[Food consumption patterns in the urban milieu of Bamako].

Food consumption patterns in urban environments are changing and diversifying. This longitudinal study of individual food consumption took into account the coexistence of two types of food consumption: within the home and outside the home. This article presents a summary of qualitative and quantitative research carried out in Bamako, Mali in 1995 and 1996 among 74 families from different socio-economic groups.

[Health care seeking behavior of children in Togo].

Epidemiological and anthropological studies were carried out in Togo on health seeking behavior for under 5 children to determine causes of dysfunctions in health services. This article reports on the main findings of the anthropological study. Anthropological literature on health seeking behavior has identified labeling and associated explanatory models of illness as important factors for making choices in the use of health services.

[Natural histories of disease: a pragmatic approach to multidisciplinary research on health care seeking behavior and therapeutic itineraries].

Public health is determined by the interaction of social, cultural and biological factors. Because of this complexity, a multidisciplinary approach is needed when doing research on public health problems. Medical anthropology and epidemiology share a common interest for human behavior and health, so it is especially appropriate for these two disciplines to work together in studying health seeking behavior and the use of health systems.

[Maternal mortality and referral maternities in Morocco: how to (re)motivate professionals?].

The very high rates of maternal mortality and perinatal mortality, as well as the deficiencies and dysfunctions observed in maternity hospitals, which play the role of referential maternity wards, led the Moroccan Minister of Public Health to implement a project in order to improve the quality of care of parturient women and new-borns. This project included 8 provinces in the country. The strategy chosen was "the team approach to resolving health problems", which is a learning process which leads local teams to implement and evaluate projects they have developed themselves.

[The time is ripe for listening to the voice of the half of the world].

Has the world of women changed? So wonders a one-time champion of what was then called women's rights, and is now known as women's empowerment, in the Third World. She recalls her surprise when she listened to advocates of birth spacing as a young mother. She remembers the debates she attended: "Today development, tomorrow the Pill", "Women's education is the key to progress", the speculations of western feminists ignorant of the burden of traditions kept alive elsewhere.

[Home and outside home food complementarity in Bamako (Mali): nutritional and economic aspects. What is the rationality behind consumers' choices?].

Background: Great modifications in social and family relationships and life style come from rapid urbanisation in developing countries. Various types of malnutrition coexist in these towns. Food consumption outside the home is more and more common.

Comparison of the safety and immunogenicity of the lyophilized Mérieux seed and the World Health Organization working reference BCG vaccines in school-aged children in Senegal.

In order to validate two new lots of Mérieux BCG vaccine (Mérieux seed derived from strain 1072), a calibration study was performed to compare their safety and immunogenicity to a full dose of the WHO-reference BCG vaccine (Tokyo strain 172) as well as the WHO-reference vaccine given at 1/10 of its normal concentration, in an open, randomized, four-arm, multicenter study in Senegal. A total of 1041 healthy Senegalese children aged 8-10 years were screened for participation in this study, of whom 548 had a negative Mantoux test and complied with inclusion and exclusion criteria. These children were randomly allocated a single dose of one of the following vaccines: full-dose Mérieux BCG vaccine (lot E0650); full-dose Mérieux BCG vaccine (lot E0624); full-dose WHO-reference vaccine (Tokyo strain 172); or 1/10 dose WHO-reference vaccine.

[Expanded program of vaccination. Results and prospects].

The expanded program on immunization, jointly launched by WHO and UNICEF in 1974 aimed in the beginning at immunizing 80% of the children of the world against measles, tetanus, pertussis, poliomyelitis, diphtheria and tuberculosis. After reaching the objectives in 1990, countries have been urged towards eradication of poliomyelitis, elimination of neonatal tetanus, and measles control. Immunization against hepatitis B and yellow fever were also proposed according to local epidemiology.

[Food habits outside the home by school children in Cotonou (Benin)].

Urban growth leads to the consumption of food outside the home, with the demand for street food coming particularly from school children. A survey of 240 primary school children aged 8 to 13 was carried out, by means of personal interviews. More than 90% were regularly given pocket money by their parents, and this money was used mainly for buying food from vendors inside or near their schools.

[Devaluation of the African Financial Community franc and the dietary strategies of families in Bamako (Mali)].

This survey, conducted in 1996, evaluated changes in the way families feed themselves caused by the effects of devaluation of the CFA franc. It involved semi-directed interviews with 64 subjects from various socio-economic backgrounds (affluent, middle-class, poor). The subjects spoke of the difficulties of daily life, lack of money and rapid, unpredictable rises in the prices of essential goods caused by the devaluation.

[Vitamin A deficiency: epidemiological aspects and control methods].

Vitamin A deficiency is one of the most common nutrient deficiency syndromes in children from developing countries. It is also correlated with the increased severity and incidence of certain infections. Until recently, vitamin A research was focused on preventing xerophthalmia and blindness in Third World Countries and on the development of synthetic retinoid molecules, with lower toxicity than vitamin A, for the treatment of skin diseases.

[Variability of home dietary habits of families living in Bamako (Mali) according to their socioeconomic status].

We investigated the influence of standard of living on the dietary and eating habits of families in Bamako (Mali). Family meals eaten at home at any time of day were studied. Families were selected for the study according to two criteria: the place of residence and the domestic commodities and urban investments.

[An approach to food consumption in an urban environment. The case of west Africa].

West Africa has undergone rapid economic and political changes during the last 20 years. After the failure of economic policies implemented since independence, programs for structural adjustment have strongly influenced the economy. Food problems affect each country differently.

[Nutritional habits of adolescents in the Paris suburbs].

Background: Physical and psychological disorders in adolescence may lead to specific food behaviours. The aim of this work was to make a group of adolescents full actors of the conception and realization of a study on their food consumption and attitudes.

Population And Methods: Seventeen self-selected adolescents (age: 12 to 18 years) were enrolled in the study.

[A method to estimate the nutritional value of food sold by street vendors].

Food bought outside the house from woman vendors accounts for a significant part of the nutritional intake in urban areas in Africa regardless of age and socio-economic category of the inhabitants. Despite this fact outdoor food consumption is not adequately taken into account in relevant studies. The great variability in space and time of recipes used by vendors makes it very difficult to estimate the nutritional value of the food consumed.

[Update on the BGC vaccine. Indications for use in Europe and in developing countries].

BCG vaccination is one of the tuberculosis control means. Since 1921, more than 3 thousand millions doses of BCG vaccine have been administered in 172 countries in the world. Vaccine, technical and side effects are today well known but we do not know nearly anything about the ideal age for initial vaccination and about the need, or not, of repeated vaccinations.

[Bamako school age children and their diet from street vendors].

Eating outside the home is very common in African cities. Food is bought from street vendors and eaten on the street. A large proportion of these consumers are school children, but little is known about what they buy, and the reasons why they make the choices they do.

[Control of Haemophilus influenzae infections].

The results of all clinical trials and mass immunization programmes carried out over the past few years are extremely encouraging and should be the prelude to systematic immunization. Three vaccines that are immunogenic in infants over 6 weeks old, are now available: HbOC linked to diphtheria toxin, PRP-OMP linked to a meningococcus protein, and PRP-T linked to tetanus toxoid. Their safety has been demonstrated particularly when administration at a very early age before the period of risk.

[Integration of the Expanded Program on Immunization into primary health care: examples of Benin and Guinea].

Since 1986, two West African countries have been delivering immunizations within the framework of reorganized peripheral health systems. This revitalization is based on strategies which are implemented by an increasing number of African countries under the name "Bamako Initiative". It aims at providing universal access to a minimum package of maternal and child health priority interventions starting with immunizations, pre and perinatal care, oral rehydration for diarrhoea, treatment of malaria and acute lower respiratory infections.

The frontline of HIV1 diffusion in the Central African region: a geographical and epidemiological perspective.

The geographical analysis of the main data on the HIV1 epidemic in Central Africa shows a frontline which has not moved significantly since 1985. The absence of a progressive increase between the countries, demonstrating a discontinuity in space, combined with the observed human and physical continuity within the areas, raises several questions. Are the low-rate areas facing only a simple delay in the diffusion, or is there a real difference between the epidemiological patterns of HIV1 in the two areas? The last hypothesis would impose a revision of the concept of an homogeneous pattern in the epidemiology of HIV1 in Africa.

[Role of BCG in the enlarged program of vaccination].

The BCG vaccine is the most given throughout the world, and the immunization coverage is the highest: 72% in 1989 for children under one year of age. Following doubts which appeared in 1980 concerning its efficacy, many epidemiological studies confirmed the protective potency of this immunization against the severe forms of tuberculosis in children. Recent problems of tolerance arose but are now resolved by the adaptation of the vaccine concentration to the routine immunization of newborns.