Publications (3)0 Total impact
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ABSTRACT: Biomedical waste is currently a real health and environmental concern. In this regard, a study was conducted in 5 hospitals in Dakar to review their management of biomedical waste and to formulate recommendations. This is a descriptive cross-sectional study conducted from 1 April to 31 July 2010 in five major hospitals of Dakar. A questionnaire administered to hospital managers, heads of departments, residents and heads of hospital hygiene departments as well as interviews conducted with healthcare personnel and operators of waste incinerators made it possible to assess mechanisms and knowledge on biomedical waste management. Content analysis of interviews, observations and a data sheet allowed processing the data thus gathered. Of the 150 questionnaires distributed, 98 responses were obtained representing a response rate of 65.3%. An interview was conducted with 75 employees directly involved in the management of biomedical waste and observations were made on biomedical waste management in 86 hospital services. Sharps as well as blood and liquid waste were found in all services except in pharmacies, pharmaceutical waste in 66 services, infectious waste in 49 services and anatomical waste in 11 services. Sorting of biomedical waste was ill-adapted in 53.5% (N = 46) of services and the use of the colour-coding system effective in 31.4% (N = 27) of services. Containers for the safe disposal of sharps were available in 82.5% (N = 71) of services and were effectively utilized in 51.1% (N = 44) of these services. In most services, an illadapted packaging was observed with the use of plastic bottles and bins for waste collection and overfilled containers. With the exception of Hôpital Principal, the main storage area was in open air, unsecured, with biomedical waste littered on the floor and often mixed with waste similar to household refuse. The transfer of biomedical waste to the main storage area was done using trolleys or carts in 67.4% (N = 58) of services and wheelbarrows in 33.7% (N = 29). Biomedical waste was disposed of in old incinerators or in artisanal ovens with a great deal of smoke emanating from these. Working conditions were deemed poor by 81.3% (N = 61) of employees interviewed and personal protection equipment was available in 45.3% (N = 39) of services. Knowledge about biomedical waste management was deemed satisfactory by 62.6% (N = 47) of interviewees and 80% (N = 60) were aware of the health risks related to biomedical waste. The poor management of biomedical waste is a reality in hospital facilities in Dakar. This can be addressed by increasing the awareness of managers for an effective application of the legislation, implementing realistic management programmes and providing the appropriate on-the-job training to staff members.Bulletin de la Société de pathologie exotique 07/2012; 105(4):296-304.
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ABSTRACT: The casualties are indemnified according to two processes. First by transaction on rate proposition of insurance physicians, and the second process on rate proposition by a medical expert assigned by law-court. Indemnification scale failure justifies the Interafrican Conference of insurance Markets code adoption. Six insurance societies and the Automotive Guarantee Fund were debtors. Only 627 victims had been indemnified between 1986 and 2003. Expert valuations done at forensic medicine service were the support of the investigation. Inquired parameters were insurance societies, regulation type, aftermaths and the retained prejudices. The data collected on computer card have been analyzed by software Epi Info. The partial permanent inabilities fixed since its adoption differ to inabilities fixed before this adoption. Transaction process concerned 567 victims (90.4%). Sixty victims were indemnified by judicial way. According to process type, the rates fixed in judicial process were 61.6% middle permanent partial inabilities. After 1997, there have observed a decrease in the high and middle permanent partial inabilities in the two processes. The appreciation of the pretium doloris is more subjective but must repair the aftermaths. The middle pretium was majority in the two processes, before and after 1997 with a high decrease of the middle pretium in the transaction process (-15.07) and a small pretium increase of 10.98 points. A common scale code has decreased the judicial litigation concerning casualties in spite of scales' limits. Only the patients with important aftermaths arrive in the judicial process since 1997.Bulletin de la Société médicale d'Afrique noire de langue française 02/2006; 51(1):27-32.
Article: [Sexual child abuse: correlation between medical certificates' conclusions and judiciary sanctions].[show abstract] [hide abstract]
ABSTRACT: Sexual child abuse, comprises of indecency attitudes and physical misbehaviours, directed towards children are dominated by rape. The objective of our study was to assess in sexual child abuse the relation between the conclusion of medical certificates and court decision. It is a retrospective study carried out from 1994 to 1998 on the clerk's office correctional repertories in Dakar regional court. An overall number of 79 cases of child abuse were collected in 5 years period. Children under 18 years old of of both sex, were concerned. Data found were correlated with a review of requisition cases received by the of gynaecology and obstetrics clinic of Aristide Dantec Hospital. This facilitates the establishement of the relationship between the offences and the pronounced sanctions, as well as the initial medical certificate and these sanctions. The sanctions were severe whenever rape had been retained. Some cases were disqualified in indecent assault and were judged as such. The judge decision, which follow the medical certificate conclusions in 11 cases out of 14 shows the importance and reliability of this medical document. All files reviewed at the medical and legal level were incomplete. The difficulty of the materiality of the rape and the psychological consequences in the long run and especially HIV infection should invite to a multidisciplinary, specialized and organized management of sexual child abuse. This study has shown the importance of a correct and complete drafting of the medical certificate, to enable the establishment by the judge the materiality of the facts.Bulletin de la Société médicale d'Afrique noire de langue française 02/2005; 50(2):85-90.