conditions. This study aims to clarify the functioning of aquifers in the city of Niamey due to the combination of geological, geophysical and hydrogeological data. Hydrogeological investigations make it possible to identify, in areas flooded by the water table, a shallow aquifer with low capacitance (effective porosity of a few %) and low permeability (2 × 10-6 to 1 × 10-4 m/s), overlying at a level shallow clay (~10 m) and lying on the Precambrian base (schists, granites). This configuration limits flows and has led to the appearance of permanent pools created by the water table in the valley thalweg in and around the city. Thus, in Niamey, an increase of up to twenty to forty meters was observed between 1961 and 2021 with seasonal piezometric fluctuations of a pluri-metric order following the rainy season. Beyond the health impacts, this trajectory negatively impacts land and locally causes degradation or displacement of traffic axes. Containing the level of the water table appears to be essential in the long term for sustainable sanitation in the city of Niamey.