Three months after the first appearance of the new coronavirus (COVID-19), Senegal recorded its first case on March 2, 2020. Faced with this pandemic, the State reacted quickly with public measures : instituting a curfew, placing a ban on travel between regions, and closing shops and places of worship. This research aims to study the acceptability of these non-pharmaceutical measures by the Senegalese population. This study was a cross-sectional and analytical survey conducted in June and July 2020 among Senegalese over 18 years old. Sampling by the representative quota method was distributed proportionally to age, gender and region. We constructed the questionnaire using the theoretical framework of acceptability of health interventions. Through a telephone call center synchronised to an internet server, we collected data on personal characteristics, knowledge of the disease, trust in information sources, trust in government, concern about the pandemic, and the seven dimensions of acceptability. We performed descriptive analysis and structural equation with R software version 4.0.2. This study included a total of 813 individuals. The average age was 34.7 years ( ± 14.2 years). They were predominantly male (54.6 %), with no education (42.6 %). The increased level of knowledge of the disease was associated with confidence in national media information sources provided by the administrative and health authorities (β=0.11, p<0.01). The increase in the level of trust in the government in response to COVID-19 was positively related to the acceptability of curfew (β=0.16, p<0.001), travel ban between regions (β=0.11, p<0.001), and closure of places of worship (β=0.1, p<0.01) and markets (β=0.09, p<0.01). In Senegal, the acceptability of the measures depended on knowledge of the disease, perception of the risk of the disease, and trust in the government. There is a need to strengthen awareness and risk communication of COVID-19.

Acute illnesses are leading causes of death among children under-five, who often receive antibiotics unnecessarily, contributing to antimicrobial resistance. Pulse oximetry and digital Clinical Decision Support Algorithms (CDSAs) can strengthen the detection and management of severe childhood illnesses, and support antibiotic stewardship in primary care, but lack evidence for scale-up. This study sought to understand the real-world impact of these tools on urgent referrals and antibiotic prescription for children under-five. A quasi-experimental pre-post study of the implementation of pulse oximetry and CDSAs for healthcare providers (HCPs) managing sick children at primary care level was conducted in Kenya and Senegal. Sick children 0–59 months attending study facilities were eligible. Trained research assistants collected data from caregivers and facility records on Day 0, with a follow-up phone call at Day 7. Providers were advised to use pulse oximetry for all sick children in Kenya, and in Senegal for all 1–59 days, and for 2–59 months with cough or difficulty breathing, or a moderate to severe illness. Urgent referral was recommended for SpO₂ <90% in Kenya and SpO₂ <92% in Senegal. Primary outcomes were antibiotic prescription and urgent referral rates at Day 0. They were assessed using generalised estimating equations for logistic regression. Results were estimated in terms of odds ratios and risk differences (RDs), adjusted where computable. The study is registered with clinicaltrials.gov (NCT05065320). A total of 50,580 sick children (1–59 days: 979 pre, 1748 post; 2–59 months: 16,782 pre, 31,071 post) were enrolled from September 13, 2021 to February 8, 2023 in Kenya and August 16, 2021 to March 31, 2023 in Senegal. In the pre-intervention period, urgent referrals were rare (0.6% in 1–59 days; 0.4% in 2–59 months), while antibiotic prescriptions were common (53.9% in 1–59 days; 74.9% in 2–59 months). Intervention uptake was 75% in Kenya and 40% in Senegal where a protracted HCP strike affected the intervention. The prevalence of SpO₂ values prompting an urgent referral recommendation was 1.3% in 1–59 days and 0.8% in 2–59 months, but few of them resulted in actual referrals (26.1% in 1–59 days; 11.4% in 2–59 months). There was no change in overall urgent referrals (RD 0.2% [−0.5%, 0.9%] in 1–59 days; adjusted RD 0.2% [−0.2%, 0.5%] in 2–59 months). Antibiotic prescription rate was reduced by 14.6% [8.7%, 20.6%] in 1–59 days and by 22.6% [18.3%, 26.9%] in 2–59 months in the post-intervention period while caregiver-reported recovery rates at Day 7 remained stable. When implemented in routine health systems at primary care level in Kenya and Senegal, pulse oximetry and CDSAs were not found to be associated with an increase in urgent referrals but likely mediated antibiotic prescription reductions. The absence of referral increase may stem from limited severe illness detection due to low hypoxaemia prevalence and barriers to referral, also affected in Senegal by a protracted post-intervention HCP strike. Strengthening the referral system and implementing broader antibiotic stewardship strategies are likely to be needed to improve the effectiveness of the intervention and its impact on child health outcomes. Unitaid grant n°2019-35-TIMCI: Tools for Integrated Management of Childhood Illness.

Monkeypox (Mpox) is a zoonotic viral infection caused by a virus of the Orthopoxvirus genus. In response to global alerts, efforts in epidemiological surveillance and infection control have intensified, following WHO recommendations for enhanced monitoring, contact tracing, and the implementation of appropriate public health measures. This study aimed to assess the epidemiological surveillance of Mpox in Senegal in 2024. This was a retrospective, cross-sectional, descriptive, and analytical study conducted over a four-month period (from July 14 to November 10, 2024). The study population included all cases sampled as part of Mpox surveillance in Senegal during this period. Key strengths in the response included the adaptation to the IDSR Kit, training of personnel at all levels on the IDSR strategy, case definition and monitoring training, development of surveillance procedures, presence of focal points for surveillance, a diversified network of reference laboratories, and the use of an electronic case notification platform. A total of 56.25% of the initially planned priority activities were completed. During the surveillance period, 100 suspected Mpox cases were reported, corresponding to 6 cases per 1 million inhabitants. Biological samples were collected from all patients. At the time of the study, no confirmed cases of Mpox were detected. Alternative viral diagnoses were established in 32% of cases—most frequently varicella-zoster virus. Co-infections were observed in 4 patients (12.5%). The median delay between symptom onset and result availability was 7 days. Symptom duration had a median of 3 days, and the median interval from consultation to result delivery was 2 days. Longer delays were significantly observed in remote or hard-to-reach areas. Overall, patient-related delays were significantly longer than surveillance-related delays (p = 0.002). Strengthening epidemiological surveillance improves sample processing times and response effectiveness. This enhancement should be prioritized in border areas and hard-to-reach regions.

Introduction In mid-2020, due to the health system challenges from increased COVID-19 cases, the Ministry of Health and Social Action in Senegal opted for contact management and care of simple cases at home. The study’s objective was to determine the acceptability of contact management, home care of simple cases of COVID-19, and its associated factors. Method This was a sequential mixed-method study. We collected data from June 11, 2020, to July 10, 2020, for the quantitative survey (N=813) and from August 24 to September 16, 2020, for the qualitative survey (N=30). We carried out a sampling strategy using marginal quotas at the national level. We collected data using a structured questionnaire in a telephone interview for the quantitative survey and using an interview guide formulated from the quantitative survey’s initial results for the qualitative data. We assessed acceptability using binomial logistic regression combined with content analysis. Results The care of simple cases of COVID-19 at home was well accepted (78.5%). This result was justified for some (saturation of the health system) but not for others (risk of contamination). The use of home contact management was less accepted (51.4%), with risk limitation as the main reason given. The acceptability of home-based care for simple cases was positively associated with knowledge of the modes of transmission of the virus (ORaj: 1.55 [95%CI: 1.04,2.28]), regular research into COVID-19 (ORaj: 2.12 [95%CI: 1.45,3.12]), belief in the existence of treatment (ORaj: 1.82 [95%CI: 1.19,2.83]), and confidence in institutional information (ORaj: 2.10 [95%CI: 1.43,3.10]). The acceptability of home-based contact management was positively associated with knowledge of the modes of transmission of the virus (ORaj: 1.77 [95%CI: 1.27,2.48]), regular research for information on COVID-19 (ORaj: 2.39 [95%CI: 1.76,3.26]), and confidence in the government in the fight against the epidemic (ORaj: 1.51 [95%CI: 1.10,2.08]). Conclusion Regular information on the disease, knowledge of its mode of transmission and trust in institutions are factors in accepting COVID-19 management at the community level. Authorities should take these factors into account for better communication to improve the acceptability of home-based care.

The payment of healthcare agents is a critical component of organizing mass health campaigns. This study examined the effects of digital payments during seasonal malaria chemoprevention (SMC) campaigns in Senegal. A quasi-experimental three-arm before–after/here–elsewhere design was implemented between March and June 2023: mandatory digital payment in Kounkané, voluntary in Koussanar, and cash-based control in Bantaco. Mixed methods were employed, and ethical approval was granted by Senegal’s National Ethics Committee (CNERS). A total of 299 agents participated, with 181 surveyed before and 118 after the intervention. Participants were distributed across Kounkané (48.8%), Koussanar (35.8%), and Bantaco (15.4%). Community health workers comprised the majority (90.9%). Median age was 32 years, with a median tenure of three years; 50.8% were male and 65.2% married. All agents owned at least one mobile money account, with Wave (96%) and Orange Money (90%) being the most common. Reliability criteria included security (95%), ease of use (90.3%), and cash availability (79.2%). Karangué Fay digital payments were perceived as secure (82.4%), reliable (83.1%), faster (78.2%), transparent (91.3%), and confidential (95.2%). Compared to cash, digital payments were significantly preferred for transaction security, speed, and usability (p < 0.001). Qualitative interviews highlighted traceability, transparency, and efficiency but noted limitations linked to internet connectivity. Digital payments were highly acceptable to SMC agents, improving engagement and performance. They also contributed to better campaign coverage across different implementation phases, underscoring their potential to strengthen health systems in low-resource settings.

Introduction: In 2021, (88.6%) of Senegal's 79 districts had not reached the full Human papillomavirus (HPV) vaccination coverage target of (90%). The Diakhao health district had full vaccination coverage of (10%) in the same year. This study aimed to identify factors associated with full vaccination coverage among girls aged 11-13 in Diakhao health district. Method: This was a descriptive and analytical study conducted in Diakhao health district among 228 custodial mothers of young girls aged 11-13 years. Data were collected using a questionnaire assessing the knowledge, attitudes, practices, and satisfaction of custodial mothers of young girls aged 11-13 years about HPV vaccination. Descriptive, bivariate analysis, and logistic regression were performed at 5% alpha. Results: The majority (74.12%) of mothers and guardians had heard of cervical cancer, and 81.58% had heard of HPV vaccination. According to the mothers and guardians of young girls, there was complete coverage (17.54%). According to the vaccination card, complete coverage was (15.79%). Factors associated with complete coverage were: the girl's schooling (ORa = 3.56 (1.12-11.29); having heard about cervical cancer vaccination (ORa = 0.09 (0.02, 0.32)]); rural residence (ORa = 0.13 (0.04-0. 44); agreement with vaccination for reasons of protection against certain communicable diseases (ORa = 8.95 (1.27-63.11) or reasons of vaccination of neighbors' children (ORa = 3.25 (1.24-8.55), satisfaction with counseling (ORa = 6.49 (1.63-25.8). Conclusion: Information to mothers or guardians of young girls is crucial to achieving the goal of full immunization coverage. It could be significantly improved by an acceleration plan focusing on interpersonal communication.