Diabetes is the most common metabolic disorder worldwide and is a major public health problem. Its frequency increases every day in all countries. However, in developing African countries, few people have access to drugs. In addition, in Africa, traditional beliefs induce people to use medicinal plants whenever they have health problems. Thus, many people in these developing countries use plants for the treatment of diabetes. Yet, few studies are focused on the knowledge and attitudes of the users on medicinal plants in Africa in general and in Senegal in particular. Hence we undertook this survey on the use of medicinal plants for the treatment of diabetes in Senegal in order to make recommendations which could contribute to the increase of the value of herbal medicines in developing countries. We did a cross-sectional survey by direct interview at a university teaching hospital, in Dakar with a representative sample of 220 patients. Forty-one plants were used by the patients and the two most frequently cited were Moringa oleifera Lam (65.90%) and Sclerocarya birrea (A. Rich) Hochst (43.20%). Patients gave several reasons for using medicinal plants (traditional treatment: 40%, efficacy: 32%, low cost: 20%). The principal suppliers of plants were tradesmen in the market (66.8%) and traditional therapists (5%). Sixty-five per cent of patients think that medicinal plants are efficient for the treatment of diabetes and 20% have reported adverse effects which could be caused by medicinal plants. In conclusion, many people in our study think that medicinal plants are efficient for the treatment of diabetes, which requires research work by scientists in developing countries in this field in order to prove their efficacy and innocuousness.

The supplementation program of the community nutrition project (PNC) launched by the Senegalese Government in order to protect the most vulnerable groups (children and women) was evaluated. Using a stable isotope (deuterium), we assessed the effect of the PNC on breastmilk output, mother's body composition, and baby's growth at three months of lactation. Breastmilk triglycerides, lactose, protein, and zinc were also determined. Mothers who were supplemented more than 60 days during pregnancy showed a significant increase in fatfree mass as compared to those who were supplemented for less than 30 days (p = .03). Breastmilk output was not influenced by the supplementation, but breastmilk lactose, total protein, and zinc contents increased significantly (p < .01) in the supplemented mothers. Growth of the babies of the supplemented mothers was better than that of those whose mothers were not supplemented. It was concluded that the food supplementation had beneficial effects on both mothers' and babies' nutritional status depending on the onset of the supplementation.

(adjusted odds ratio, 0.25; 95% confidence interval, 0.12 to 0.53).Conclusions. This intervention shows that a community-based strategy, such as the positive deviance approach, can contribute to improving the effectiveness of iron supplementation during pregnancy.

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